California’s Tobacco Control Program Saved $814 Billion in Health Care Costs

Preventing tobacco use has saved Californians billions, according to recent research.

A recent study updated what is known about the impact of California’s smoking control program, finding that for every dollar expended, health care costs fell by $231.

The California Tobacco Control Program (CTCP) was created in 1988 when voters increased the tobacco tax from 10 to 35 cents a pack, and allocated 20% of the proceeds to fund it.

The CTCP uses an integrated approach to tobacco use and prevention.

Previous research used data through 2008 to estimate a model for the effect of the tax, using cumulative real per capita tobacco control expenditure to predict smoking behavior. This study, published in PLoS One, updates a predictive model using the most recently available data and estimates the effect of the CTCP program through 2019.

Since the tax increase, California’s smoking population fell from 21.8% in 1989 to 10% in 2019, with the program accounting for 2.7 of those percentage points.

Even those who did not quite smoking entirely still reduced their habit, cutting back by an average of 119 packs per year because of the higher taxes, the study said.

Overall, Californians kept $51.4 billion they would otherwise have spent on cigarettes. Total health care savings came to $816 billion.

The cost of the CTCP program was $3.5 billion.


Lightwood JM, Anderson S, Glantz SA. Smoking and healthcare expenditure reductions associated with the California Tobacco Control Program, 1989 to 2019: a predictive validation. PLoS One. Published online March 16, 2023. doi:10.1371/journal.pone.0263579

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