The research appears in two articles in the November/December issue of
the American Journal of Health Promotion.
One study, which examined patients in a Minnesota managed
care organization, found that smokers who have higher health care bills — suggesting
an increased use of primary care — will try to quit smoking as
a result of the cost increase, say Brian Martinson and colleagues of
HealthPartners
Research Foundation. This was true whether the patients were apparently
healthy or had been diagnosed with diabetes, heart disease, high blood
pressure or high cholesterol.
Earlier research tracked healthcare costs in former or
current smokers from the point of quitting, but Martinson says his study
is the first
to predict smoking cessation based on recent prior health care costs. A
health-related
event sends a patient to the doctor’s office or hospital, incurring
new charges, which may remind the patient of the consequences of smoking,
Martinson says. Doctors might also think of such visits as good occasions
for intervention.
“The effects observed in this study,” Martinson says, “suggest
the importance of primary care physicians continuing their efforts to
encourage smoking cessation among their patients.”
Previous research by other scientists has found that once people quit
smoking, they continue using the health care system more and incur higher
costs than people who have never smoked.
Nationally, smokers are responsible for $1,623 each in excess medical
expenditures above the average and $1,760 in lost productivity. Smoking-cessation
programs do pay off eventually, returning a benefit of $1.74 for every
dollar expended.
But the excess medical costs from smoking don’t
decrease right away, say Shirley Musich, Ph.D., of the Health Management
Research Center at
the University of Michigan and colleagues.
In a new study of 20,332 employees of General Motors Corporation and their
spouses, Musich found that former smokers who had quit in the previous
four years actually had higher charges for cancers, circulatory ailments
and musculoskeletal problems than current smokers. Like Martinson, Musich
says that illness may serve as a wake-up call.
“This may indicate that the medical problem may have motivated smoking
cessation,” she says.
Three common chronic conditions that are not usually associated with smoking
occur more often among smokers and increase costs even after they quit
-- arthritis, allergies and back pain. Smoking triples the risk of frequent
back pain, doubles the risk of rheumatoid arthritis and raises the risk
of chronic allergies by as much as five times above that of non-smokers.
She said it took approximately five years for former smokers without chronic
conditions and nearly 10 years for former smokers with chronic conditions
to reduce their medical charges to levels close to those of people who
never smoked.
