Collaboration in Civic Spheres

UW, WA researchers: tobacco-prevention ROI more than 5-1

by Matt Rosenberg March 30th, 2012

Washington state has gotten a good bang for its buck on tobacco-prevention spending, at a rate of more than five dollars in benefits for every dollar spent, according to a recent analysis published in the American Journal of Public Health by a team including researchers from the University of Washington and the Washington state Department of Health’s Tobacco Prevention and Control Program. Tobacco control efforts in Washington state consist of three key approaches: price hikes (through tax increases on tobacco products); policies (such as enforcement of an indoor public smoking ban, and now a spread of local measures banning smoking in government-controlled outdoor properties); and programs (such as prevention education, particularly aimed at children and teens).

At least $5.73 saved for every dollar spent
The state spent almost $259.7 million on all forms of tobacco prevention from 2000 through 2009 and the researchers say they conservatively calculate the savings at $1.5 billion, for a return-on-investment (ROI) ratio of $5.73 saved for every dollar spent. The $1.5 billion in savings came in the form of almost 36,000 hospitalizations avoided for diseases found in peer-reviewed scientific literature to be significantly linked to smoking, such as heart disease, strokes, respiratory disease and cancer.

Drawing on authoritative state and federal data banks on hospitalizations, diagnoses and billing; plus others covering state and federal cancer data; and using federal and state data on adult smoking prevalence; the researchers were able to document a continued decrease in Washington in the percent of adults who smoked versus the national average, and a significant drop in smoking-related hospitalizations for key smoking-related diseases, compared to previous years.

Real savings are likely even higher, authors assert
The authors stress the real savings could be even higher because they did not include the value of avoided “hospitalizations for conditions in which tobacco might be a contributing factor factor (e.g. diabetes complications) physician costs, pharmacotherapy, rehabilitation, loss of work time and other costs to families.” that, they write, would have more than doubled the estimated savings.

A warning against anti-smoking program cuts
The research team warns that experience shows decreasing government funding for comprehensive tobacco prevention programs can lead to a scaling back up of smoking. This, they say, is exactly what happened in Oregon between defunding of that state’s program in 2003 and 2007, when funding was restored. They recommend, “policymakers and public health leaders should continue to invest in tobacco control interventions, including comprehensive programs.”

Role of cigarette tax hikes stressed, but not in isolation
While the report says it is less clear that the indoor public smoking ban approved by voters in 2005 contributed greatly to reduced smoking and smoking-related hospitalizations, public education and cigarette tax hikes are more potent weapons. Inflation dilutes the effect of cigarette tax hikes so it is smart to support “continuous and frequent increases of cigarette prices” through tax hikes, as a form of prevention, they argue.

New study published CDC also links anti-smoking taxation, and education
In a separate report just published by the U.S. Centers for Disease Control in their journal Morbidity and Mortality Weekly Report, Washington ranks fifth nationally among the 50 states in the amount of 2011 tax on a pack of 20 cigarettes, at $3.025; and second nationally in the percent its cigarette taxes have grown between 2009 and 2011 (nearly 50). The CDC’s article’s authors, add: “Because increasing the price of cigarettes is effective in reducing cigarette use and preventing initiation, the Surgeon General has concluded that increased cigarette taxes would lead to substantial long-term improvements in health. The effectiveness of cigarette excise tax increases in reducing smoking-related death and disease can be increased when combined with other evidence-based interventions of a comprehensive tobacco control program, including smoke-free policies and media campaigns.”

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