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This Article Full Text Full Text (PDF) Data Supplement All Versions of this Article: AJPH.2008.137430v1 99/4/754    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 Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Waters, H. R. Articles by Samet, J. Search for Related Content PubMed PubMed Citation Articles by Waters, H. R. Articles by Samet, J. Related Collections Epidemiology Insurance Social Science Tobacco Control Secondhand Smoke

Hugh R. Waters, PhD, Steven S. Foldes, PhD, Nina L. Alesci, MPH and Jonathan Samet, MD

Hugh R. Waters and Jonathan Samet are with Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Steven S. Foldes and Nina L. Alesci are with the Center for Prevention, Blue Cross and Blue Shield of Minnesota, St Paul.

Correspondence: Requests for reprints should be sent to Hugh Waters, MS, PhD, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, #403, Baltimore, MD 21205 (e-mail: hwaters{at}jhsph.edu).

Objectives. Using the risk categories established by the 2006 US surgeon general's report, we estimated medical treatment costs related to exposure to secondhand tobacco smoke (SHS) in the state of Minnesota.

Methods. We estimated the prevalence and costs of treated medical conditions related to SHS exposure in 2003 with data from Blue Cross and Blue Shield (Minnesota's largest insurer), the Current Population Survey, and population attributable risk estimates for these conditions reported in the scientific literature. We adjusted treatment costs to the state level by health insurance category by using the Medical Expenditure Panel Survey.

Results. The total annual cost of treatment in Minnesota for conditions for which the 2006 surgeon general's report found sufficient evidence to conclude a causal link with exposure to SHS was $228.7 million in 2008 dollars—equivalent to $44.58 per Minnesota resident. Sensitivity analyses showed a range from $152.1 million to $330.0 million.

Conclusions. The results present a strong rationale for regulating smoking in public places and were used to support the passage of Minnesota's Freedom to Breathe Act of 2007.