The Governmental Composition of the Insurance Costs of Smoking.

The estimated health risks from smoking have significant external financial consequences for society. Studies at the national level indicate that cigarettes are self-financing since external costs such as those due to illnesses are offset by cost savings associated with premature death, chiefly pension costs. This paper extends this analysis to all 50 states and considers the costs considered in the state attorneys general suits against the cigarette industry. Cigarettes are always self-financing from the standpoint of costs to each state. The extent of the cost savings is less than at the federal level. However, smokers' higher medical costs are outweighed by reduced nursing home expenditures, lower pension costs, and excise taxes, where each of these factors alone usually exceeds the medical cost effect. Copyright 1999 by the University of Chicago.