Tauras John A, Peck Richard M, Cheng Kai-Wen, Chaloupka Frank J
Department of Economics, University of Illinois at Chicago, Chicago, IL 60637, USA.
National Bureau of Economic Research (NBER), Cambridge, MN 02138, USA.
Int J Environ Res Public Health. 2017 Feb 8;14(2):164. doi: 10.3390/ijerph14020164.
The U.S. Food and Drug Administration (FDA) has estimated the economic impact of Graphic Warning Labels (GWLs). By omitting the impact on tobacco consumption by pregnant women, the FDA analysis underestimates the economic benefits that would occur from the proposed regulations. There is a strong link between the occurrence of low birth weight babies and smoking while pregnant. Low birth weight babies in turn generate much higher hospital costs than normal birth weight babies. This study aims to fill the gap by quantifying the national hospital cost savings from the reductions in prenatal smoking that will arise if GWLs are implemented in the U.S. This study uses several data sources. It uses Natality Data from the National Vital Statistics System of the National Center for Health Statistics (NCHS) in 2013 to estimate the impact of prenatal smoking on the likelihood of having a low-birth-weight baby, controlling for socio-economic and demographic characteristics as well as medical and non-medical risk factors. Using these estimates, along with the estimates of Huang et al. (2014) regarding the effect of GWLs on smoking, we calculate the change in the number of LBW (low birth weight) babies resulting from decreased prenatal smoking due to GWLs. Using this estimated change and the estimates from Russell et al. (2007) and AHRQ (2013) on the excess hospital costs of LBW babies, we calculate cost saving that arises from reduced prenatal smoking in response of GWLs. Our results indicated that GWLs for this population could lead to hospital cost savings of 1.2 billion to 2.0 billion dollars over a 30 year horizon.
美国食品药品监督管理局（FDA）估算了图形警示标签（GWLs）的经济影响。由于未考虑对孕妇烟草消费的影响，FDA的分析低估了拟议法规将带来的经济效益。低体重儿的出现与孕期吸烟之间存在紧密联系。相比正常出生体重的婴儿，低体重儿会产生高得多的住院费用。本研究旨在填补这一空白，通过量化如果在美国实施图形警示标签，因产前吸烟减少而在全国范围内节省的医院成本。本研究使用了多个数据源。它利用了2013年国家卫生统计中心（NCHS）国家生命统计系统的出生数据，来估计产前吸烟对生出低体重儿可能性的影响，同时控制社会经济和人口特征以及医疗和非医疗风险因素。利用这些估计值，以及黄等人（2014年）关于图形警示标签对吸烟影响的估计值，我们计算出因图形警示标签导致产前吸烟减少而产生的低体重儿数量变化。利用这一估计变化以及拉塞尔等人（2007年）和美国医疗保健研究与质量局（AHRQ，2013年）关于低体重儿额外住院费用的估计值，我们计算出因图形警示标签导致产前吸烟减少而产生的成本节约。我们的结果表明，针对这一人群的图形警示标签在30年的时间跨度内可节省12亿至20亿美元的医院成本。
