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March 2, 1994

Smokers May Pay, but Not Their Own Way

JAMA. 1994;271(9):644-645. doi:10.1001/jama.1994.03510330012007

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PREMATURE DEATH is not usually considered to be cost-effective.

Yet the assumption that early death cuts future medical and Social Security expenditures is essential to the tobacco industry's assertion that cigarette sales taxes and excise taxes more than cover the cost to government of diseases caused by smoking.

"If it weren't for that particular argument, there would be no way any calculation could show that smokers pay their own way," says Jeffrey E. Harris, MD, PhD, an internist and economics professor at the Massachusetts Institute of Technology, Cambridge.

Harris told the US House Ways and Means Committee that even with the proposed 75-cent-per-pack tax increase being proposed to finance health system reform, nonsmokers will still be paying for more than half of smoking-related health care costs.

Harris estimated in his congressional testimony that "cigarette smoking accounts for 8% of all health care spending in the United States," with a range

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