Cigarette smoking is a leading cause of illness and death, and communities of color bear the greatest burden of tobacco-related illness and death for smokers, as shown in many studies including our ongoing TRDRP study. Recent studies have found that exposure to secondhand smoke is also an important risk factor for illness and death. Though California has among the strictest workplace smoking restrictions in the nation, there remain those who are exposed to tobacco smoke at work, and these are more likely to be people of color. Californians also continue to be exposed to tobacco smoke at home. However, while the healthcare cost of smoking to smokers has been documented, the costs associated with exposure to secondhand smoke have rarely been considered. We are here proposing to extend our work to nonsmokers exposed to secondhand smoke.
The study will develop models of the costs attributable to secondhand smoke exposure for African Americans, Hispanics, Asian/Pacific Islanders, American Indian/Alaska Natives, and others in California for 2005. We will estimate the direct healthcare costs of SHS-related illness as well as the indirect costs of lost productivity from premature death. The study has three specific aims:
• Aim 1. Estimate exposure to secondhand smoke. The number and proportion of African Americans, Hispanics, Asian/Pacific Islanders, and other Californians who are exposed to secondhand smoke will be estimated. The study will focus on children exposed at home, and on neversmoking adults exposed at home and at work.
• Aim 2. Assess deaths from secondhand smoke exposure. We will develop three measures of mortality for children and nonsmoking adults for each of the groups of interest. The measures are the number of deaths attributed to secondhand smoke exposure, the years of potential life lost, and the value of lost productivity.
• Aim 3. Model the healthcare costs of passive smoking. The healthcare costs resulting from exposure to secondhand smoke will be modeled and estimated. The models will estimate the probability of a person exposed to secondhand smoke being diagnosed with a smoking-related disease, the probability of having poor health, the probability of using healthcare services, and the level of healthcare expenditures for those who use them.
An advisory group consisting of leaders of community groups and experts on smoking in communities of color will assist the study team. This group will inform the study and help us to implement our dissemination plan, which involves meeting with community groups to present our findings, preparing and distributing Research Briefs and Fact Sheets, presenting findings at professional meetings, and preparing manuscripts for publication in peer-reviewed journals. The four-pronged dissemination plan will assure that our findings are made available to community groups, advocates, and policymakers as well as the academic research community. Our findings will be useful for evaluating the impact of smoking ordinances and smokefree workplace, restaurant, and bar policies on healthcare costs. The results will also help determine how tobacco control policies related to secondhand smoke should be targeted. |