The Financial Costs of Smoking Tobacco

Tobacco use in the United States contributes to approximately 480,000 deaths every year. To put this into perspective, 480,000 is more than three times the average number of U.S. citizens who die from a stroke on an annual basis. And this statistic just accounts for those who actually die. Smoking can ruin your health and your life long before ending it. A 2019 report from the CDC states that, “More than 16 million Americans are living with a disease caused by smoking.”

Direct Costs of Smoking

On top of the negative impacts on your physical health, smoking is also not good for your financial health.


The average cost of a pack of cigarettes in the United States is approximately $6.

There are 20 cigarettes in one pack, so a moderate-to-heavy smoker who smokes 10 cigarettes per day can expect to spend about $90 per month, or $1,080 per year. That’s enough money to buy groceries for a family of four for over a month. Even someone who only smokes one cigarette per day stands to lose more than $100 over the course of a year.

There are many online calculators that allow you to find out how much you would save by quitting smoking based on your individual smoking habits.

Cigars, Little Cigars, and Cigarillos

Cigarettes are not the only popular means of ingesting nicotine. Cigars, little cigars, and cigarillos are a few more problematic good ol’ boys in that realm.

Cigar: A cigar is tobacco wrapped in another tobacco product, usually tobacco leaves.

Little cigar: Like regular cigars, little cigars are wrapped in tobacco products. However, this is usually paper that contains tobacco leaf. As the name implies, little cigars are slimmer and shorter than regular cigars; they also often have filters, which is uncommon in regular cigars.

Cigarillos: Cigarillos are short, narrow cigars.

There is a common myth that these options are healthier than cigarettes, but they still pose serious health risks. The cigar-related health risks are largely very similar to those posed by cigarettes, including:

  • Cancer;
  • Gum disease;
  • Heart disease;
  • Lung disease.

Cheaper cigars cost about $2 per cigar, while well-branded, handcrafted cigars are often more in the ballpark of $5 to $8 at the lower end. Therefore, a daily cigar smoker might spend anywhere from $730 to over $3,000 per year on their habit.

Little cigars are often much cheaper, commonly selling for as little as $1. This, in addition to the fact that they are usually wrapped individually, is thought to make them particularly appealing to younger buyers.

Cigarillos are priced similarly to little cigars.

Health Care Costs of Smoking

As you might expect due to the amount of illness caused by cigarette smoking, the most significant financial toll comes from the associated healthcare costs.

Smoking is a problem that is far from confined to the United States. According to the CDC, worldwide smoking causes over 7 million deaths every year. Considering that the cost of smoking in the form of healthcare and loss of productivity is over $300 billion per year just in the United States, the worldwide economic impact is astronomical.

Increased Risk of Chronic Illness

Long-term smokers are at risk of many illnesses, including the following, serious conditions:

  • Lung cancer;
  • Coronary heart disease;
  • Stroke;
  • Liver cancer;
  • Emphysema;
  • Chronic bronchitis;
  • Pneumonia.

Medical Procedure Costs

There are many procedures and medications associated with the treatment of illnesses caused by smoking, and these are often expensive. Below are just a few examples.

Alteplase (medication);
Illness: Stroke;
Estimated Cost: $6,400 (100 mg as of 2014);

Amoxicillin (medication);
Illness: Pneumonia;
Estimated Cost: $16.00 (per bottle);

Cabozantinib-S-Malate (medication);
Illness: Liver cancer;
Estimated Cost: $21,000 (20 mg, 30 tablets);

Carotid Endarterectomy (procedure);
Illness: Stroke;
Estimated Cost: $15,000;

Radiation Therapy (procedure);
Illness: Lung cancer;
Estimated Cost: $7,500 to $11,100 (one course);

Cisplatin (medication);
Illness: Lung cancer;
Estimated Cost: $430 (one injection);

Clopidogrel (medication);
Illness: Heart disease;
Estimated Cost: $14.00 (75 mg, 30 tablets);

Coronary Angioplasty (procedure);
Illness: Heart disease;
Estimated Cost: $5,516;

Heart Bypass Surgery (procedure);
Illness: Heart disease;
Estimated Cost: $40,000;

Liver Transplant (procedure);
Illness: Liver cancer;
Estimated Cost: $577,100;

Lung Transplant (procedure);
Illness: Lung cancer;
Estimated Cost: $543,900;

Oxygen Therapy (symptom management tool);
Illness: Emphysema;
Estimated Cost: $200.00 (per month);

Pulmonary Rehabilitation (therapy);
Illness: Bronchitis;
Estimated Cost: $2,000;

Salbutamol (medication);
Illness: Emphysema;
Estimated Cost: $60.00 (per refill);

Stroke Rehabilitation (therapy);
Illness: Stroke;
Estimated Cost: $12,000 per year;

Wedge Resection (procedure);
Illness: Lung cancer;
Estimated Cost: $51,487.

In addition to the costs of the actual medications, therapy, and procedures, there are many other hidden costs of care and/or hospitalization, such as those incurred by lab tests, X-rays, and in-patient care.

Other Physical Costs of Smoking

Beyond the more serious diseases listed above, smoking can have many other serious repercussions on your physical wellbeing, including:

  • Persistent coughing;
  • Dulled senses of smell and taste;
  • Unhealthy teeth;
  • Poor vision;
  • Infertility;
  • Irregular blood clotting;
  • Wrinkly skin;
  • Loss of appetite;
  • Chronic obstructive pulmonary disease (COPD);
  • Anxiety and irritability.

Other Costs Involved in Smoking

Smoking can also make your insurance more expensive.

Life, Health, and Critical Illness Insurance

Health insurance often takes the worst blow. Because smoking poses so many significant health risks, a person’s status as a smoker often raises their health insurance premiums significantly.

On average, smokers can expect to pay 15% to 20% more for their health insurance payments. This, in addition to the health problems smoking causes, creates a domino effect of financial hardship for smokers. On top of all of this, people of lower socioeconomic status are more likely to be smokers. As such, it is not at all a reach to assume that smoking can contribute to the poverty cycle.

Home Insurance

The cost of buying a home is not a simple price tag; there are many underlying expenses that you might not expect. Homebuyers usually need to purchase mortgage insurance, and many factors can affect the insurance rate — including smoking.

Having a swimming pool, living near an ocean, or owning an older home are all risks commonly associated with higher home insurance rates. However, anything that poses a risk to the dwelling may cause rates to increase, and that includes fire risk. This is how smoking can negatively affect home insurance — in some cases, the risk of fire will increase your monthly payments by up to 20%.

Car Insurance

Risk-based rate increases function the same way when it comes to car insurance premiums; any unusually high chance of damage to the insured property will often result in higher rates. Because smoking also poses a fire damage risk to vehicles, smokers may experience higher car insurance rates.

Loss of Earnings/Loss of Job

Smokers miss more work than nonsmokers on average, both in the long and short term. In the short term, they often take more breaks during the workday, and in the long term, they are more likely to experience health consequences that result in them missing work.

In fact, according to a report from the National Center for Biotechnology Information, on average, smokers are absent from work 10.7 more days than other workers annually. This not only may result in lost wages during such absences, but also may result in poor standing in the workplace, which can cause smokers to miss out on raises and promotions — or lose their jobs entirely.

Societal Costs of Smoking

The cost of smoking goes far beyond the individual smoker.

The Health Care System

Beyond the personal healthcare costs associated with smoking-related illnesses, healthcare costs of assisting those with such illnesses are also often paid out by the state and federal government.

In addition to programs such as Medicaid, Medicare, and the VA, hospitals receive federal payments to offset the burden of uncompensated care. The estimated cost breakdown of annual smoking-related government healthcare expenditure is as follows:

  • Medicaid: $39.6 billion;
  • Medicare: $45.0 billion;
  • Other: $23.8 billion.

Secondhand Smoke

Smoking doesn’t just hurt the smoker. Exposure to secondhand smoke can also be very damaging to the health of others.

According to the CDC, approximately 2.5 million adults have died as a result of secondhand smoke since 1964. Secondhand smoke is also implicated in Sudden Infant Death Syndrome. In addition to mortal consequences, secondhand smoke can have many other health effects, such as asthma, respiratory infections, and ear infections.

Negative health effects caused by secondhand smoke are especially concerning with respect to children. There is no federal law barring smoking in a closed area with children present, and only a handful of states have laws against smoking in vehicles that children occupy. Meanwhile, children are largely unable to make the choice to avoid or vacate these areas, and therefore are forced to risk the associated health problems.

Environmental Impact

On an even larger scale, smoking can have a negative impact on the environment. This is largely due to tobacco farming. According to the World Health Organization, “Deforestation for tobacco growing has many serious environmental consequences —  including loss of biodiversity, soil erosion and degradation, water pollution and increases in atmospheric carbon dioxide.”

Resources for Quitting Smoking

The resources below are great catalogs of information and assistance for people who want to quit smoking.

Government Resources

Non-government Resources

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