Health care expenditures in Colorado directly related to smoking:(1) $930 million
Colorado Medicaid payments directly related to smoking:(1) $150 million
Additional expenditures in Colorado for babies’ health problems caused by mothers smoking during pregnancy, approximately:(1) $33 million
Non-health costs related to tobacco use in Colorado (fires, lost productivity, early termination of employment, maintenance, etc.), at least:(2) $650 million

Potential Cost Savings in Colorado:(3)

  • A comprehensive program to prevent and reduce tobacco use in Colorado would start paying dividends immediately.
  • Most health care savings from reduced smoking do not begin to appear for several years and do not peak for a decade or more. But deaths and illness from a variety of tobacco-related illnesses would begin to decrease promptly as adults begin to quit. Substantial health care savings-and lower taxpayer burdens-would result within the first year. And the savings would continue to grow as fewer and fewer people continue to smoke.
$9.9 million:
Colorado’s Savings from Reducing Adult Smoking by 1% per year for 5 years.
Fewer Heart Attacks 15 35 45 50 52
Fewer Strokes 9 19 24 26 27
Health Care Savings (millions) $0.7 $1.7 $2.3 $2.5 $2.7
NOTE: This table does not include other immediate savings, such as those from reduced smoking by pregnant women. Nor does it reflect the enormous additional health care savings from reducing the amount of smoking-caused lung cancer, emphysema, chronic lung disease, and other smoking-related health problems.(1)
  • The greatest health and economic benefits would be realized 20-30 years after a comprehensive program is begun as tens of thousands of Colorado children who would have otherwise been smokers grow up tobacco free.

Immediate savings from fewer smoking-related infant and childhood illnesses and deaths:

  • The number of low birthweight (LBW) births would begin to decrease promptly as fewer pregnant women continued to smoke.
  • Colorado has the 6th highest rate of low-weight births in the nation, with 8.9% of infants born weighing less than 5.5 pounds (5,029 low-weight births in 1997). Low birthweight babies incur at least $24,000 more in medical costs in their first year of life than babies of normal birthweight.(4)
Immediate Savings from Fewer Low Birthweight Births – $11 million: (5)
Colorado’s LBW Savings Per Year from Reducing Smoking by Pregnant Women
Maternal Age Number of LBW births that would be prevented for each 1000 women in each age group who stop smoking Estimated number of LBW births that would be prevented per year by smoking cessation programs Estimated medical care cost savings Per year
Under 18 years 45/1000 18 $432,000
18 to 29 years 69/1000 284 $6,816,000
30 to 34 years 91/1000 95 $2,280,000
Over 35 years 100/1000 63 $1,512,000
TOTAL $11,040,000
  • Smoking attributable complications of pregnancy would begin to decrease immediately as fewer pregnant women continued to smoke (placenta previa, abruptio placenta, ectopic pregnancy and spontaneous abortion). Estimated annual costs to Colorado: $2.4 million to $3 million.(6)
  • As fewer parents continue to smoke, the incidence of severe asthma, middle ear infections, and hospitalizations for respiratory infections in children will begin to fall immediately. Estimated annual costs to Colorado: $8.2 million.(7)
  • In Colorado each year, approximately 4,400 cases of asthma in children under 15 can be attributed to exposure to smoking in the household (based upon 307,000 cases nationwide.) Children with asthma incur 88% more in healthcare costs than the general population of children using health services. Estimated excess cost of treating smoking-related asthma in Colorado’s children: more than $2.9 million annually.(8)


(1) L. Miller et al., “State Estimates of Total Medical Expenditures Attributable to Cigarette Smoking, 1993,” Public Health Reports 113:447-58 (September/October 1998).

(2) Centers for Disease Control, Making Your Workplace Smokefree: A Decision Maker’s Guide (1996).

(3) J.M. Lightwood & S.A. Glantz, “Short-Term Economic and Health Benefits of Smoking Cessation-Myocardial Infarction and Stroke,” Circulation 96(4): 1080-1096 (Aug. 19, 1997).

(4) Lewit E.M., Baker L.S., “The direct cost of low birthweight,” The Future of Children 5(1): 35-56, (Spring 1995).

(5) French J.A., “Reducing Low Birthweight in Colorado: Population Attributable Fraction for Known Risk factors for Low Birthweight Among Singleton Births,” Dept. of Obstetrics and Gynecology, Denver Health Medical Center, September 1999, (Unpublished report).

(6) Adams E.K., Melvin C.L., “Costs of maternal conditions attributable to smoking during pregnancy,” American Journal of Preventive Medicine, 15(3): 212-9, (Oct. 1998).

(7) Aligne C.A., Stoddard J.J., “Tobacco and children. An economic evaluation of the medical effects of parental smoking,” Archives of Pediatric and Adolescent Medicine, 151(7): 648-53 (Jul 1997).

(8) Lozano P., Fishman P., “Health Care Utilization and cost among children with asthma who were enrolled in a health maintenance organization,” Pediatrics, 99(6): 757-64 (June 1997).