There are an estimated 34.2 million tobacco users in the U.S., and smoking costs more than $300 billion each year in healthcare costs and lost productivity, according to the U.S. Centers for Disease Control and Prevention (CDC). But to discover which U.S. state has the highest costs directly related to smoking and secondhand smoke, WalletHub engaged experts to find out.
WalletHub calculated the potential monetary losses -- including the lifetime and annual costs of a cigarette pack per day, healthcare expenditures, income losses, and other costs -- brought on by smoking and exposure to secondhand smoke.
In terms of annual healthcare costs, WalletHub reported that Connecticut, Massachusetts, and New York had annual costs of approximately $262,000 per smoker. These costs contrast with the states of Arkansas, Kentucky, Georgia, and Tennessee, which had costs of less than $125,000 per smoker.
In terms of total costs per smoker by state, 10 states and the District of Columbia each listed more than $2 million. New York finished highest at $2,458,044. Meanwhile, North Carolina was the lowest at $1,228,493.
Per-year numbers for smokers show North Carolina with the lowest number at $24,088 while New York's $48,197 topped the list.
| Comparison of total and healthcare costs per year of the top and bottom 3 U.S. states per adult smoker | ||
| State | Healthcare cost per smoker | Total cost per smoker |
| New York | $5,143 | $48,197 |
| Connecticut | $5,704 | $47,999 |
| Massachusetts | $5,388 | $46,593 |
| North Carolina | $2,651 | $24,088 |
| Georgia | $2,436 | $24,110 |
| Missouri | $3,173 | $24,236 |
The ADA notes that dental practices may provide a uniquely effective setting for tobacco use recognition, prevention, and cessation. Dental professionals can help smokers quit by consistently identifying patients who smoke, advising them to stop, and offering them information about cessation treatment.
One of the experts WalletHub has engaged for previous reports is Joseph G.L. Lee, PhD, MPH, an assistant professor in the department of health education and promotion at the College of Health and the Brody School of Medicine at East Carolina University in Greenville, NC. Healthcare providers could be beneficial for patients who wish to stop smoking, Dr. Lee noted.
"One of the best things someone can do to quit smoking is to ask for help from a healthcare professional," he stated. "Healthcare professionals can help with finding the right medication or dose of nicotine replacement therapy like the patch."
Another expert, John Spangler, MD, suggested that patients wishing to stop smoking talk with a healthcare practitioner and consider prescription medication to help them stop smoking.
"The medications include the nicotine gum, lozenge or patch; as well as nonnicotine medications such as bupropion (Wellbutrin, Zyban), varenicline (Chantix), clonidine, and nortriptyline," stated Dr. Spangler, a professor of family medicine at the Wake Forest University School of Medicine in Winston-Salem, NC.
To compile the rankings, WalletHub researchers used data from various sources, including the U.S. Census Bureau, Bureau of Labor Statistics, the Centers for Disease Control and Prevention, and others.
For more information, the full report is available on the WalletHub website.
