STATE ESTIMATES OF TOTAL MEDICAL EXPENDITURES ATTRIBUTABLE TO CIGARETTE-SMOKING, 1993

Objective, To estimate state-by-state totals of medical expenditures a ttributable to cigarette smoking for calendar year 1993. Methods. The smoking-attributable fractions (SAFs) of total state medical expenditu res, by type of expenditure, were estimated using a national model tha t describes the relationship between smoking and medical expenditures, controlling for a variety of sociodemographic, economic, and behavior al factors. Employing data from the Behavioral Risk Factor Surveillanc e System, the authors used the national model to estimate SAFs for the 50 states and the District of Columbia, then applied these SAFs to pu blished slate medical expenditures, by type of expenditures. to estima te total 1993 state medical expenditures attributable to smoking. Nati onal estimates are the sums of state estimates. Results. In 1993, the estimated proportion of total medical expenditures attributable to smo king for the U.S, as a whole was 11.8%, with a range across states fro m 6.6% to 14.1%. By type of expenditure, SAFs ranged from a low of 8.0 % for home health expenditures to a high of 15.9% for nursing home exp enditures for the nation as a whole. Total U.S. medical expenditures a ttributable to smoking amounted to an estimated $72.7 billion in 1993 (95% interval estimate $48.0-$97.4 billion). Estimates of total smokin g-attributable state medical expenditures (SAEs) ranged from $79.6 mil lion to $8.72 billion, Conclusions. Cigarette smoking accounted for a substantial portion of state and national medical expenditures in 1993 , with considerable variation among states. The range across stales wa s due to differences in smoking prevalence, health status, other socio economic variables used in the model, and the magnitude and patterns o f state medical expenditures.