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Smoking or obesity: Which costs health plans more?

Christian Schappel
by Christian Schappel
April 11, 2012
2 minute read
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When it comes to wellness programs, the two biggest goals have always been: a) Get employees to lose weight, and b) get them to stop smoking. But a recent study gives employers a better idea of what their No. 1 wellness focus should be.
Researchers at the Mayo Clinic in Rochester, MN, set out to find which was associated with high healthcare costs — smoking or obesity.
The study, which was published in the March Journal of Occupational and Environmental Medicine, the official publication of the American College of Occupational and Environmental Medicine, analyzed the costs of smoking and obesity among 25,022 Mayo Clinic employees and 5,507 retirees between 2001 and 2007.
Healthcare costs were defined as the sum of the expenses incurred by the patient and health plan combined. They were calculated using medical and pharmacy claims data.
Result? Obesity was found to be the costliest by far.
The cost breakdown for smokers v. non-smokers:

  • Compared to non-smokers, the average cost of healthcare for employees who smoked was $1,274 higher, and
  • The cost of care for retirees who smoked was $1,401 higher than for those who didn’t smoke.

The cost breakdown for those with a normal body mass index v. obese individuals:

  • Compared to those with a normal BMI, obese workers generated $1,850 more in healthcare costs
  • Workers classified as morbidly obese I generated $3,086 more
  • Workers classified as morbidly obese II generated $5,530 more
  • Retirees classified as morbidly obese I generated $2,907 more in healthcare costs than non-obese retirees, and
  • Retirees classified as morbidly obese II generated $5,467 more.

The numbers are clear. Obesity can cost more — a lot more — than smoking. And healthcare costs go up exponentially the heavier plan participants are.
The researchers also pointed out that their findings were consistent with numerous previous studies.
Source: “The effects of Incremental Costs of Smoking and Obesity on Health Care Costs Among Adults: A 7-Year Longitudinal Study,” Journal of Occupational and Environmental Medicine, March 2012.

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