California’s Anti-Smoking Push Spurs Big Savings on Health Costs

For Every Dollar Spent, the State Has Seen a $231 Return

By Laura Kurtzman | | March 16, 2023

cigarette illustration

In the late 1980s, when smoking was still allowed on some airline flights, California boosted its tax on cigarettes from 10 to 35 cents a pack, devoting 5 cents to programs to prevent smoking.

The newly created California Tobacco Control Program funded anti-tobacco media campaigns and community programs to try to improve public health, but some questioned whether the efforts were worth the cost.

Now comes an answer: For every dollar California spent on smoking control, health care costs fell by $231.

Over three decades that witnessed historic lawsuits and expanding smoking bans, California’s smoking population fell from 21.8% in 1989 to 10% in 2019. Its anti-tobacco program accounted for 2.7 of those percentage points, which may seem small but yielded large savings. Those who didn’t quit ended up cutting back by an average of 119 packs per year in response to the program, according to the study, which appears March 16 in PLoS One.

Senior author Stanton Glantz, PhD, the recently retired founding director of the UCSF Center for Tobacco Control Research and Education, summed up the findings this way: “Tobacco control programs save a fortune.”

Over the 30-year history of the program, Californians pocketed $51.4 billion they would otherwise have spent on cigarettes. Total health care savings came to $816 billion.

“The return on investment is gigantic,” Glantz said. “These programs aren’t just saving lives and making people feel better, they’re also saving people money.”