Lorillard
Statement of Roger Herdman, M.D. Acting Director Office of Technology Assessment and Maria Hewitt, Dr.P.H. Senior Analyst, Health Program Office of Technology Assessment and Mary Laschober, M.S. Analyst, Health Program Office of Technology Assessment on Smoking - Related Deaths and Financial Costs: Office of Technology Assessment Estimates for 900000 Before the Senate Special Committee on Aging Hearing on Preventive Health: An Ounce of Prevention Saves A Pound of Cure
Fields
- Author
- Herdman, R.
- Hewitt, M.
- Laschober, M.
- Hewitt, M.
- Area
- SPEARS,ALEXANDER/OFFICE
- Alias
- 87679973/87680013
- Type
- DEPO, DEPOSITION/TRIAL TRANSCRIPT
- BIBL, BIBLIOGRAPHY
- FOOT, FOOTNOTE
- BIBL, BIBLIOGRAPHY
- Site
- G65
- Recipient (Organization)
- Senate
- Special Comm on Aging
- Named Person
- Cowan, C.A.
- Herdman, R.
- Hewitt, M.
- Hodgson, T.
- Horn, A.
- Kopstein, A.N.
- Laschober, M.
- Lazenby, H.C.
- Levit, K.R.
- Manning, W.G.
- Mckusick, D.R.
- Nelson, D.
- Novotny, T.E.
- Peskin, J.
- Rice, D.P.
- Shultz, J.M.
- Sonnefeld, S.T.
- Surgeon General
- Waldo, D.R.
- Warner, K.E.
- Herdman, R.
- Date Loaded
- 12 Feb 1999
- Document File
- 87679789/87680362/Missing
- Named Organization
- American Cancer Society
- Ccdphp
- Cdc
- Cdcp
- Center for Chronic Disease Prevention +
- Centers for Disease Control + Prevention
- Dhhs
- Hcfa
- Health Care Financing Administration
- Health Care Financing Review
- Indian Health Service
- Mmwr
- Mortality Branch
- Natl Center for Health Statistics
- Natl Centers for Disease Control + Preve
- Nchs
- Nhis
- Office of Technology Assessment
- Office of the Actuary
- Office on Smoking + Health
- Ord
- Osh
- Phs
- Senate
- Special Comm on Aging
- US Bureau of the Census
- US Dept of Commerce
- US Dept of Defense
- US Dept of H+Ss
- US Dept of Labor
- Usda, U.S. Dept of Agriculture
- Usdhhs
- Advance Report of Final Mortality Statis
- Alcohol Drug Abuse + Mental Health Admin
- Ccdphp
- Litigation
- Stmn/Produced
- Author (Organization)
- Office of Technology Assessment
- US Congress
- Master ID
- 87679895/0021
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Document Images
premature death. Other policies that might discourage smoking include raising
taxes on tobacco products, enforcing minor-access laws, restricting smoking in
public places, and restricting tobacco
advertising and promotion (MMWR, April
2, 1993).
10
Figure 1--Components of 1990 Smoking-Related
Cost Estimates
Direct Costs + Indirect Costs = Total Costs
$ 21 Billion
(Costs of providing
+
$ 47 Billion
_ $ 68 Billion
health care to persons
with smoking-related illnesses)
Indirect Morbidity Costs
$ 7 Billion
(Costs of lost productivity
for persons disabled by
smoking-attributable diseases)
Indirect Mortality Costs
$ 40 Billion
(Estimates of forfeited
earnings of those dying
premature deaths from
smoking-attributable diseases)
Source: Office of Technology Assessmentas calculated using the SAMMEC 2.1 program, 1993.
VBes494g
Table 1--Total Deaths and Deaths Attributable to Smoking
by Cause of Death, United States. 1990
Total Smoking-attributable deaths
Cause of death deaths' Number Percent
All causes 2,148,463 416,829 19.4%
Neoplasms 505,322 148,224 29.3
Cardiovascular disease 916,007 179,436 19.6
Respiratory disease 168,203 84,872 50.5
Perinatal disease 15,237 2,215 14.5
Burns° 4,175 2,082 49.9
'Total neoplasm deaths include ICD-9 codes 140-208, total cardiovascular
diseases include ICD-9 codes 390-448, total respiratory diseases include ICD-
9 codes 10-12, 466, 480-87, 490-96, total perinatal conditions include ICD-9
codes 765, 769, 770, 798.0, and total burn deaths include ICD-9 codes E-890-
899.
e0ne-half of all burn deaths are assumed to be cigarette-related (DHHS, CDC.
Office on Smoking and Health, 1990).
SOURCES: Office of Technology Assessment, as calculated using the SAMMEC 2.1
program, 1993; USDHHS, PHS, CDC, NCHS, Advance Report of Final
Mortality Statistics. 1990 41(7) Supplement, January 7, 1993.
Table 2--Total Deaths and Deaths Attributable to Smoking by Detailed Cause of Death,
United States, 1990
Cause of death
All causes
Neoplasms
Lip, oral cavity, pharynx
Esophagus
Pancreas
Larynx
Trachea, lung, bronchus
Cervix, uterus
Urinary bladder
Kidney, other urinary
Cardiovascular diseases
Rheumatic heart disease
Hypertension
Ischemic heart disease
Pulmonary heart disease
Other heart disease
Cerebrovascular disease
Atherosclerosis
Aortic aneurysm
Other arterial diseases
Respiratory diseases
Respiratory TB
Pneumonia, influenza
Bronchitis, emphysema
Asthma
Chronic airways obstruction
Pediatric diseases
Short gestation, low birth weight
Respiratory distress syndrome
Respiratory conditions of newborn
Sudden infant death syndrome
Burns
Total Smokinz-attributable deaths
deaths Number Percent
2,148,463 416,829 19.4%
8,311 6,470 77.8
9,698 7,277 75.0
25,006 6,109 24.4
3,702 2,988 80.7
140,947 116,848 82.9
4,303 1,292 30.0
10,316 4,024 39.0
10,153 3,217 31.7
5,864 922 15.7
32,351 5,436 16.8
487,900 98,707 20.2
11,185 1,977 17.7
186,166 32,342 17.4
142,638 23,231 16.3
18,027 6,408 35.5
16,275 7,271 44.7
8,075 3,143 38.9
1,267 359 28.3
77,574 19,158 24.7
19,196 15.295 79.7
4,284 1,093 25.5
61,556 48,967 79.5
4,013 654 16.3
2.850 464 16.3
2,957 482 16.3
5,417 615 11.4
4,175 2,082 49.9
SOURCES: Office of Technology Assessment, as calculated using the SAMMEC 2.1
program, 1993; USDHHS, PHS, CDC, NCHS, Mortality Branch, Arthur Horn,
personal communication, 1993.
Table 3--Total Deaths and Deaths Attributable to Smoking by Age
and Sex, United States. 1990
Total Smokinr-attributable deaths
deaths Number Percent
Total
< 1-34 150,542 3,083 2.0%
35-64 454,866 121,275 26.7
>_ 65 1,542,493 292,471 19.0
All ages' 2,148,463 416,829 19.4
Male
< 1-34
102,882
1,855
1.8
35-64 286,762 84,804 29.6
> 65 723,370 188,937 26.1
All ages' 1,113,417 275,597 24.8
Female
< 1-34
47,660
1,227
2.6
35-64 168,104 36,470 21.7
> 65 819,123 103,534 12.6
All ages' 1,035,046 141,232 13.6
'Age-specific numbers of deaths do not add to the total because of a small
number of deaths with unknown age of death.
SOURCES: Office of Technology Assessment as calculated using the SAMMEC 2.1
program, 1993; USDHHS, PHS, CDC, NCHS, Advance Report of Final
Mortalitv Statistics, 1990 41(7) Supplement, January 7, 1993.
Table 4--Smoking-Attributable Mortality by Age and Cause of Death, United States, 1990
Niunher of deaths Years of nott•nt ial life lost
all ages < 35 35-64 65 + to age 65 to life expectancy
Cause of death
Neoplasms 148,224
Cardiovascular diseases 179,436
Respiratory diseases 84,872
Peritiatal diseases 2,215 0
0
0
2,215 53,139
55,258
12,305
0 95,085
124,179
72,567
0 429,010
495,777
89,321
142,857 2,421,891
2,559,615
1,029,642
165,408
Burns
Total 2,082
416,829 868
3,083 573
121,275 641
292,471 51,166
1,208,130 78,057
6,254,612
SOURCE: Office of Technology Assessment, as calculated using the SAMMEC 2.1 program, 1993.
98664949
Table 5--Smoking Prevalence, United States, 1990
Males Females
Age Currently Formerly Currently Formerly
smoke smoked smoke smoked
35-64 31.6% 35.2% 24.8% 22.7%
65+ 14.6 55.2 11.5 23.2
SOURCE: National Centers for Disease Control and Prevention, Center for
Chronic Disease Prevention and Health Promotion, Office on Smoking
and Health, special tabulation of the 1990 National Health Interview
Survey, April 1993.
Table 6--Relative Risk of Death for Current and Former Smokers by Cause of Death and Sex, United
States
(Page 1 of 2)
Men Women
Cause of death IC[)-9
code Currently
smoke Formerly
smoked Currently
smoke Formerly
smoked
Neoplasms
Lip, oral cavity, pharynx 140-149 27.48 8.80 5.59 2.88
Esophagus 150 7.60 5.83 10.25 3.16
reas
P 157 14
2 1
12 33
2 78
1
anc . . . .
Laryiix 161 10.48 5,24 17.78 11.88
Trachea, lung, bronchus 162 22.36 9.36 11.94 4.69
Cervix, uterus 180 -- -- 2.14 1.94
Urinary bladder 188 2.86 1.90 2.58 1.85
Kidney, other urinary 189 2.95 1.95 1.41 1.16
Cardiovascular diseases
Rheumatic heart disease 390-398 1.85 1.32 1.69 1.16
Hypertension 401-404 1.85 1.32 1.69 1.16
Ischemic heart disease 410-414
35-64 years 2.81 1.75 3.00 1.43
65 and over 1.62 1.29 1.60 1.29
Pulmonary heart disease 415-417 1.85 1.32 1.69 1.16
Other heart disease 420-429 1.85 1.32 1.69 1.16
Cerebrovascular disease 430-438
35-64 years 3.67 1.38 4.80 1.41
65 and over 1.94 1.27 1.47 1.01
Atherosclerosis 440 4.06 2.33 3.00 1.34
Aortic aneurysm 441 4.06 2.33 3.00 1.34
Other arterial diseases 442-448 11.06 2.33 3.00 1.34
Respiratory diseases
Respiratory TB
010-012
1.99
1.56
2.18
1.38
Pneumonia, influenza 480-487 1.99 1.56 2.18 1.38
Bronchitis, emphysema 490-492 9.65 8.75 10.47 7.04
Asthma 493 1.99 1.56 2.18 1.38
Chronic airways obstruction 496 9.65 8.75 10.41 7.04
0666G9L9
Table 6--Relative Risk of Death for Current and Former Smokers by Cause of Death and Sex, United
States
(Page 2 of 2)
Men Women
Cause of death ICD-9
code Currently
smoke Formerly
smoked Currently
smoke Formerly
smoked
Pediatric diseases
Short gestation, low birth weight 765 1.76 1.76
Respiratory distress syndrome 769 1.76 1.76
Respiratory conditions of newborn 770 1.76 1.76
Sudden infant death syndrome 798.0 1.50 1.50
SOURCE: US DIIIIS, PHS, CDC, National Center for Chronic Disease Prevention and Health Promotion,
Office on Smoking
and Ilealth, SAMMEC 2.1 Comuuter Software and Docwnenration.
T6E6494e
Table 7--Smoking-Attributable Direct and Indirect Financial Costs by Age and Sex, United States.
1990
Uirect costs Indirect morbidity costs lndirect mortality costs'
(millions of $)
a ge (millions of $)
age (millions of $)
age
35-64 65 + Total 35-64 65 4 Total 35-64 65 t Total
Mcile $11,315 $3,395 $14,710 $3,507 $1,171 $4,678 $25,088 $4,411 $29,499
Female 3,077 2,988 6,065 2,019 187 2,207 8,250 2,548 10,798
Total 14,392 6,383 20,775 5,527 1,358 6,885 33,339 6,959 40,298
dThe indirect mortality cost estimates are based on a 4 percent rate to discount future lifetime
earnings and exclude deaths
of persons under age 35.
SOURCE: Office of Technology Assessment, as calculated using the SAMMEC 2.1 program, 1993.
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