Smoking comes at a price – and not just the price tag on a pack at a convenience store. Smokers have much higher health care costs, compared to nonsmokers.
The federal health care reform law makes it easier for smokers to get help to quit smoking. States and employers also are working to address the problem of higher medical bills associated with tobacco use.
About 19 percent of adults in the United States were smokers in 2011, according to the U.S. Centers for Disease Control and Prevention.
How much does smoking cost employers?
Because it directly impacts their bottom line, many employers are concerned about the extra health care costs associated with smoking. Each employee who smoked cost employers nearly $6,000 in additional health care costs and lost productivity, according to a 2013 Ohio State University study.
In fact, men who smoke incur $15,800 more in lifetime medical expenses, and women who smoke incur $17,500 more in lifetime medical expenses, according to a 1992 study published in the Milbank Quarterly. Likewise, men who smoke are absent from work four days more per year than nonsmoking men, women who smoke are absent from work two days more each year than women who don’t smoke, according to a 1996 study published in the Journal of Occupational and Environmental Medicine.
Why is that the case? Carly Stewart, a medical doctor serving as a health expert at Money Crashers Personal Finance, explained, "Smokers are at a higher risk for many diseases and illnesses, such as cancers, chronic obstructive pulmonary disease, emphysema, pneumonia, asthma, osteoporosis and even erectile dysfunction. These must be treated, and those associated costs drive up premiums for everyone, nonsmokers included.”
In addition to the increased health care costs, employers also experience higher costs for life insurance, disability claims and workers’ compensation claims due to employees who smoke.
As a result, many employers offer smoking cessation programs for their workers. The programs often include printed informational materials, coaching via phone calls and texts and online systems to track progress. Some employers offer employees a discount on their health care premium contributions if they don’t smoke or if they enter a smoking cessation program.
Health care costs for smokers
Smoking hits the individual’s wallet, too. Smokers pay about $1,275 more per year in health care costs, compared to nonsmokers, according to a study published in the Journal of Occupational and Environmental Medicine last year.
Medical bills are higher for smokers in part because smoking causes cancer, heart disease, stroke and lung diseases, such as emphysema, bronchitis and chronic airway obstruction, according to the Centers for Disease Control and Prevention (CDC). That means more out-of-pocket costs in the form of deductibles, copays and coinsurance. Smokers also pay higher premiums if they have an individual health plan, not a group plan offered by an employer.
On average, smokers die 10 years earlier than nonsmokers, the CDC reports.
Smoking as a preexisting condition
Under the Affordable Care Act, also known as Obamacare, smoking cessation programs are considered preventive care, and insurers must cover this without charging a copay, coinsurance or deductible.
However, there’s bad news for smokers: The federal law permits insurers in most states to charge smokers a 50 percent higher premium, compared to nonsmokers, for individual coverage. But if you participate in a smoking cessation program, you can avoid having to pay the higher premium.
Vermont, Rhode Island, Massachusetts and the District of Columbia have deemed smoking a preexisting condition. “In those states, insurers on the individual exchanges are therefore not allowed to charge more for health insurance for smokers,” Stewart says.
Dr. Risa Lavizzo-Mourey, president of the Robert Wood Johnson Foundation, a nonprofit organization that focuses on health care issues, says, “Smoking rates are still unacceptably high. We know that if we make the places where we live smoke-free, it improves health and reduces health care costs.”