Abstract
BackgroundIn 2023, President Biden issued an executive order requiring cost-benefit analyses for new regulations to account for distributional effects. To inform new tobacco regulations, we estimate for the first time racial and ethnic disparities in spending and outcomes associated with smoking.MethodsWith the 2008–2019 Medical Expenditure Panel Survey linked to the National Health Interview Survey, n=118 084 adults-years, logit models estimate the per cent of the top 10 health conditions attributable to smoking. Two-part regression models estimate the share of and total annual healthcare spending attributable to smoking.ResultsWhite adults had higher ever-smoked rates, but minority smoking adults had twice as much of their annual medical spending associated with smoking than white smoking adults, 25% vs 12% (p<0.01). minority adults who smoked had 41% (p<0.05) higher risks of multiple chronic conditions associated with smoking than white adults. While the share of white smoking adults trying to quit declined to 53% in 2019, this desire increased to 63% for minorities. From 2008–2016, smoking comprised 7.5% of the nation’s spending for white adults and 10.7% for minorities (p<0.05). In 2017–2019, this declined to 2.5% of the nation’s spending for white adults and 8.9% for minorities (p<0.05). For any new antitobacco regulation, the cost savings would be $134 million per year for every 100 000 minorities averted from initiating smoking, 135% more than the $57 million saved annually for 100 000 white adults averted.ImplicationsMinority adults may benefit substantially more from antitobacco regulations and past federal cost-benefit analyses would have overlooked this.
Subject
Public Health, Environmental and Occupational Health,Health (social science)
Reference22 articles.
1. Tobacco regulation and cost-benefit analysis: how should we value foregone consumer surplus;Levy;Am J Health Econ,2018
2. Why ban the sale of cigarettes? the case for abolition;Proctor;Tob Control,2013
3. U.S. Food and Drug Administration . FDA ANNOUNCES plans for proposed rule to reduce Addictiveness of cigarettes and other Combusted tobacco products. 2022. Available: https://www.fda.gov/news-events/press-announcements/fda-announces-plans-proposed-rule-reduce-addictiveness-cigarettes-and-other-combusted-tobacco
4. U.S. Centers for Disease Control and Prevention . Office on smoking and health, national center for chronic disease prevention and health promotion. In: Costs and Expenditures. Available: https://www.cdc.gov/tobacco/data_statistics/fact_sheets/fast_facts/cost-and-expenditures.html#print