California tobacco control measures 'cut healthcare costs by $134bn'

In collaboration with the Press Association

Tobacco control measures in California have saved $134 billion (£86 billion) in healthcare costs.

Over almost 20 years the state scheme has helped reduce cigarette sales by around 6.8 billion packs, worth $28.5 billion to cigarette companies, according to a study published in the journal PLOS ONE.

Smoking became less widespread and the average number of cigarettes people smoked also fell as a result of the measures.

Legislation called 'Proposition 99' was passed in California in 1988, and aimed to save lives and reduce healthcare costs.

A key focus was on changing social perceptions of smoking through a media campaign, backed up by community programmes with three key messages: that the tobacco industry lies; that nicotine is addictive; and that passive smoking kills.

Around two-thirds (64 per cent) of the healthcare cost savings were gained from established smokers smoking fewer cigarettes, while the remainder (36 per cent) of the savings were due to the reduction in the number of smokers.

"Our research shows that large scale aggressive tobacco control programmes not only save lives, but make an important contribution to healthcare cost containment," said senior author Professor Stanton Glantz, from the University of California San Francisco Centre for Tobacco Control Research and Education.

Researchers compared smoking and healthcare costs in California with 38 other states that did not have significant state tobacco control programmes or cigarette tax increases before 2000.

The smoking-related health care costs included both the short- and long-term direct effects on smokers and the effects of second- and third-hand smoke exposure to non-smokers.

Robin Hewings, Cancer Research UK’s tobacco policy manager, said: “This is a timely reminder that Government action is a hugely effective and necessary weapon against the deadly effects of tobacco. Such action not only saves lives, but it results in major health care cost savings too.

“We urge the Government to keep this in mind as it decides whether to support our call for plain standard cigarette packs to protect young people from tobacco marketing.”

Copyright Press Association 2013


  • Lightwood J., Glantz S.A. & Fielding R. (2013). The Effect of the California Tobacco Control Program on Smoking Prevalence, Cigarette Consumption, and Healthcare Costs: 1989–2008, PLoS ONE, 8 (2) e47145. DOI: