How Costly Are Smokers to Other People? Longitudinal Evidence on the Near Elderly
Abstract
Many studies have estimated the cost of smoking. In recent years, such estimates have
been widely used in litigation against the tobacco companies. Both longitudinal and
cross-sectional methods have been used. On balance, the longitudinal approach, the
one used in this study, is much preferable since one can account for the effects of
smoking on the pool of eligibles rather than just conditioning expenditures on being
eligible. We used data from four waves of the Health and Retirement Study to assess
the impact of smoking on use of hospital and physicians’ services and nursing home
care. The analysis was limited to utilization among persons aged 51 to 67 (“near elderly”
). During this phase of the life cycle, many adverse effects of smoking, measured
in terms of mortality and morbidity,
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Frank A. Sloan
J. Alexander McMahon Distinguished Professor Emeritus of Health Policy and Management
Professor Sloan is interested in studying the subjects of health policy and the economics
of aging, hospitals, health, pharmaceuticals, and substance abuse. He has received
funding from numerous research grants that he earned for studies of which he was the
principal investigator. His most recent grants were awarded by the Robert Wood Johnson
Foundation, the Center for Disease Control, the Pew Charitable Trust, and the National
Institute on Aging. Titles of his projects include, “Why Mature S

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