Study finds African-Americans bear disproportionate burden of smoking costs in California

African Americans comprise six percent of the California adult population, yet they account for over eight percent of the state's smoking-attributable health care expenditures and 13 percent of smoking-attributable mortality costs, according to a new analysis by UCSF researchers.

In order to provide an objective picture of the disproportionate economic burden of tobacco use for African American Californians, the UCSF team assessed data from 2002, including health care costs related to smoking and productivity losses from smoking-caused mortality. Study findings are published in the January 2010 issue of the "American Journal of Public Health."

"California has one of the most comprehensive tobacco control programs in the world, and smoking prevalence in the state has been declining steadily as a result. However, not all Californians have benefited equally from these efforts," said lead author Wendy Max, PhD, professor-in-residence of health economics and co-director of the UCSF Institute for Health & Aging, School of Nursing. "Hopefully these data can be used to strengthen tobacco control programs and smoking cessation efforts throughout African American communities."

Researchers analyzed smoking-attributable costs for diseases, such as cancer and cardiovascular disease, for which incidence is identified in the 2004 US Surgeon General Report as causally related to cigarette smoking. They focused on expenditures for ambulatory care, prescription drugs, inpatient care, and home health care. The team also assessed smoking-attributable mortality for Californians aged 35 years and older using three measures: deaths, years of potential life lost, and productivity losses.

Findings include:

• African Americans lose more years (16.3) of life per death than other Californians (12.5 years) due to smoking-attributable causes. A total of 3013 African American Californians died of smoking-attributable illness in 2002, representing a loss of over 49,000 years of life and $784 million in productivity.
  
• Adult smoking prevalence in 2002 for African Americans was 19.3 percent compared with 15.4 percent for all Californians.
  
• The total cost of smoking for the African American community amounted to $1.4 billion in 2002, or $1.8 billion in 2008 dollars.