The effects of obesity, smoking, and drinking on medical problems and costs

Health Aff (Millwood). 2002 Mar-Apr;21(2):245-53. doi: 10.1377/hlthaff.21.2.245.


This paper compares the effects of obesity, overweight, smoking, and problem drinking on health care use and health status based on national survey data. Obesity has roughly the same association with chronic health conditions as does twenty years' aging; this greatly exceeds the associations of smoking or problem drinking. Utilization effects mirrors the health effects. Obesity is associated with a 36 percent increase in inpatient and outpatient spending and a 77 percent increase in medications, compared with a 21 percent increase in inpatient and outpatient spending and a 28 percent increase in medications for current smokers and smaller effects for problem drinkers. Nevertheless, the latter two groups have received more consistent attention in recent decades in clinical practice and public health policy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Alcoholism / complications
  • Alcoholism / economics*
  • Alcoholism / epidemiology
  • Chronic Disease / economics*
  • Chronic Disease / epidemiology
  • Health Care Costs / statistics & numerical data*
  • Health Services / statistics & numerical data
  • Health Status Indicators
  • Humans
  • Middle Aged
  • Obesity / complications
  • Obesity / economics*
  • Obesity / epidemiology
  • Prevalence
  • Risk Factors
  • Sickness Impact Profile
  • Smoking / adverse effects
  • Smoking / economics*
  • Smoking / epidemiology
  • Time
  • United States / epidemiology