The Burden of Tobacco Use in Connecticut

The Surgeon General reports that tobacco use is the leading preventable cause of disease in the United States.  Every year, cigarette smoking is responsible for 1 in 5 of all US deaths (or 443,000); 37% cancer, 32% heart disease and stroke and 21% due to respiratory disease.  Smoking accounts for at least 30% of all cancer deaths and 87% of lung cancer deaths. Chronic diseases are exacerbated by insufficient policies and systems; certain environments in which we live, learn, and work; and limited access to healthcare.  The most effective way to improve the health of Connecticut residents and reduce the burden of chronic diseases is through comprehensive statewide health promotion. Many deaths resulting from chronic diseases are premature and preventable.  In Connecticut, tobacco use continues to be a leading cause of preventable death.  Between 2000 and 2004, over 4,800 adults ages 35 and older died each year as a result of tobacco use, a smoking-attributable mortality rate of 238.3/100,000.  In addition, another 440 adult nonsmokers die each year from exposure to secondhand smoke. 

The Cost of Tobacco

Annual health care costs in Connecticut attributed to cigarette use are estimated at $2 billion (in 2008 dollars), and the portion of that covered by the State’s Medicaid Program is $507 million.  In addition, another $1.03 billion of tobacco-related “cost” is attributed to productivity losses of persons affected by tobacco-related diseases/treatments.  These amounts do not include the health consequences or economic costs of exposure to secondhand smoke, smoking-related fires, or use of other forms of tobacco.

In 2009, 15.4% of Connecticut’s adult population (ages 18+) — over 400,000 individuals — were current cigarette smokers.  The prevalence for adult men was 16.2% and for adult women it was 14.7%.  The age group with the highest smoking prevalence was among 18 to 24 year-olds (24%).  Smoking rates vary by socio-economic status (SES), education, age, race, and presence of psychiatric illness.  Overall, smoking rates are higher in individuals with lower income and education levels, in younger adults compared to older adults, military veterans, and in individuals with psychiatric and substance use diagnoses.  Nationally, the prevalence of smoking is comparable in Caucasians and African-American groups, but is lower in Hispanics.  However in Connecticut smoking rates are higher among Hispanics as compared to Blacks or Whites.  For adults who reported an annual income of less than $25,000, the cigarette-smoking rate was 30%, compared to about 12% for those earning $50,000 or more per year.

A Health Disparity Issue

While the last ten years have seen dramatic changes in smoking rates for whites, college graduates and persons with income over $50,000 per year, these same trends are not true for groups at high risk of being smokers.  This is particularly true among Medicaid recipients, persons with no insurance, racial/ethnic groups, persons suffering from mental health and substance abuse, and persons with low socio-economic status.  Expanding and developing cessation programs that target these populations and aggressive media counter-marketing activities are needed to reduce tobacco use and smoking-related medical costs.

(Report of the Tobacco and Smoking Cessation Task Force to Sustinet Board)