TABLE 2.

External, Quasi-External, and Private Costs per Cigarette Pack for US Smoker Aged 24 Years Over a Lifetime

Private Costs Confined to Smokers		Quasi-External Costs Imposed by Smokers on Household Members		External Costs Imposed by Smoking on Societya
Cause	Cost, $	Cause	Cost, $	Cause	Cost, $
Mortality cost	20.28	Spousal mortality + infant deathb	5.34	Work loss (sick leave)	0.76
Medical care cost	0.24	Medical expenditures	0.14	Medical care cost not borne by smoker	0.49
Disability cost	3.44	Spouse disability cost	0.25	Productivity losses	0.24
Social Security outlays lost	1.01	Social Security survivor benefitsc	−0.17	Social Security outlaysc	−0.84
Private pension outlays foregone	1.36	Private pension spouse benefitsc	−0.12	Private pension outlaysc	−1.24
Life insurance outlays avoidedc	−1.78			Life insurance outlays	1.78
Social Security taxable earnings foregoned	5.10			Income taxes on foregone Social Security taxable earningsd	1.02
Cost of cigarettese	3.12
Total	32.78	Total	5.44	Total	2.20

Note. Traditional economic calculations call for excise taxes to offset negative externalities and quasi-externalities of tobacco use. Negative externalities are the harm that private actions cause society and quasi-externalities are the harm caused to immediate family members. The traditional approach recognizes private costs to smokers, but these are not corrected by taxes because they are assumed to reflect smokers' personal preferences rather than an unsuccessful history of quitting. Calculations are in year 2000 dollars.

Source. Adapted from Sloan et al, 2004.¹⁴

^aExternal costs are liminted to effects outside households. After subtracting per-pack federal excise taxes ($0.40) and state excise taxes ($0.36), net external costs are $1.44.

^bSpousal mortality costs = $5.20; infant death costs = $0.14.

^cThe negative values result from earlier deaths of smokers.

^dEarlier deaths result in foregone Social Security earnings, but also imply foregone taxes on those earnings.

^eTaxes per pack over the lifetime of a 24-year-old smoker, calculated in year 2000 dollars and assuming that tax rates stayed constant after 2002, are $0.40 and $0.36 for federal and state excise taxes, respectively.