In Vermont the annual direct costs to the economy attributable to smoking were in excess of $652 million, including workplace productivity losses of $138 million, premature death losses of approximately $221 million, and direct medical expenditures of $293 million, according to a new study by the American Lung Association.While the retail price of a pack of cigarettes in Vermont is on average $6.54 ($5.60 New Hampshire; $7.89 New York; $7.23 Massachusetts), the combined medical costs and productivity losses attributable to each pack of cigarettes sold are approximately $24.52 per pack of cigarettes. The ratio of benefits to cost varies from $0.90 to $2.62 saved per dollar spent on smoking cessation programs, depending upon the type of intervention. Nicotine replacement therapies, generic bupropion and varenicline showed substantial benefits to costs from the societal perspective across the sensitivity ranges used for treatment effectiveness. Only brand name bupropion did not have a positive benefits to cost ratio at the low end of the range.The American Lung Association concludes that for most smoking cessation treatments, the benefits of smoking cessation programs statewide greatly outweigh the cost to implement them. The study was conducted by Pennsylvania State University. The report’s Executive Summary says in part:”Cigarette smoking is the single leading cause of preventable disease and preventable death in the United States (US), leading to more than 400,000 deaths annually. The CDC and the U.S. Department of Health and Human Services have both issued guidelines on smoking cessation to help people to quit smoking that include: access to counseling, access to all FDA-approved over-the-counter and prescription medications; multiple quit attempts; and reduced or eliminated co-pays. However, access to these aids is limited since many payers do not cover these treatments. The objective of this study was to determine whether the cost of making such smoking cessation programs available at the state level could be justified by the benefits.”We performed a cost-benefit analysis of access to smoking cessation programs using a societal perspective using state specific data. Smoking cessation programs based on three treatment alternatives were studied: nicotine replacement therapy (NRT), bupropion, and varenicline. Each approach was evaluated with and without individual counseling. Benefits were estimated as reductions in medical expenditures, premature deaths and increased workplace productivity. Costs were estimated as direct cost of the smoking cessation programs, the lost tax revenue to the public sector and the lost revenue to retailers and distributors, since smokers who quit will no longer purchase cigarettes. Other model parameters included how many smokers take advantage of the programs and the programs’ effectiveness in helping smokers to quit. The cost-benefit model was parameterized using data from CDC, and various national surveys, including the Behavioral Risk Factors Surveillance Survey and the Current Population Survey.”Source: American Lung Association. 9.16.2010 Detailed results and the full report can be found here: REPORT.