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This Article Full Text Full Text (PDF) All Versions of this Article: AJPH.2008.149542v1 100/1/152    most recent Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Max, W. Articles by Stark, B. PubMed PubMed Citation Articles by Max, W. Articles by Stark, B. Related Collections African Americans/Blacks Tobacco Control

Wendy Max, PhD, Hai-Yen Sung, PhD, Lue-Yen Tucker, BA and Brad Stark, BA

At the time of the study, all authors were with the Institute for Health and Aging, School of Nursing, University of California, San Francisco.

Correspondence: Correspondence should be sent to Wendy Max, PhD, Institute for Health and Aging, 3333 California St, Suite 340, San Francisco, CA 94118 (e-mail: wendy.max{at}ucsf.edu). Reprints can be ordered at http://www.ajph.org by clicking the "Reprints/Eprints" link.

Objectives. We estimated the economic impact of smoking on African Americans in California in 2002, including smoking-attributable health care expenditures and productivity losses from smoking-caused mortality.

Methods. We estimated econometric models of smoking-attributable ambulatory care, prescription drugs, inpatient care, and home health care using national and state survey data. We assessed smoking-attributable mortality using epidemiological models.

Results. Adult smoking prevalence for African Americans was 19.3% compared with 15.4% for all Californians. The health care cost of smoking was $626 million for the African American community. 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. The total cost of smoking for this community amounted to $1.4 billion, or $1.8 billion expressed in 2008 dollars.

Conclusions. Although African Americans account for 6% of the California adult population, they account for over 8% of smoking-attributable expenditures and fully 13% of smoking-attributable mortality costs. Our findings confirm the need to tailor tobacco control programs to African Americans to mitigate the disproportionate burden of smoking for this community.