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What does a pack of cigarettes cost a smoker, the smoker's family, and society? This longitudinal study on the private and social costs of smoking calculates that the cost of smoking to a 24-year-old woman smoker is $86,000 over a lifetime; for a 24-year-old male smoker the cost is $183,000. The total social cost of smoking over a lifetime—including both private costs to the smoker and costs imposed on others (including second-hand smoke and costs of Medicare, Medicaid, and Social Security)—comes to $106,000 for a woman and $220,000 for a man. The cost per pack over a lifetime of smoking: almost $40.00. The first study to quantify the cost of smoking in this way, or in such depth, this accessible book not only adds a weapon to the arsenal of antismoking messages but also provides a framework for assessment that can be applied to other health behaviors. The findings on the effects of smoking on Medicare and Medicaid will be surprising and perhaps controversial, for the authors estimate the costs to be much lower than the damage awards being paid to 46 states as a result of the 1998 Master Settlement Agreement.
The world is living dangerously - either because it has little choice or because it is making the wrong choices -- Dr Gro Harlem Brundtland WHO Director-General
States have banned smoking in workplaces, restaurants, and bars. They have increased tobacco tax rates, extended "clean air" laws, and mounted dramatic antismoking campaigns. Yet tobacco use remains high among Americans, prompting many health professionals to seek bolder measures to reduce smoking rates, which has raised concerns about the social and economic consequences of these measures. Retail and hospitality businesses worry smoking bans and excise taxes will reduce profit, and with tobacco farming and cigarette manufacturing concentrated in southeastern states, policymakers fear the decline of regional economies. Such concerns are not necessarily unfounded, though until now, no comprehensive survey has responded to these beliefs by capturing the impact of tobacco control across the nation. This book, the result of research commissioned by Legacy and Columbia University's Institute for Social and Economic Research and Policy, considers the economic impact of reducing smoking rates on tobacco farmers, cigarette-factory workers, the southeastern regional economy, state governments, tobacco retailers, the hospitality industry, and nonprofit organizations that might benefit from the industry's philanthropy. It also measures the effect of smoking reduction on mortality rates, medical costs, and Social Security. Concluding essays consider the implications of more vigorous tobacco control policy for law enforcement, smokers who face social stigma, the mentally ill who may cope through tobacco, and disparities in health by race, social class, and gender.
The health and economic costs of tobacco use in military and veteran populations are high. In 2007, the Department of Veterans Affairs (VA) and the Department of Defense (DoD) requested that the Institute of Medicine (IOM) make recommendations on how to reduce tobacco initiation and encourage cessation in both military and veteran populations. In its 2009 report, Combating Tobacco in Military and Veteran Populations, the authoring committee concludes that to prevent tobacco initiation and encourage cessation, both DoD and VA should implement comprehensive tobacco-control programs.
Tobacco smoking is a major public health issue worldwide. Smoking causes more than a quarter of all cancer deaths, with nearly 80% of deaths from lung cancer, 80% of deaths from bronchitis and emphysema and almost one fifth of deaths from cardiovascular disease. The role of tobacco smoke in the development of cancer, cardiovascular and respiratory diseases is widely discussed in the chapters of this book. It is responsible for many preventable diseases, contributes to a large number of premature deaths and accounts for enormous economic costs. The chapters in this book review a variety of topics related to the sociodemographic characteristics of people consuming tobacco, tobacco product promotion and merchandising consequences of smoking on health, the studied mechanism of damage and the different interventions promoted for tobacco control. The mechanisms by which cigarette smoke affects health are diverse. Thousands of chemical components -- mainly toxins and carcinogens -- are part of tobacco smoke. These components could act through specific or nonspecific mechanisms in the development of cancer, cardiovascular and respiratory disease. Common pathways include DNA damage, gene mutations, vasomotor dysfunction and oxidative stress, among others. The effects on health of first-hand and second-hand smoke exposure have been widely studied, and there is growing evidence regarding consequences of third-hand smoke exposure. The constituents, dynamic transformation and distribution of third-hand smoke are a fruitful area of study, as much as the quantification of its exposure. In this book, many useful indicators of exposure to environmental tobacco smoke, ranging from surrogate indicators to direct measurements of the components that reflect dose are analysed. Advances in this field can provide useful information on the extent and effects of smoking, implementing and assessing tobacco control policies. Furthermore, the World Health Organization developed a framework for an international treaty that provides evidence-based recommendations for health promotion and tobacco control. After more than ten years of its implementation, the effectiveness of different strategies adopted worldwide is analysed and reflections on the new challenges of its implementation are presented. In this book, smoking is reviewed pertaining to the effects and implications for health, as well as the current challenges on implementation and evaluation of tobacco control interventions.
Tobacco use by adolescents and young adults poses serious concerns. Nearly all adults who have ever smoked daily first tried a cigarette before 26 years of age. Current cigarette use among adults is highest among persons aged 21 to 25 years. The parts of the brain most responsible for cognitive and psychosocial maturity continue to develop and change through young adulthood, and adolescent brains are uniquely vulnerable to the effects of nicotine. At the request of the U.S. Food and Drug Administration, Public Health Implications of Raising the Minimum Age of Legal Access to Tobacco Products considers the likely public health impact of raising the minimum age for purchasing tobacco products. The report reviews the existing literature on tobacco use patterns, developmental biology and psychology, health effects of tobacco use, and the current landscape regarding youth access laws, including minimum age laws and their enforcement. Based on this literature, the report makes conclusions about the likely effect of raising the minimum age to 19, 21, and 25 years on tobacco use initiation. The report also quantifies the accompanying public health outcomes based on findings from two tobacco use simulation models. According to the report, raising the minimum age of legal access to tobacco products, particularly to ages 21 and 25, will lead to substantial reductions in tobacco use, improve the health of Americans across the lifespan, and save lives. Public Health Implications of Raising the Minimum Age of Legal Access to Tobacco Products will be a valuable reference for federal policy makers and state and local health departments and legislators.
The Economics of Aging presents results from an ongoing National Bureau of Economic Research project. Contributors consider the housing mobility and living arrangements of the elderly, their labor force participation and retirement, the economics of their health care, and their financial status. The goal of the research is to further our understanding both of the factors that determine the well-being of the elderly and of the consequences that follow from an increasingly older population with longer individual life spans. Each paper is accompanied by critical commentary.
This booklet for schools, medical personnel, and parents contains highlights from the 2012 Surgeon General's report on tobacco use among youth and teens (ages 12 through 17) and young adults (ages 18 through 25). The report details the causes and the consequences of tobacco use among youth and young adults by focusing on the social, environmental, advertising, and marketing influences that encourage youth and young adults to initiate and sustain tobacco use. This is the first time tobacco data on young adults as a discrete population have been explored in detail. The report also highlights successful strategies to prevent young people from using tobacco.
It is becoming increasingly important to examine the relationship between the outcomes of a clinical trial and the costs of the medical therapy under study. The results of such analysis can affect reimbursement decisions for new medical technologies, drugs, devices or diagnostics. It can aid companies seeking to make claims about the cost-effectiveness of their product, as well as allowing early consideration of the economic value of therapies which may be important to improving initial adoption decisions. It is also vital for addressing the requirements of regulatory bodies. Economic Evaluation in Clinical Trials provides practical advice on how to conduct cost-effectiveness analyses in controlled trials of medical therapies. This new edition has been extensively rewritten and revised; topics discussed range from design issues such as the types of services that should be measured and price weights, to assessment of quality-adjusted life years. Illustrative materials, case histories and worked examples are included to encourage the reader to apply the methods discussed. These exercises are supported with datasets, programmes and solutions made available online.