To the Editor.
—Drs Warner and Fulton1 are to be congratulated for their dispassionate analysis of a highly charged issue, tobacco and its economic impact. Tobacco-related health expenditures cost at least as much if not more than direct spending on tobacco products, as the authors indicated in their study.In addition to excess use of medical care, there are other economic costs of smoking2 that have an economic impact on non-tobacco-related industries. These include the costs of more frequent sick leave, higher group life insurance and health insurance premiums, and decreased productivity attributable to smoking-related illnesses. These costs are directly related to the poorer health of smokers compared with nonsmokers and may have important economic implications should the rate of tobacco consumption change. Furthermore, in 1988, an estimated 1 198 887 years of potential life lost before the age of 65 years were attributable to smoking.3 This results
Evans JM. The Economic Effects of Tobacco Sales in a Nontobacco State. JAMA. 1994;272(4):276. doi:10.1001/jama.1994.03520040036036