Cigarette Tax at Issue : Smokers’ Ills Found to Cost $65 Billion a Year

WASHINGTON — The adverse health effects of smoking cost the United States an average of $65 billion a year in medical bills, premature deaths and time lost from work--about $2.17 for each pack of cigarettes consumed, according to the findings of a congressional study released Monday.

The calculations by the Office of Technology Assessment, a scientific advisory arm of Congress, are significantly higher than U.S. Surgeon General C. Everett Koop’s 1984 estimate that smoking costs the nation $40 billion annually.

The tobacco industry sharply disputed the results of the new study, however, and said it “demonstrates how little is known about the relationship of personal behavior to disease, and then, in turn, of disease to cost.”

But California Rep. Fortney H. (Pete) Stark Jr. (D-Oakland), who requested the report, declared: “This study confirms our suspicions that smoking is not only a deadly habit but a costly one for the federal health care budget.”

Stark, chairman of the House Ways and Means subcommittee on health, is among those in Congress who want to retain a 16-cents-a-pack federal excise tax on cigarettes, which amounts to $4.8 billion in revenue a year. Unless Congress acts, the tax will revert to 8 cents Sept. 30.

Releasing the report shortly before the surtax is scheduled to end is “blatant intervention, confected and released by the staff of an agency to support a regressive tax increase,” charged the Tobacco Institute, a Washington lobby.

Productivity Loss Estimated

According to the report, the United States will spend $12 billion to $35 billion this year to treat smoking-related diseases such as lung cancer--or 3% to 9% of total U.S. health care spending. Additional costs due to lost productivity will total between $27 billion and $61 billion, it said.

Thus, the total cost ranges from $39 billion to $96 billion, with an average estimate of $65 billion, the study found.

In contrast, Medicare costs this year are expected to range between $1.7 billion and $5.4 billion, while Medicaid costs will be $300 million to $1.1 billion.

About 50 million Americans smoke, the study found, and about 30 billion packs--or 600 billion cigarettes--were sold in the United States last year. It estimated total medical costs attributable to smoking at about 72 cents a pack, and lost productivity amounting to $1.45 a pack.

The Office of Technology Assessment said much of the basic data for its calculations were found in an American Cancer Society study of nearly 1 million Americans, conducted from 1959 to 1965.

In its analysis, OTA estimated that 139,000 persons died in 1982 from smoking-related cancers, 123,000 died from cardiovascular disease associated with smoking and 52,000 deaths were caused by chronic lung disease related to smoking.

Furthermore, it noted that it counted only cancers, heart disease and chronic respiratory diseases and excluded other factors such as higher risk of miscarriage among women smokers and so-called “passive smoking,” the effects of smoke on nonsmokers.

The report added, however, that because smokers sometimes tend also to be heavy drinkers, “an apparent excess of disease in smokers may not be because of the use of tobacco, but due to the consumption of alcohol.”