The Real Cost of Smoking by State
2:45 AMPosted by: Adam McCann
Smoking doesn’t just ruin your health. It can also burn a nasty hole through your wallet. Tobacco use accounts for nearly half a million deaths in the U.S. each year and is the leading cause of lung cancer, according to the American Lung Association. Even those around tobacco smokers aren’t safe from its harmful effects. Since 1964, smoking-related illnesses have claimed over 20 million lives in the U.S., 2.5 million of which belonged to nonsmokers who developed diseases merely from secondhand-smoke exposure.
However, the economic and societal costs of smoking are just as huge. Every year, smoking costs the U.S. more than $300 billion, which includes both medical care and lost productivity. Unfortunately, some people will have to pay more depending on the state in which they live.
To encourage the estimated 37.8 million tobacco users in the U.S. to kick the dangerous habit, WalletHub looked into the true per-person cost of smoking in each of the 50 states and the District of Columbia. We calculated the potential monetary losses — including both the lifetime and annual cost of a cigarette pack per day, health care expenditures, income losses and other costs — brought on by smoking and exposure to secondhand smoke. Read on for the complete ranking and analysis, insight from a panel of experts and a full description of our methodology.
Costs Over a Lifetime Embed on your website<iframe src="//d2e70e9yced57e.cloudfront.net/wallethub/embed/9520/smoke-geochart.html" width="556" height="347" frameBorder="0" scrolling="no"></iframe> <div style="width:556px;font-size:12px;color:#888;">Source: <a href="http://bit.ly/2sfPklr> The Real Cost of Smoking by State| Overall Rank* | State | Total Cost per Smoker | Out-of-Pocket Cost (Rank) | Financial Opportunity Cost (Rank) | Health-Care Cost per Smoker (Rank) | Income Loss per Smoker (Rank) | Other Costs per Smoker (Rank) |
|---|---|---|---|---|---|---|---|
| 1 | Georgia | $1,396,882 | $87,304(2) | $960,789(2) | $120,432(4) | $216,146(19) | $12,211(28) |
| 2 | Missouri | $1,413,082 | $86,001(1) | $946,449(1) | $158,651(28) | $210,291(15) | $11,689(23) |
| 3 | North Carolina | $1,421,995 | $88,235(3) | $971,032(3) | $145,527(14) | $205,306(11) | $11,895(25) |
| 4 | Mississippi | $1,431,749 | $93,447(8) | $1,028,393(8) | $125,746(7) | $171,397(1) | $12,766(33) |
| 5 | South Carolina | $1,444,815 | $91,400(5) | $1,005,858(5) | $136,049(9) | $199,026(9) | $12,481(32) |
| 6 | Tennessee | $1,460,661 | $94,378(9) | $1,038,636(9) | $118,281(3) | $198,729(8) | $10,638(13) |
| 7 | Alabama | $1,466,602 | $95,123(10) | $1,046,830(10) | $122,788(6) | $189,606(4) | $12,255(29) |
| 8 | North Dakota | $1,479,467 | $88,235(3) | $971,032(3) | $157,975(26) | $250,043(35) | $12,181(27) |
| 9 | Arkansas | $1,517,205 | $100,335(13) | $1,104,191(13) | $122,290(5) | $178,757(2) | $11,632(22) |
| 10 | Wyoming | $1,528,876 | $92,517(6) | $1,018,150(6) | $158,177(27) | $248,627(32) | $11,406(20) |
| 11 | Idaho | $1,549,515 | $98,473(11) | $1,083,705(11) | $148,168(15) | $208,019(14) | $11,150(16) |
| 12 | Virginia | $1,553,915 | $92,703(7) | $1,020,198(7) | $148,941(16) | $280,565(43) | $11,507(21) |
| 13 | Kentucky | $1,554,715 | $103,127(16) | $1,134,920(16) | $117,094(1) | $189,863(5) | $9,711(3) |
| 14 | Louisiana | $1,572,467 | $104,058(17) | $1,145,163(17) | $117,642(2) | $190,577(6) | $15,028(43) |
| 15 | Indiana | $1,588,001 | $102,383(15) | $1,126,725(15) | $136,097(10) | $212,903(16) | $9,894(5) |
| 16 | Nebraska | $1,617,084 | $98,846(12) | $1,087,802(12) | $184,874(34) | $231,234(27) | $14,329(38) |
| 17 | West Virginia | $1,622,152 | $108,153(19) | $1,190,232(19) | $135,429(8) | $179,769(3) | $8,569(1) |
| 18 | Oregon | $1,656,658 | $105,175(18) | $1,157,454(18) | $155,135(23) | $228,966(25) | $9,929(6) |
| 19 | Colorado | $1,657,723 | $101,452(14) | $1,116,482(14) | $157,832(25) | $267,069(39) | $14,888(42) |
| 20 | Kansas | $1,701,577 | $109,084(21) | $1,200,474(21) | $151,276(19) | $226,346(24) | $14,396(39) |
| 21 | Florida | $1,724,214 | $110,759(22) | $1,218,912(22) | $169,369(31) | $207,603(13) | $17,571(50) |
| 22 | Montana | $1,726,841 | $112,062(23) | $1,233,252(23) | $162,330(30) | $207,268(12) | $11,929(26) |
| 23 | Ohio | $1,749,287 | $114,482(26) | $1,259,884(26) | $151,951(20) | $213,821(17) | $9,149(2) |
| 24 | New Mexico | $1,755,784 | $116,530(28) | $1,282,418(28) | $154,978(22) | $190,609(7) | $11,249(17) |
| 25 | Iowa | $1,767,680 | $113,738(24) | $1,251,689(24) | $160,394(29) | $230,806(26) | $11,053(14) |
| 26 | Texas | $1,778,428 | $115,413(27) | $1,270,127(27) | $142,370(13) | $232,768(30) | $17,751(51) |
| 27 | Oklahoma | $1,790,938 | $119,322(31) | $1,313,147(31) | $139,985(11) | $203,049(10) | $15,434(47) |
| 28 | Nevada | $1,791,700 | $117,833(29) | $1,296,758(29) | $141,115(12) | $226,171(23) | $9,822(4) |
| 29 | South Dakota | $1,799,612 | $117,833(29) | $1,296,758(29) | $152,936(21) | $220,834(22) | $11,251(18) |
| 30 | New Hampshire | $1,831,788 | $108,898(20) | $1,198,426(20) | $221,733(44) | $290,924(44) | $11,807(24) |
| 31 | Michigan | $1,837,060 | $121,184(32) | $1,333,633(32) | $157,172(24) | $214,885(18) | $10,186(8) |
| 32 | Delaware | $1,853,160 | $114,110(25) | $1,255,786(25) | $215,769(42) | $257,187(37) | $10,308(9) |
| 33 | Arizona | $1,957,342 | $131,422(35) | $1,446,305(35) | $150,179(18) | $218,321(21) | $11,115(15) |
| 34 | Utah | $1,962,625 | $127,513(34) | $1,403,285(34) | $149,138(17) | $266,526(38) | $16,163(48) |
| 35 | Maine | $2,034,058 | $131,980(36) | $1,452,451(36) | $222,747(46) | $216,338(20) | $10,541(11) |
| 36 | Wisconsin | $2,067,915 | $136,262(37) | $1,499,569(37) | $189,926(36) | $231,577(28) | $10,582(12) |
| 37 | Maryland | $2,070,151 | $126,582(33) | $1,393,042(33) | $215,452(41) | $321,977(51) | $13,098(34) |
| 38 | Illinois | $2,107,634 | $138,496(38) | $1,524,152(38) | $182,745(33) | $249,814(34) | $12,427(31) |
| 39 | California | $2,208,472 | $143,149(40) | $1,575,367(40) | $200,851(39) | $274,050(42) | $15,055(44) |
| 40 | Pennsylvania | $2,214,073 | $149,851(41) | $1,649,116(41) | $172,331(32) | $232,360(29) | $10,415(10) |
| 41 | New Jersey | $2,221,879 | $139,799(39) | $1,538,492(39) | $217,464(43) | $312,018(49) | $14,107(37) |
| 42 | Washington | $2,321,694 | $153,946(42) | $1,694,185(42) | $191,249(37) | $269,990(41) | $12,324(30) |
| 43 | Vermont | $2,409,483 | $161,578(43) | $1,778,177(43) | $222,497(45) | $235,857(31) | $11,373(19) |
| 44 | Minnesota | $2,491,247 | $166,418(46) | $1,831,441(46) | $210,731(40) | $268,052(40) | $14,606(40) |
| 45 | Hawaii | $2,492,217 | $165,301(44) | $1,819,149(44) | $188,119(35) | $305,686(47) | $13,962(36) |
| 46 | Alaska | $2,499,920 | $165,487(45) | $1,821,198(45) | $192,591(38) | $310,545(48) | $10,099(7) |
| 47 | Rhode Island | $2,681,967 | $179,821(47) | $1,978,939(47) | $259,073(49) | $249,055(33) | $15,079(45) |
| 48 | Massachusetts | $2,762,273 | $180,193(48) | $1,983,036(48) | $281,033(50) | $302,601(46) | $15,409(46) |
| 49 | District of Columbia | $2,813,525 | $186,150(49) | $2,048,591(49) | $248,089(48) | $316,808(50) | $13,887(35) |
| 50 | New York | $2,851,475 | $194,899(51) | $2,144,875(51) | $240,981(47) | $256,081(36) | $14,638(41) |
| 51 | Connecticut | $2,854,614 | $187,267(50) | $2,060,883(50) | $289,154(51) | $301,026(45) | $16,284(49) |
*1=Least Costly
Costs per Year| Overall Rank* | State | Total Cost per Smoker | Out-of-Pocket Cost (Rank) | Financial Opportunity Cost (Rank) | Health-Care Cost per Smoker (Rank) | Income Loss per Smoker (Rank) | Other Costs per Smoker (Rank) |
|---|---|---|---|---|---|---|---|
| 1 | Georgia | $27,390 | $1,712(2) | $18,839(2) | $2,361(4) | $4,238(19) | $239(28) |
| 2 | Missouri | $27,707 | $1,686(1) | $18,558(1) | $3,111(28) | $4,123(15) | $229(23) |
| 3 | North Carolina | $27,882 | $1,730(3) | $19,040(3) | $2,853(14) | $4,026(11) | $233(25) |
| 4 | Mississippi | $28,074 | $1,832(8) | $20,165(8) | $2,466(7) | $3,361(1) | $250(33) |
| 5 | South Carolina | $28,330 | $1,792(5) | $19,723(5) | $2,668(9) | $3,902(9) | $245(32) |
| 6 | Tennessee | $28,640 | $1,851(9) | $20,365(9) | $2,319(3) | $3,897(8) | $209(13) |
| 7 | Alabama | $28,757 | $1,865(10) | $20,526(10) | $2,408(6) | $3,718(4) | $240(29) |
| 8 | North Dakota | $29,009 | $1,730(3) | $19,040(3) | $3,098(26) | $4,903(35) | $239(27) |
| 9 | Arkansas | $29,749 | $1,967(13) | $21,651(13) | $2,398(5) | $3,505(2) | $228(22) |
| 10 | Wyoming | $29,978 | $1,814(6) | $19,964(6) | $3,102(27) | $4,875(32) | $224(20) |
| 11 | Idaho | $30,383 | $1,931(11) | $21,249(11) | $2,905(15) | $4,079(14) | $219(16) |
| 12 | Virginia | $30,469 | $1,818(7) | $20,004(7) | $2,920(16) | $5,501(43) | $226(21) |
| 13 | Kentucky | $30,485 | $2,022(16) | $22,253(16) | $2,296(1) | $3,723(5) | $190(3) |
| 14 | Louisiana | $30,833 | $2,040(17) | $22,454(17) | $2,307(2) | $3,737(6) | $295(43) |
| 15 | Indiana | $31,137 | $2,008(15) | $22,093(15) | $2,669(10) | $4,175(16) | $194(5) |
| 16 | Nebraska | $31,708 | $1,938(12) | $21,329(12) | $3,625(34) | $4,534(27) | $281(38) |
| 17 | West Virginia | $31,807 | $2,121(19) | $23,338(19) | $2,655(8) | $3,525(3) | $168(1) |
| 18 | Oregon | $32,483 | $2,062(18) | $22,695(18) | $3,042(23) | $4,490(25) | $195(6) |
| 19 | Colorado | $32,504 | $1,989(14) | $21,892(14) | $3,095(25) | $5,237(39) | $292(42) |
| 20 | Kansas | $33,364 | $2,139(21) | $23,539(21) | $2,966(19) | $4,438(24) | $282(39) |
| 21 | Florida | $33,808 | $2,172(22) | $23,900(22) | $3,321(31) | $4,071(13) | $345(50) |
| 22 | Montana | $33,860 | $2,197(23) | $24,181(23) | $3,183(30) | $4,064(12) | $234(26) |
| 23 | Ohio | $34,300 | $2,245(26) | $24,704(26) | $2,979(20) | $4,193(17) | $179(2) |
| 24 | New Mexico | $34,427 | $2,285(28) | $25,145(28) | $3,039(22) | $3,737(7) | $221(17) |
| 25 | Iowa | $34,660 | $2,230(24) | $24,543(24) | $3,145(29) | $4,526(26) | $217(14) |
| 26 | Texas | $34,871 | $2,263(27) | $24,904(27) | $2,792(13) | $4,564(30) | $348(51) |
| 27 | Oklahoma | $35,116 | $2,340(31) | $25,748(31) | $2,745(11) | $3,981(10) | $303(47) |
| 28 | Nevada | $35,131 | $2,310(29) | $25,427(29) | $2,767(12) | $4,435(23) | $193(4) |
| 29 | South Dakota | $35,287 | $2,310(29) | $25,427(29) | $2,999(21) | $4,330(22) | $221(18) |
| 30 | New Hampshire | $35,917 | $2,135(20) | $23,499(20) | $4,348(44) | $5,704(44) | $232(24) |
| 31 | Michigan | $36,021 | $2,376(32) | $26,150(32) | $3,082(24) | $4,213(18) | $200(8) |
| 32 | Delaware | $36,336 | $2,237(25) | $24,623(25) | $4,231(42) | $5,043(37) | $202(9) |
| 33 | Arizona | $38,379 | $2,577(35) | $28,359(35) | $2,945(18) | $4,281(21) | $218(15) |
| 34 | Utah | $38,483 | $2,500(34) | $27,515(34) | $2,924(17) | $5,226(38) | $317(48) |
| 35 | Maine | $39,883 | $2,588(36) | $28,479(36) | $4,368(46) | $4,242(20) | $207(11) |
| 36 | Wisconsin | $40,547 | $2,672(37) | $29,403(37) | $3,724(36) | $4,541(28) | $207(12) |
| 37 | Maryland | $40,591 | $2,482(33) | $27,315(33) | $4,225(41) | $6,313(51) | $257(34) |
| 38 | Illinois | $41,326 | $2,716(38) | $29,885(38) | $3,583(33) | $4,898(34) | $244(31) |
| 39 | California | $43,303 | $2,807(40) | $30,890(40) | $3,938(39) | $5,374(42) | $295(44) |
| 40 | Pennsylvania | $43,413 | $2,938(41) | $32,336(41) | $3,379(32) | $4,556(29) | $204(10) |
| 41 | New Jersey | $43,566 | $2,741(39) | $30,167(39) | $4,264(43) | $6,118(49) | $277(37) |
| 42 | Washington | $45,523 | $3,019(42) | $33,219(42) | $3,750(37) | $5,294(41) | $242(30) |
| 43 | Vermont | $47,245 | $3,168(43) | $34,866(43) | $4,363(45) | $4,625(31) | $223(19) |
| 44 | Minnesota | $48,848 | $3,263(46) | $35,911(46) | $4,132(40) | $5,256(40) | $286(40) |
| 45 | Hawaii | $48,867 | $3,241(44) | $35,670(44) | $3,689(35) | $5,994(47) | $274(36) |
| 46 | Alaska | $49,018 | $3,245(45) | $35,710(45) | $3,776(38) | $6,089(48) | $198(7) |
| 47 | Rhode Island | $52,588 | $3,526(47) | $38,803(47) | $5,080(49) | $4,883(33) | $296(45) |
| 48 | Massachusetts | $54,162 | $3,533(48) | $38,883(48) | $5,510(50) | $5,933(46) | $302(46) |
| 49 | District of Columbia | $55,167 | $3,650(49) | $40,168(49) | $4,864(48) | $6,212(50) | $272(35) |
| 50 | New York | $55,911 | $3,822(51) | $42,056(51) | $4,725(47) | $5,021(36) | $287(41) |
| 51 | Connecticut | $55,973 | $3,672(50) | $40,409(50) | $5,670(51) | $5,902(45) | $319(49) |
*1=Least Costly
Ask the Experts
Many studies show that smoking can have significant negative physical and financial effects. To advance the discussion, we asked a panel of experts to share their insight regarding smoking-cessation programs, e-cigarettes and other smoking-related concerns. Click on the experts’ profiles to read their bios and responses to the following key questions:
- What are the most effective strategies for people trying to quit smoking? What approaches typically fail?
- Should e-cigarettes be regulated and taxed as cigarettes or as medical devices?
- How might marijuana legalization affect tobacco use?
- How can state and local authorities encourage people to quit smoking? Is there a role for employers? Health insurance companies?
John G. Spangler Professor, Wake Forest University
Joseph G. L. Lee Ph.D., MPH – Assistant Professor, Department of Health Education & Promotion, College of Health & Human Performance, Affiliated Faculty, Center for Health Disparities, Brody School of Medicine, East Carolina University
John G. Spangler Professor, Wake Forest University
Joseph G. L. Lee Ph.D., MPH – Assistant Professor, Department of Health Education & Promotion, College of Health & Human Performance, Affiliated Faculty, Center for Health Disparities, Brody School of Medicine, East Carolina UniversityIn order to assess the impact of tobacco use on a smoker’s finances both over a lifetime and in a single year, WalletHub calculated the potential monetary losses — including the cumulative cost of a cigarette pack per day over several decades, health-care expenditures, income losses and other costs — brought on by smoking and exposure to secondhand smoke.
For our calculations, we assumed an adult who smokes one pack of cigarettes per day beginning at age 18, when a person can legally purchase tobacco products in the U.S. We also assumed a lifespan of 51 more years, taking into account that 69 is the average age at which a smoker dies.
Out-of-Pocket CostsTo determine per-person Out-of-Pocket Costs Over a Lifetime, we took the average cost of a pack of cigarettes in each state and multiplied that figure by the total number of days in 51 years. For Costs per Year, we multiplied the average cost by 365 days.
Financial Opportunity CostTo determine the per-person Financial Opportunity Cost, we calculated the amount of return a person would have earned by instead investing that money in the stock market over the same period. We used the historical average market return rate for the S&P 500 minus the inflation rate during the same time period to reflect the return in present-value terms.
Health-Care Cost per SmokerDirect medical costs to treat smoking-connected health complications are one of the biggest financial drains caused by tobacco use. To calculate related health-care costs, we obtained state-level data from the Centers for Disease Control and Prevention — namely the annual health care costs caused by smoking — and divided that amount by the total number of adult smokers in each state.
Income Loss per SmokerPrevious studies have shown that smoking can lead to loss of income, either because of absenteeism, workplace bias or lower productivity due to smoking-related health problems. This can create a wage gap between smokers and nonsmokers. To represent the negative relationship between earnings and smoking, we assumed an average 8 percent decrease in the median household income for each state. We arrived at this figure after a recent study from the Federal Reserve Bank of Atlanta found that smokers earn 20 percent less than nonsmokers, 8 percent of which is attributed to smoking and 12 percent to other factors.
Other Costs per SmokerNonsmokers are generally entitled to a homeowner’s insurance credit of between 5 and 15 percent, according to the Independent Insurance Agents & Brokers of America. Given that fact, we assumed an 11.1 percent increase (i.e. the inverse of a 10 percent credit, or the average between the two percentages) in the average homeowner’s insurance premium for each state to represent the penalty cost for smokers.
We then took into account the costs for victims of secondhand-smoke exposure. To calculate these costs, we used the per-nonsmoker expenditure in the state of New York as a proxy. We then multiplied that figure by the number of nonsmokers in each state to obtain the total costs of exposure to secondhand smoke at the state level. Finally, we divided the resulting total by the number of smokers in each state. This approach assumes that, in a perfect society, smokers would also pay the costs related to the harmful smoke that tobacco releases into the air.
Formula for Financial Cost of SmokingFinancial Cost of Smoking = Out-of-Pocket Costs + Financial Opportunity Cost + Related Health-Care Costs + Income Loss Due to Smoking-Related Issues + Increase in Homeowner's Insurance Premium + Secondhand Smoke-Exposure Costs.
Sources: Data used to create this ranking were collected from the U.S. Census Bureau, Bureau of Labor Statistics, Centers for Disease Control and Prevention, Insurance Information Institute, Campaign for Tobacco-Free Kids, NYsmokefree.com, Federal Reserve Economic Data (FRED), Kaiser Family Foundation and the Independent Insurance Agents & Brokers of America.
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