A peer-reviewed journal that offers evidence-based clinical information and continuing education for dentists.

Health Costs Are Tip of the Iceberg for Smokers

When counseling patients to quit smoking, dentists and other health professionals naturally stress the impact of nicotine on health.


When counseling patients to quit smoking, dentists and other health professionals naturally stress the impact of nicotine on health. However, a new study underscores the impact of also educating patients about the ramifications of smoking on their long-term financial well-being. According to an analysis of market and government data by the personal finance website WalletHub, health care costs related to smoking — though sizable — are tiny compared to the overall societal costs of tobacco use.1

Assuming someone begins smoking a pack a day at age 18 and continues until he or she dies at age 69 — the average lifespan of smokers in the United States — the total cost of their habit, including tobacco purchases, health care expenditures, insurance premiums, income losses, and other costs related to smoking, ranges between $1.4 million and $2.9 million, according to WalletHub’s calculations. Of this, only around 10% may be due to direct health care costs.1

Most oral health professionals already counsel patients to stop using tobacco due to its negative impact on health and oral health, in­cluding impaired healing, oral cancers, mucosal lesions,  gingival recession and periodontal disease. However, this latest analysis indicates it may also be helpful to speak about the esthetic and functional aspects of smoking, including tooth discoloration and tooth loss from smoking-related oral issues. According to American Dental Association (ADA) survey data, one in five adults experience anxiety due to the condition of their mouth and teeth, and about the same number report the appearance of their teeth affects their ability to interview for a job.2

Dentistry as a whole could improve the level of tobacco cessation education patients receive. Although the ADA and U.S. Centers for Disease Control and Prevention both offer free cessation materials,3,4 not all practices may be incorporating such counseling into daily care. According to the 2010 National Health Interview Survey, only 11.8% of smokers who visited the dentist said an oral health professional had advised them to quit.5

Improving outreach for tobacco cessation may not only save patients significant lifetime expenditures, it will also reduce costs to society as a whole — and that should have everyone smiling all the way to the bank.


  1. Wallethub.com. The real cost of smoking by state. Available at: wallethub.com/edu/the-financial-cost-of-smoking-by-state/9520/. Accessed February 19, 2019.
  2. American Dental Association Health Policy Institute. Oral Health and Well-being in the United States Fact Sheet. Available at: ada.org/~/media/ADA/Science%20and%20Research/HPI/OralHealthWell-Being-StateFacts/US-Oral-Health-Well-Being.pdf. Accessed February 19, 2019.
  3. American Dental Association. Oral Health Topics: Smoking and Tobacco Cessation. Available at: ada.org/en/member-center/oral-health-topics/smoking-and-tobacco-cessation. Accessed February 19, 2019.
  4. U.S. Centers for Disease Control and Prevention. Dental Professionals: Help Your Patients Quit Smoking. Available at: cdc.gov/tobacco/campaign/tips/partners/health/dental/index.html. Accessed February 19, 2019.
  5. Danesh D, Paskett ED, Ferketich AK. Disparities in receipt of advice to quit smoking from health care providers: 2010 National Health Interview Survey. Prev Chronic Dis. 2014;11:E131.


From Decisions in Dentistry. March 2019;5(3):46.

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