HEALTH

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The Effects Of Obesity,
Smoking, And Drinking
On Medical Problems
And Costs
Obesity outranks both smoking and drinking in its deleterious effects on health and health costs. by Roland Sturm
ABSTRACT: This paper compares the effects of obesity, overweight, smoking, and problem drinking on health care use and health status based on national survey data. Obesity has roughly the same association with chronic health conditions as does twenty years’ aging; this greatly exceeds the associations of smoking or problem drinking. Utilization effects mirrors the health effects.
Obesity is associated with a 36 percent increase in inpatient and outpatient spending and a 77 percent increase in medications, compared with a 21 percent increase in inpatient and outpatient spending and a 28 percent increase in medications for current smokers and smaller effects for problem drinkers. Nevertheless, the latter two groups have received more consistent attention in recent decades in clinical practice and public health policy.

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a n y b e h a v i o r a l r i s k f a c t o r s , chief among them smoking, heavy drinking, and obesity, are known causes of chronic health conditions. Chronic health conditions, like cancer, diabetes, or heart disease, in turn are primary drivers of health care spending, disability, and death. This paper compares the associations of smoking, problem drinking, and obesity with health care use and chronic conditions. All three risk factors are prevalent, although only obesity has dramatically increased over the past twenty-five years. There is an extensive literature of the association of individual risk factors with selected clinical problems. Overall assessments are rare, however, and no direct comparisons of obesity and other risk factors have been reported. Obesity research is also a newcomer in