The disproportionate cost of smoking for African Americans in California

Am J Public Health. 2010 Jan;100(1):152-8. doi: 10.2105/AJPH.2008.149542.


Objectives: We estimated the economic impact of smoking on African Americans in California in 2002, including smoking-attributable health care expenditures and productivity losses from smoking-caused mortality.

Methods: We estimated econometric models of smoking-attributable ambulatory care, prescription drugs, inpatient care, and home health care using national and state survey data. We assessed smoking-attributable mortality using epidemiological models.

Results: Adult smoking prevalence for African Americans was 19.3% compared with 15.4% for all Californians. The health care cost of smoking was $626 million for the African American community. A total of 3013 African American Californians died of smoking-attributable illness in 2002, representing a loss of over 49,000 years of life and $784 million in productivity. The total cost of smoking for this community amounted to $1.4 billion, or $1.8 billion expressed in 2008 dollars.

Conclusions: Although African Americans account for 6% of the California adult population, they account for over 8% of smoking-attributable expenditures and fully 13% of smoking-attributable mortality costs. Our findings confirm the need to tailor tobacco control programs to African Americans to mitigate the disproportionate burden of smoking for this community.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • African Americans / statistics & numerical data*
  • Ambulatory Care / economics
  • California / epidemiology
  • Drug Prescriptions / economics
  • Efficiency
  • Female
  • Health Care Costs / statistics & numerical data*
  • Home Care Services / economics
  • Hospitalization / economics
  • Humans
  • Male
  • Models, Econometric
  • Smoking / economics*
  • Smoking / ethnology*
  • Smoking / mortality