Difference in lifetime medical expenditures between male smokers and non-smokers

Health Policy. 2010 Jan;94(1):84-9. doi: 10.1016/j.healthpol.2009.08.007. Epub 2009 Sep 22.


Objectives: It is controversial whether smokers have higher lifetime medical expenditures than non-smokers, because smokers have high annual medical expenditures but comparatively short lives. We examined differences in lifetime medical expenditures between them.

Methods: We constructed life tables for male smokers and non-smokers from 40 years of age. We calculated average annual medical expenditures of them categorized by survivors and deceased, which were used to examine differences in lifetime medical expenditures between them and perform sensitivity analyses.

Results: Smokers had a higher mortality rate, shorter life expectancy, and generally higher annual medical expenditures than non-smokers. We also observed tendencies for smokers to have higher inpatient expenditures, but non-smokers to have higher outpatient expenditures. Although non-smokers had lower long-term cumulative medical expenditures between 64 and 81 years of age, their lifetime medical expenditures were higher by a minimal amount. Sensitivity analyses did not change this result.

Conclusions: Smoking may not cause increases in lifetime medical expenditures because smokers had lower lifetime medical expenditures than non-smokers. However, it was clear that smokers, especially survivors, often had higher annual medical expenditures than non-smokers. The importance of tobacco control is still relevant.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Ambulatory Care / economics
  • Case-Control Studies
  • Cohort Studies
  • Cost of Illness
  • Health Expenditures / statistics & numerical data*
  • Health Services Research
  • Hospitalization / economics
  • Humans
  • Japan / epidemiology
  • Life Expectancy*
  • Life Tables
  • Logistic Models
  • Male
  • Middle Aged
  • Smoking* / economics
  • Smoking* / mortality
  • Survivors / statistics & numerical data