This statistic is being used as the argument that smoking costs society too much money, and that denying health insurance and employment, to people who smoke, is appropriate and justifiable
There is of course more to the story, smokers pay around 20 Billion dollars in state and federal cigarette taxes. Additionally, the cost of the tobacco settlement has been passed on to smokers amounting to another 10 billion dollars a year. This money is based on the amount of cigarettes that are sold in an individual state as well as other factors. This number makes the total paid directly by smokers an additional 30 billion dollars per year, leaving a deficit of 45 billion dollars in tax revenue versus healthcare costs, so far.
Anti tobacco extremists would be happy if the story ended here.
But wait, the CDC, in the same report that it estimates healthcare costs attributed to smoking, says that smokers die 14 years earlier than non-smokers, to the tune of 438,000 premature deaths per year. This puts the average male smokers estimated demise at 60 years old and for females the estimate is 64 years old, in this group. .
How much money is being saved on pension and social security payments as a result of these premature deaths?
The Social Security Administration reports that the average monthly social security benefit is 879.30. This number results in a savings to the Social Security Fund of $10,551 per year, per smoker. Multiply that number by 438,000 and multiply it one more time for the 14 years worth of uncollected benefits, and this leads to an annual savings of 64.4 billion dollars per year, without adjusting for future annual increases in monthly social security payments. Making smokers positive contributors in the amount of 19.4 billion dollars per year.
Some might argue that 19.4 billion dollars is not enough to cover other additional costs to society of smoking. We would argue that for almost every cost there is a cost savings, a reduction in pension benefit payments, is just one example.
Is it fair and proper to assess the entire cost of smoking related illness on current smokers?
More than half of those who have ever smoked have quit. People who have quit smoking tend to be older. The majority of smoking related illness falls on the group of older and former smokers. By comparison the largest percentage of current smokers falls in the 18 to 25 year old age range (39.5% according to the US Department of Health) . The second largest group at 33% is in the 26 to 34 year old age range. These groups of smokers do not tend to get ill from smoking until much later in life, if at all. The most commonly associated illness from smoking is lung cancer, 60% of all lung cancer cases are among former smokers and non-smokers. In the present scenario, illnesses that affect former smokers’ are unjustly being blamed on present smokers.
Smoking related illness is a much smaller burden on the healthcare system than one might imagine.
Roughly half of the population used tobacco or still does. With such a high number of people in this category, and the number of diseases being blamed on smoking, you would imagine the costs of healthcare, as a percentage, should be much higher than 8%. This habit enjoyed in the past and the present by 50% of the population, does not appear to over burden the system. After all, that number of people must be paying at least 8% of the total health insurance payments, if not more.
Quitting smoking does not prevent death or disease; it merely postpones them.
It is unreasonable to believe that refraining from smoking would prevent all illnesses. Of all heart attacks suffered in the United States, 80% can’t be attributed to smoking (no matter how hard they may try). It is very likely that a large part of the health care costs of smoking would simply show up at some later date. With annual, double digit rises in healthcare costs; it would certainly be more expensive to treat these people sometime in the future, than it is today.
Will denying smokers access to health insurance save non-smokers any money?
By denying smokers access to health insurance 25% of the population would be no longer be paying monthly premiums into the system. The resulting savings from a theoretical 8% drop in healthcare costs would not be enough to offset the loss in insurance payments. Additionally, poor smokers would ultimately get their healthcare for free. After running out of money from paying their own healthcare costs, or not having the money to begin with, those people with smoking related illnesses would simply turn to hospital emergency room care, which under federal law can only deny them treatment, if they have no room for them.
Should we charge smokers more money?
It is obvious from the statistics provided that most current or former smokers will not suffer any ill effects from their habit. Asking them to pay for those who do, seems unfair. Sadly, our country has a history, at least temporarily, of putting people into groups, which unfairly categorizes them. By and large, we have decided to practice and to teach our children, that all people should be judged as individuals. If we single out smoking as a behaviour that requires additional health insurance premiums, where do we go from there? Other risky behaviours such as sporting activities, alcohol use, poor diets or lack of exercise would almost certainly be next, possibly leading to an individual’s record of previous health insurance claims, being used to determine their monthly healthcare premium. This policy would shift a large percentage of health insurance costs to the elderly and the poor. They would simply not participate and ultimately get their healthcare for free.
Targeting Smokers will not solve the healthcare crisis
The real crisis or burden in the healthcare system is among the elderly and the poor. As our population ages this will continue to be a growing problem. While I can offer no immediate solutions to the crisis, I can say with absolute certainty that targeting smokers, which to date is the only attempts being made to correct the system, will not work.
A very large part of the 75.5 billion dollars being spent on smoking related illnesses is being spent on former smokers. If every current smoker gave up the habit today, there would be an immediate drop in revenue, the potential future drop in the costs of smoking related illnesses, decades from now, if at all, would be insufficient to offset the increased drain on Social Security; created by those additional non-smokers.
During the movement against alcohol in early 1900’s, moral extremists justified their personal war on alcohol by blaming a litany of health and social costs on alcohol use. Many of the diseases they sought to blame on alcohol use, such as tuberculosis, were actually not caused by alcohol use and were later cured and rendered irrelevant to the debate.
If the medical advances of the last 50 years continue, even at a reduced rate, most of the diseases accurately or inaccurately associated with smoking, will likely be treated with great success, rendering most of the arguments we are making today, irrelevant.
Jonathan Pinard, Executive Director New York Coalition of Social Smokers www.socialsmokers.org
