Health and economic implications of a tobacco-free society
K. E. Warner
Department of Public Health Policy and Administration, School of Public Health, University of Michigan, Ann Arbor 48109-2029.
Cigarette smoking causes more premature deaths than do all the following
together: acquired immunodeficiency syndrome, cocaine, heroin, alcohol,
fire, automobile accidents, homicide, and suicide. Attainment of a
tobacco-free society ultimately would produce a national life-expectancy
gain comparable with that that would accompany the complete elimination of
all cancers not caused by tobacco use. In particular, each year 350,000
individuals who would have experienced tobacco-related deaths would realize
a life-expectancy gain of 15 years. Reflecting their higher smoking
prevalence and rates of smoking-related diseases, blacks would benefit more
than whites. By altering the mix of morbid conditions and fatal diseases,
the end of tobacco-related diseases would shift the need for particular
medical specialties and health care facilities. The tobacco industry
implies that the demise of tobacco consumption would wreak havoc with the
economy. By contrast, some antitobacco activists suggest that the end of
tobacco use would yield a multibillion dollar fiscal dividend. Each
argument is fundamentally flawed. The economic impacts of a tobacco-free
society would be modest and of far less consequence than the principal
implication: a significantly enriched quality and quantity of life.
