Maternal Smoking Linked to Higher Medical Expenses

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MATERNAL SMOKING LINKED TO HIGHER MEDICAL EXPENSES FOR YOUNG CHILDREN University of Wisconsin study documents costs

MADISON -- A research team at the University of Wisconsin-Madison has, for the first time, documented differences in medical expenses for children whose mothers smoke compared to those whose mothers donπt.

For children under six years of age, the researchers estimate that exposure to maternal smoking nearly doubles respiratory-related health spending. The nation as a whole spends an estimated $661 million (in 1995 dollars) annually for treatment of young childrenπs respiratory illness attributable to their mothersπ smoking. That figure represents 19 percent of all health expenses for childhood respiratory conditions.

The study, by assistant professor of pediatrics and preventive medicine Dr. Jeffrey Stoddard of the UW Medical School and Bradley Gray of the UW-Madison economics department, is published in the current issue of the "American Journal of Public Health".

Stoddard and Gray analyzed information from the 1987 National Medical Expenditure Survey (NMES), which was designed to estimate use and expense for health services by the U.S. population. The UW researchers analyzed a subsample of 2,624 children age 5 and under because those children are most likely to be exposed to parental smoking and are therefore at highest risk for respiratory illness associated with environmental tobacco smoke.

After controlling for a number of factors -- including childπs age, gender, race or ethnicity, census region of residence, urban vs. rural residence, income, childπs health insurance type, maternal education and family size -- the UW researchers estimate maternal smoking to be associated with an average of $120 a year per child in increased health expenditures for children 5 and under. The average increase is $175 a year for children age 2 and under.

≥We know from previous studies that exposure to tobacco smoke in the environment contributes to respiratory problems among children,≤ said Stoddard, who is also a pediatrician at UW Childrenπs Hospital. ≥Our study is a fairly conservative estimate of how much individuals and the nation as a whole are spending on respiratory care for children whose mothers smoke.≤

The expenses analyzed in the paper include hospital care, outpatient services, emergency department care, doctor services and prescription medicines for childhood illnesses when a respiratory problem was diagnosed.

Paternal smoking information was not included in the paper because smoking status was not ascertained in nearly 35 percent of the sample, and researchers believed such a high non-response rate might introduce bias.

≥Given the magnitude of these costs,≤ the authors say, ≥it would seem prudent for administrators of health plans and managed care organizations to consider the economic benefits of providing smoking prevention and cessation services for teens and young women.≤

Spending on respiratory conditions is the third largest contributor to childhood medical expenditures, according to researchers at the National Public Services Research Institute.

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