Smoking takes heaviest financial toll in Northeast, least in the South

Comment Print
Related Articles

With the economic and societal costs of smoking totaling more than $600 billion per year, the personal-finance website WalletHub today released its report on The Real Cost of Smoking by State, as well as expert commentary.

To encourage the estimated 34.2 million tobacco users in the U.S. to kick this dangerous habit, WalletHub calculated the potential monetary losses - including the lifetime and annual costs of a cigarette pack per day, health care expenditures, income losses and other costs - brought on by smoking and exposure to secondhand smoke.

States with the Lowest Smoking Costs States with the Highest Smoking Costs
1. Missouri 42. Washington
2. Mississippi 43. Minnesota
3. Georgia 44. Alaska
4. North Carolina 45. Hawaii
5. Alabama 46. Maryland
6. Kentucky 47. Rhode Island
7. Louisiana 48. Massachusetts
8. South Carolina 49. New York
9. Tennessee 50. Connecticut
10. Idaho 51. District of Columbia

Key Stats

  • The estimated financial cost of smoking over a lifetime is just above $2.8 million per smoker.
  • The average out-of-pocket cost per smoker is $147,408 over a lifetime. Smokers in New York will pay the highest cost, $209,539, which is two times higher than in Missouri, where smokers will pay the lowest cost at $107,047.
  • Each smoker will incur an average of $561,990 in income loss over a lifetime. Smokers in the District of Columbia will lose the highest amount, $784,875, which is two times higher than in Mississippi, where smokers will lose the lowest amount at $401,855.
  • Each smoker will incur an average of $188,869 in smoking-related health-care costs over a lifetime. Smokers in the District of Columbia will pay the highest amount, $332,526, which is 2.8 times higher than in Arkansas, where smokers will pay the lowest amount at $117,476.

To view the full report and your state or the District's rank, please visit:

Expert Commentary

What are the most effective strategies for individuals trying to quit smoking? What approaches typically fail?

"People who want to quit smoking have more ways than ever to get support. State quit lines and digital quit smoking programs like or BecomeAnEX offer free and readily available online information, individual and community support, and text messaging support programs. Nicotine replacement therapy is available over the counter and combining nicotine patches and nicotine lozenges or gum is particularly effective. Very effective prescription medications, such as varenicline, are also a good option to consider. The key is to keep trying until a quit attempt sticks. Be clear about why you are quitting, tell people you care about that you are quitting, and plan ahead for how you will handle times when you are craving. For people who drink alcohol, consider avoiding drinking for 2-4 weeks while you quit smoking and if you do drink, make sure to limit how much you drink and drink only when you are with people who support your smoking quitting. Finally, although people quitting smoking often experience some irritability and moodiness initially, after completely avoiding smoking for a month or more, people report less stress and depression on average compared to before they quit. Remind yourself that quitting smoking can have both physical and mental health benefits."
Christopher W. Kahler, Ph.D. - Professor and Chair, Department of Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, Brown University

"There are a variety of nicotine replacement therapy products available over-the-counter (without a doctor's prescription), such as gums, lozenges, and patches. There are also prescription options available, like bupropion (Zyban) and varenicline. Using a combination of NRT (a patch and an oral product) can help curb cravings. It is important to remember that slips happen, and the occasional cigarette smoked is okay. Quitting smoking can be incredibly challenging, and it takes time for it to stick. The least effective (and yet most common) way of quitting is cold turkey. Remember that it is not the nicotine that is harmful, it is the smoke that accompanies it, so NRTs are safe and effective in replacing the nicotine that you are used to in cigarettes."
Clifford E. Douglas, J.D. - Director, Tobacco Research Network; Adjunct Professor, University of Michigan

How can state and local authorities encourage people to quit smoking? Is there a role for employers? Health insurance companies?

"Clear and accurate education, combined with effective incentives and support, are useful in encouraging quitting. Employers and state and local authorities should ensure coverage of a variety of nicotine replacement therapies to help people looking to quit find a product that works for them. The FDA has approved a variety of nicotine replacement therapies as medicinal aids for quitting. Every state offers a free telephone quit line (call 1-800-QUIT-NOW), which is effective and easy to use. The FDA has also begun to authorize a variety of e-cigarettes and other non-medicinal nicotine products, which can be enormously helpful to adults who smoke and either cannot or will not otherwise quit smoking. In addition to e-cigarettes, those seeking to stop combustible tobacco product use can also turn to alternatives such as nicotine pouches and snus, which, like e-cigarettes, pose much less risk than continued smoking. Supporting those who decide to switch to such a product can be crucial to their success."
Clifford E. Douglas, J.D. - Director, Tobacco Research Network; Adjunct Professor, University of Michigan

"The more opportunities and encouragement to quit the better. Campaigns, incentives, access to quit lines, and insurance coverage of cessation products are all options, each with evidence of effectiveness. For example, Medicaid cessation coverage is associated with increased quitting."
Julie Williams Merten, Ph.D., MCHES - Associate Professor, University of North Florida, in collaboration with Jessica King Jensen, Ph.D. - Assistant Professor, University of Utah

Should e-cigarettes be regulated and taxed as cigarettes or as medical devices?

"As e-cigarettes are currently considered a tobacco product under FDA regulatory action, I believe they should be taxed similarly to cigarettes/other tobacco products. Should e-cigarettes wish to be considered as an approved and evidence-based tobacco cessation device, then these companies should focus on providing compelling evidence to support this effort. The continued availability and appeal of these products to youth is alarming and should be the priority in decision-making surrounding the public health threat."
Melinda J. Ickes, Ph.D. - Associate Professor; Director of Graduate Studies, University of Kentucky, Department of Kinesiology and Health Promotion

"Most agree that e-cigarettes should be regulated and taxed but not at the same level as cigarettes (harm reduction)...Several studies show that when e-cigarettes have restrictions as or more stringent than cigarettes, cigarette rates increase. Several countries regulate as medical devices, and there are certainly distinctions in rates of use between the US and those countries, but that could be due to differences in marketing and the products themselves. Australia and England are examples of this."
Julie Williams Merten, Ph.D., MCHES - Associate Professor, University of North Florida, in collaboration with Jessica King Jensen, Ph.D. - Assistant Professor, University of Utah

Read more from:
Comment Print
Powered by Bondware
News Publishing Software

The browser you are using is outdated!

You may not be getting all you can out of your browsing experience
and may be open to security risks!

Consider upgrading to the latest version of your browser or choose on below: