Medical expenditures attributable to smoking

This study estimates that the total U.S. medical expenditures attributable to smoking amounted to $73 billion in 1993. But the study has two major flaws.

First, the calculation is based on something called "smoking attributable fraction" (SAF). The SAF is calculated by estimating the difference in medical expenditures between groups of smokers and nonsmokers. The theory is that the difference in medical expenditures between the two groups is due to smoking.

But this is probably not true. Smokers tend to have the "smoking lifestyle" -- a whole set of "unhealthy" habits like not exercising, poorer diet, higher alcohol consumption, being less health conscious, etc. The difference in medical expenditures between smokers and nonsmokers could be due to these lifestyle differences -- not just smoking.

Second, the analysis seems to assume that, BUT FOR smoking, these medical expenditures would not be incurred. But due to shortened life expectancy, smokers incur their health related expenses earlier and for a shorter period of time than nonsmokers. Nonsmokers get sick and die, too. It just takes them longer -- and probably costs more money.

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