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Disproportionate cost of smoking for communities of color

Institution: University of California, San Francisco
Investigator(s): Wendy Max, Ph.D.
Award Cycle: 2004 (Cycle 13) Grant #: 13RT-0030 Award: $278,980
Subject Area: Public Health, Public Policy, and Economics
Award Type: Research Project Awards

Initial Award Abstract
Cigarette smoking continues to be the leading cause of preventable death in the United States and in California, accounting for one out of five deaths. Minority groups have the highest illness and mortality rates, and among them, African Americans bear the greatest burden. Smoking is a major concern among Hispanics as well. While the negative health consequence of smoking for these groups has been well-documented, the associated economic costs have not. This is critical in light of the economic relationship that the tobacco industry has long maintained with communities of color, and given industry marketing of cigarette brands specifically targeted to these groups. This study proposes to translate into economic terms the cost of smoking for the African American and Hispanic communities in California.

We will develop models of smoking-attributable costs for African Americans, Hispanics, and all other people in California for 2002. The study has three aims: • Aim 1. Estimate the Direct Costs of Smoking-Related Illness. Annual direct health care costs will be estimated. The direct health care costs of smoking-related illness will include hospitalization costs as well as the cost of physician services, emergency department visits, medications, home health care, and nursing home care. The models will take into account the impact of occasional smoking, an important factor for these groups. • Aim 2. Estimate the Value of Lost Productivity from Smoking-Related Illness. The value of lost productivity from smoking-related illness will include the value of time lost from paid employment and household production. Estimates will be for people living with smoking-related illness. • Aim 3. Estimate the Losses Resulting from Smoking-Caused Mortality. Three measures of mortality costs will be estimated: the number of deaths, the number of years of life expectancy remaining at the age of death, and the present value of lifetime earnings lost from employment and household production as a result of premature death from smoking-related illness. A fourth intangible cost for the African American community, the loss of grandparents who are caring for their grandchildren, will also be explored.

Total and per person cost estimates will be made based on a series of econometric models. The models will be estimated 3 times – for African Americans, Hispanics, and all other Californians. This will permit us to compare the costs among the three groups.

An advisory panel will be formed which includes members of both communities as well as the heads of the African American and Hispanic/Latino Tobacco Education Networks in California. A three-pronged dissemination plan is included: 1) We will set up meetings with members of the networks to present our findings and discuss strategies for making them available to their communities. 2) We will prepare a Research Brief describing the entire study as well as two fact sheets – one for African Americans and one for Hispanics – and will mail them to 500 people or organizations provided by our advisory panel members. These documents will also be posted on the UCSF Tobacco Center website. 3) We will prepare at least 2 manuscripts to be submitted to peer-reviewed journals. This three-pronged strategy will allow us to disseminate our findings both quickly and credibly, and will put the findings in the hands of the advocates and policymakers who can make best use of them.