ANN ARBOR—Smoking costs employers billions of dollars in lost productivity and medical expenses. But if employees quit smoking, how long do the cost savings take? Nearly twice as long for former smokers with arthritis, allergies or back pain as for those without these chronic conditions, according to the University of Michigan Health Management Research Center.

“It took about five years for former smokers without chronic conditions and nearly 10 years for former smokers with chronic conditions to reduce their medical charges to levels close to those of never-smokers,” HMRC senior research analyst Shirley Musich reports in the November/December American Journal of Health Promotion.

The study looked at 20,332 General Motors Corp. employees and spouses who completed a Health Risk Appraisal in 1996. They were categorized according to 1996 self-reported smoking status into subgroups that included current smokers, former smokers sorted by the number of years since quitting, and non-smokers. The study examined average medical expenses from 1996 to 1999, comparing the 11,921 who reported arthritis, allergies or back pain with the 8,411 without these conditions.

People who had never smoked and had no chronic conditions had the lowest medical costs—about $2,200. Smokers without chronic conditions averaged $2,600. Among those with chronic conditions, current and former smokers cost in the $4,000 range, about $1,000 higher than persons with chronic conditions who had never smoked.

“Studies of smoking cessation effectiveness have often focused on people with pre-existing risks for heart disease, stroke and cancer,” Musich said. “Little attention has been given to the presence of chronic conditions such as arthritis, allergies or back pain. But cigarette smoking has been increasingly shown to be a risk factor for both the incidence and severity of these conditions.”

Numerous studies reaffirm that medical expenses decrease after people quit smoking, eventually reaching similar levels similar to those who have never smoked, HMRC Director Dee Edington said.

But Musich’s study is the first to address the time frame for the decrease in medical utilization or costs among those with chronic diseases.

“Smoking cessation is a cost effective way to reduce medical costs” Edington said. “But in companies where a large proportion of employees report arthritis, allergies or back pain, the savings will occur over a longer time frame.”

“Programs and strategies to help people quit smoking have typically focused on preventing heart disease, stroke and cancer,” Musich said. “The study shows why smoking cessation should also be promoted to those suffering from or at risk for arthritis, allergies or back pain. These programs can be a strategy for managing or preventing these conditions and providing medical savings and productivity gains for the organization.”

For further information smusich@umich.edu