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Wendy Max, Hai-Yen Sung, and Yanling Shi.  Deaths From Secondhand Smoke Exposure in the United States: Economic Implications. American Journal of Public Health: November 2012, Vol. 102, No. 11, pp. 2173-2180.
doi: 10.2105/AJPH.2012.300805

Accepted on: Mar 14, 2012

Deaths From Secondhand Smoke Exposure in the United States: Economic Implications

Wendy Max, PhD, Hai-Yen Sung, PhD, and Yanling Shi, MS

Wendy Max, Hai-Yen Sung, and Yanling Shi are with the Institute for Health and Aging, University of California, San Francisco. Wendy Max and Hai-Yen Sung are also with the Department of Social and Behavioral Sciences, University of California, San Francisco.

Correspondence should be sent to Wendy Max, PhD, Institute for Health & Aging, Suite 340, 3333 California Street, San Francisco, CA 94118 (e-mail: ). Reprints can be ordered at http://www.ajph.org by clicking on the “Reprints” link.

Peer Reviewed

Contributors

W. Max obtained the funding, designed the study, and prepared the first draft of the article. H.-Y. Sung helped design the study and oversaw the data analyses. Y. Shi managed the data and conducted the analyses. All authors participated in reviewing statistical analyses and revising the article.


ABSTRACT

Objectives. We estimated the number of deaths attributable to secondhand smoke (SHS), years of potential life lost (YPLL), and value of lost productivity for different US racial/ethnic groups in 2006.

Methods. We determined the number of SHS–related deaths among nonsmokers from 2 adult and 4 infant conditions using an epidemiological approach. We estimated adult SHS exposure using detectable serum cotinine. For each death, we determined the YPLL and the value of lost productivity.

Results. SHS exposure resulted in more than 42 000 deaths: more than 41 000 adults and nearly 900 infants. Blacks accounted for 13% of all deaths but 24% to 36% of infant deaths. SHS–attributable deaths resulted in a loss of nearly 600 000 YPLL and $6.6 billion of lost productivity, or $158 000 per death. The value of lost productivity per death was highest among Blacks ($238 000) and Hispanics ($193 000).

Conclusions. The economic toll of SHS exposure is substantial, with communities of color having the greatest losses. Interventions need to be designed to reduce the health and economic burden of smoking on smokers and nonsmokers alike and on particularly vulnerable groups.