Sarah Goodwin

Kathi Ovnic
Holly Korschun
March 26, 1999


National studies of the cost of smoking generally have omitted short-term costs related to smoking during pregnancy and exposure of young children to environmental tobacco smoke, according to a review article published this month in the journal Medical Care Research and Review.

While reviewing several studies of health care costs attributable to smoking, short-term expenses of smoking related to maternal and child care were evaluated by authors E. Kathleen Adams, Ph.D., associate professor of health policy and management at the Rollins School of Public Health of Emory University and Terri L. Young of Glaxo Wellcome Inc.

"Short-term costs related to smoking during pregnancy and exposure of children to environmental tobacco smoke may be of particular interest to health maintenance organizations and employers who insure young, more transient, populations," says Dr. Adams, who is affiliated with the center for public health practice at Emory's school of public health.

Major findings of the review article include the following:

  • Health care costs related to smoking during pregnancy due to adverse maternal and infant outcomes (e.g. lower birthweight) are significant.
  • In addition, significant costs are incurred for the treatment of pediatric respiratory illnesses, including asthma, that can be traced to children's exposure to environmental tobacco smoke.
    • These costs are more likely to be borne by individuals in the working age groups, though not necessarily employers, since Medicaid insures a large portion of births and medical care for young children.
  • National studies have largely omitted these maternal and child health costs and have not separately identified those borne by employers.
    • Due to labor turnover and retirement, employers may not fully realize the potential for substantial savings in health care costs made possible when a cohort of workers quits smoking.
  • Private smoking cessation programs may therefore need to be subsidized and/or complemented by public programs.



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