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Willard G. Manning, PhD; Emmett B. Keeler, PhD; Joseph P. Newhouse, PhD; Elizabeth M. Sloss, PhD; Jeffrey Wasserman, PhD
The University of Michigan School of Public Health Ann Arbor

JAMA. 1989;262(7):901.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

In Reply.—

Dr Rufleth's concern about the additional costs from neonatal intensive care units is well taken. By omitting maternity costs from our calculations, we omitted the extra costs of neonatal care caused by women's smoking during pregnancy. However, the magnitude of the omission is small and does not alter our overall conclusions on cigarette taxes.

Women who smoke during pregnancy have babies whose birth weights average 200 g lower, and smokers are twice as likely to have low—birth-weight babies as nonsmokers.¹ Low birth weight is one of the strongest predictors of use of a neonatal intensive care unit. A recent report on neonatal intensive care² indicates that between 150 000 and 200 000 infants are treated annually in neonatal intensive care units; 50% to 80% are low—birth-weight babies, at an average cost of $12 000 to $39 000. If we use the midpoint of each range, the . . . [Full Text PDF of this Article]

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