Surveillance and Health Equity Science, American Cancer Society, Kennesaw, GA, USA.
Department of Economics, University of Dhaka, Dhaka, Bangladesh; Department of Psychology, University of Waterloo, Waterloo, ON, Canada.
Lancet Public Health. 2022 Oct;7(10):e834-e843. doi: 10.1016/S2468-2667(22)00202-X.
Despite large geographical disparities in the prevalence of cigarette smoking across the USA, there is a paucity of state-level estimates of economic loss attributable to smoking to inform tobacco control policies at the national and state levels. We aimed to estimate the state-level economic loss attributable to cigarette smoking in the USA.
In this economic modelling study, we used a dynamic macroeconomic model of personal income per capita at the state level. Based on publicly available data on state-level income, its determinants, and smoking status for 2011-20, we first estimated the elasticity of personal income per capita with respect to the prevalence of non-smoking adults (aged ≥18 years) in the USA using a mixed-effects, generalised linear, dynamic panel data model. We used the estimated elasticity to measure the state-specific, annual, avoidable economic loss attributable to cigarette smoking in 2020 under the counterfactual 5% prevalence of cigarette smoking. We then estimated the state-specific cumulative economic loss attributable to cigarette smoking in 2020 using the coefficient of lagged income in the dynamic model. National estimates on economic loss attributable to cigarette smoking were obtained by summing state-specific estimates.
In the mixed-effects model, the elasticity of personal income per capita with respect to the prevalence of non-smoking adults was 0·143 (p=0·063). The estimated annual income loss per capita in 2020 ranged from US$331 in Utah to $1674 in Kentucky. The state mean population-weighted loss per capita was $1100. The annual combined loss of income and unpaid household production at the national level was $436·7 billion (equivalent to 2·1% of US gross domestic product [GDP] in 2020). The cumulative loss of income and unpaid household production was $864·5 billion (equivalent to 4·3% of US GDP in 2020).
Smoking causes substantial economic loss in the USA. Tobacco control efforts that lower the prevalence of smoking equitably can contribute considerably to improved macroeconomic performance in the short and long term by reducing health expenditures and avoiding productivity losses.
American Cancer Society.
尽管美国各地的吸烟率存在巨大的地域差异，但缺乏针对吸烟造成的经济损失的州级估计数，无法为国家和州级的烟草控制政策提供信息。我们旨在估计美国因吸烟造成的州级经济损失。
在这项经济建模研究中，我们使用了一种基于州级个人人均收入的动态宏观经济模型。基于 2011-20 年公开的州级收入及其决定因素和吸烟状况数据，我们首先使用混合效应、广义线性、动态面板数据模型，估算个人人均收入对美国非吸烟成年人（年龄≥18 岁）流行率的弹性。我们使用估算的弹性来衡量 2020 年假设吸烟率为 5%时，吸烟造成的各州特定、每年、可避免的经济损失。然后，我们使用动态模型中的滞后收入系数来估算 2020 年吸烟造成的各州特定累积经济损失。全国因吸烟造成的经济损失估计数是通过各州特定估计数相加得到的。
在混合效应模型中，个人人均收入对非吸烟成年人流行率的弹性为 0.143（p=0.063）。2020 年，人均收入损失估计值为每年 331 美元至 1674 美元，范围从犹他州到肯塔基州。州平均人口加权人均损失为 1100 美元。全国层面的收入和无报酬家庭生产的年度综合损失为 4367 亿美元（相当于 2020 年美国国内生产总值的 2.1%）。收入和无报酬家庭生产的累积损失为 8645 亿美元（相当于 2020 年美国国内生产总值的 4.3%）。
吸烟在美国造成了巨大的经济损失。通过降低吸烟的流行率，烟草控制工作可以在短期和长期内通过减少医疗支出和避免生产力损失，对改善宏观经济表现做出重大贡献。
美国癌症协会。
