402S94004
The Costs and Benefits of Smoking Restrictions
An Assessment of the
Smoke-Free Environment Act of 1993
(H.R. 3434)
Executive Summary
Prepared at the request of:
Congressman Henry \Vaxman
Chairman, Subcommittee on Health and The Environment
Committee on Energy and Commerce
U.S. House of Representatives
Indoor Air division 6607J
Office of Radiation and Indoor Air
U.S. Environmental Protection Agency
401 M Street, SW
Washington, DC 20460
April 1994
XX-2.
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The Costs and Benefits of Smoking Restrictions
An Assessment of the
Smoke-Free Environment Act of 1993
(HJL 3434)
Prepared at the request of:
Congressman Henry Waxman
Chairman, Subcommittee on Health and The Environment
Committee on Energy and Commerce
U.S. House of Representatives
Indoor Air Division 6607J
Office of Radiation and Indoor Air
U.S. Environmental Protection Agency
401 M Street, SW
Washington, DC 20460
April 1994
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The Costs and Benefits of Smoking Restrictions
An Assessment of the
Smoke-Free Environment Act of 1993
(H.R. 3434)
Prepared by:
David H. Mudarri Ph.D
Indoor Air Division 6607J
Office of Radiation and Indoor Air
U.S. Environmental Protection Agency
401M Street, SW
Washington, DC 20460
April 1994
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The Costs and Benefits of Smoking Restrictions
An Assessment of the
Smoke-Free Environment Act of 1993
(H.R. 3434)
TABLE OF CONTENTS
EXECUTIVE SUMMARY. , .ES-1
INTRODUCTION. 1
GENERAL METHODOLOGY.... 3
ASSESSMENT OF COSTS AND BENEFITS OF SMOKING RESTRICTIONS
IN A SOCIETY WITH NO SMOKING RESTRICTIONS 5
Section 1. Cost of Implementing Smoking Restrictions. 5
Section 2. Benefits from Reduced Exposure to Environmental
Tobacco Smoke (ETS) 10
Section 3. Savings in Operating and Maintenance Expenses 15
Section 4. Increased Productivity and Decreased Absenteeism
Resulting from Smoking Restrictions 17
Section 5. Savings to Smoking-Related Fires 19
Section 6. Impacts of Smoking Restrictions on Smokers 20
COSTS AND BENEFITS OF H.R. 3434 BASED ON CURRENT CONDITIONS... 28
REFERENCES , R-l
EXHIBITS
APPENDIX A Review of Selected Literature
APPENDIX B Technical Appendix
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The Costs and Benefits of Smoking Restrictions
An Assessment of the
Smoke-Free Environment Act of 1993
(H.R.3434)
Executive Summary
Introduction
In August 1993, H.R. 3434, the Smoke-Free Environment Act of 1993, was introduced
in the House of Representatives by Congressman Henry Waxman (Chairman of the
Subcommittee on Health and the Environment of the Committee on Energy and
Commerce) with more than 40 co-sponsors. This Bill would require that all nonresidential
buildings regularly entered by 10 or more persons in the course of a week adopt a policy that
bans smoking inside the building or restricts it to separately ventilated and exhausted
smoking rooms. The Bill would allow enforcement actions in the United States District
Courts by an individual, government, or other aggrieved entity, with allowable fines of up
to $5,000 per day,
H.R. 3434 would effectively ban or restrict smoking in most indoor environments.
As written, these envii onments would include such diverse establishments as office
buildings, schools and other educational establishments, theaters, restaurants, hotels,
hospitals and other health care facilities, sports arenas, retail establishments, and
manufacturing plants.
In a recent letter to Carol Browner, Administrator of the United States
Environmental Protection Agency (EPA), Congressman Waxman requested that EPA
analyze (quantitatively where possible) the compliance costs and the health and economic
benefits of H.R. 3434. Specifically, he asked that EPA assess the cost of compliance including
provisions for smoking lounges; the value of benefits resulting from reduced exposure to
environmental tobacco smoke and changes in smoking behavior; the value of increased
productivity and reduced absenteeism; savings from reduced operation and maintenance
costs; and savings in fire related injuries and property damage.
Role and Limits of Cost-Benefit Analysis
In principle, cost-benefit analysis can be a useful tool for helping to identify those
government actions which leave society as a whole better off. It can contribute to such
assessments by providing a systematic framework for measuring and comparing the net
economic benefits of policy alternatives. Cost-benefit analysis does not by itself, however,
provide definitive answers regarding the merits of public health and environmental policy
alternatives. Rather, net benefit estimates must be combined with other information, and
weighed with other policy considerations, to formulate effective public policy. Pursuant to
this, and consistent with Executive Order 12866, EPA routinely weighs the hill range of
April 20,1994
ES-1
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relevant policy considerations, such as distributional effects, legal issues/ and institutional
issues in making regulatory decisions. In keeping with this approach, EPA presents the
current analysis, which the Agency believes provides useful insights regarding many of the
potential costs and benefits of H.R. 3434.
Summary Results
This analysis indicates that passage of H.R. 3434, or sinuiar restrictions, could
achieve net benefits (i.e., benefits minus costs) ranging from $39 to $72 billion per year,
excluding some potentially significant costs and benefits to smokers. For various reasons
these and other potentially significant effects of H.R. 3434 could not be characterized in
terms of economic value. Major costs reflected in these estimates include the costs of
compliance and enforcement. Major benefits include those associated with reduced
exposure to environmental tobacco smoke (ETS) and reduced operating and maintenance
expenses. Benefits are also achieved from reduced absenteeism and reduced smoking-
related fires, but these are not significant relative to other benefits. The net effect is that
estimated benefits exceed estimated costs by $39 billion to $72 billion.
~As noted above, the current analysis leaves open the question of whether smokers
themselves gain or lose due to H.R. 3434. Clearly, smoking restrictions impose a burden on
smokers. The losses in terms of time and inconvenience associated with forcing smokers to
shift the location and /or timing of their cigarette consumption, and the potential burden
associated with quitting, may be substantial. However, these losses would be offset to some
unknown extent by the benefits of improved health among smokers who quit, cut back, or
fail to start smoking in the first place. The net economic valuation of these and other costs
and benefits of smoking to smokers themselves is beyond the scope of this analysis for
reasons discussed in more detail below.
Nevertheless, it is important to emphasize that this analysis found that, of those
effects which could be quantified, the estimated benefits exceeded the estimated costs by $39
billion to $72 billion. In order to reach a finding that H.R. 3434 would impose a net
economic loss to society, the net effect of all unqualified costs and benefits - inchidin-
some important costs and benefits to smokers themselves - would have to be additional
costs of at least $39 billion per year.
Document Review
While EPA makes no commitment to revise and reissue the present study, this
document has been developed and submitted to Congress in a form intended for review by
outside experts, interested parties, and the public.
The principal author of the study is Dr. David H. Mudarri, an economist in the
Indoor Air Division of EPA's Office of Air and Radiation. This version of the study reflects
extensive review by other EPA offices, the Office of Management and Budget, the Council of
Economic Advisors, and the Department of Health and Human Services. In addition, a
previous version of this report was reviewed by several economists in the public and
private sectors.
April 20,1994
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General Methodology
Assessing Annual Costs and Benefit
This analysis assesses the costs and benefits that would occur each year into the
future for present and future generations. All estimates are represented as annual costs or
benefits. That is, all costs are converted to an annual equivalent that would occur every
year into the future based on 1990 population characteristics. Varying time streams of costs
or benefits are converted to equivalent annual values using a 3% social discount rate.
Sensitivity analyses using 5% and 7% discount rates are also provided.
Throughout this analysis it is assumed that H.R. 3434 would apply to all the
previously stated buildings, at all times, without exception. It is also assumed that full
compliance would be achieved within the first year of implementation.
Choice of Baseline for Assessing Costs and Benefits
Per capita cigarette consumption has been steadily falling over the past several years.
In addition, recent survey data suggest that many establishments already have some form
of smoking policy, and the percent of establishments which report having such policies has
been increasing in the past few years (DHHS, 1992; BNA 1991). Therefore, it was necessary
to establish a baseline from which to measure the effects of H.R. 3434 from enactment
forward. This was accomplished by a three step procedure.
In the first step, the net costs and benefits are computed assuming current cigarette
consumption levels, and assuming that there are currently no restrictions. This is an
artificial baseline used for analytic convenience, but may be interpreted as a reflection of the
cost and benefit differences in a society with and without smoking restrictions comparable
toH.R.3434.
Second, survey data were examined concerning the prevalence of smoking policies
already in place, and using assumptions about the nature of those policies as well as policies
in small establishments not covered in those surveys, an estimate was derived that 23% of
the population is covered by smoking restrictions comparable to the requirements of H.R.
3434. Current cigarette consumption levels, and 23% coverage by existing policies are
therefore used as the baseline for this study. As a result, this study concludes that 23% of
the previously calculated cost and benefits are attributable to existing policies, and 77% are
attributable to H.R. 3434, or other future restriction policies, including private initiatives.1
Finally/ sensitivity analyses to the baseline assumptions are conducted by calculating
the changes to the costs and benefits that would result from alternative assumptions about
lAs this report was being prepared, the President signed into law the Goals 2000: Educate America Act.
This legislation restricts smoking in all federally funded primary and secondary schools and in day care centers.
Because a sensitivity analysis is presented of the alternative baseline assumptions, no specific adjustments to
account for this new law were made to the 23% baseline calculations used to assess the effect of H.R. 3434.
April 20,1994
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future trends. The specific variables tested include future trends in cigarette consumption,
and future trends in the development of public and private smoking restriction policies
which could take place in the absence of national legislation. These alternative scenarios of
potential future trends are intended to demonstrate how the absolute levels of incremental
costs and benefits attributable to H.R. 3434 are sensitive to assumptions about the future
prevalence of smoking restrictions enacted by other public and private entities, and to
future trends in cigarette consumption.
Other Economic Impacts
Economic considerations which legislators may wish to consider go beyond just costs
and benefits assessed in this analysis. Where information from this analysis sheds light on
some of these considerations, they are briefly described..
Summary Comparison of Costs and Benefits
Exhibit ES-1 summarizes the estimated costs and benefits of implementing national
legislation such as H.R. 3434, using a basdine estimate that 23% of the population is already
subject to such restrictions. The following sections provide additional detail on these
results.
Costs of Implementing Smoking Restrictions
Policy Implementation
In implementing the restrictions oi K.R. 3434, establishme would incur the costs
of establishing a policy, communicating the policy to employees 01 ntele, posting signs,
assuring compliance, and possibly offering smoking cessation servic The current study
estimates that these activities would cost between $0.2 billion and $0.5 billion per year.
i, Coking Lounges
-tion and other
rts of the building.
In
The main determinant of cost is the expenditure associated v ith the constr *on
and maintenance of smoking lounges. Smoking lounges meeting i»; requirements of H.R.
3434 would be required to meet stringent standards concerning ver
provisions to insure that the air in the lot*' ;fre does not enter other •
addition, smoking policies involving sm ..,g lounges are gener-: associated with greater
complaints and with lower reported satis/action than smoking bans/ and smoking bans are
becoming increasingly popular (Sorensen. fiLal-1991; 1991a, 1992; Stillman. eLal-1991).
Finally, the structural features of many existing buildings make it infeasible or cost
prohibitive to construct a smoking lounge which would meet the requirements of H.R.
3434. While the extent to which smoking lounges will be relied upon to comply with this
legislation is uncertain, this analysis is based on the assumption that, for the reasons
mentioned above, only 10% to 20% of establishments would opt fov smoking lounges. For
the 10% to 20% of establishments which opt to build smoking loun^us, the cost of those
April 20,1994
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lounges is estimated to be between $0.3 billion (10% lounges) and $0.7 billion (20% lounges)
per year.
The current analysis estimates that the total cost of implementation by the public
and private sector, including the cost of smoking lounges, would be approximately $0.5
billion per year (10% smoking lounge) to $1.4 billion per year (20% smoking lounge).2
Enforcement Costs
The cost to building owners for ensuring compliance in their buildings is included
as part of the cost of establishing and maintaining a policy. With respect to enforcement,
H.R. 3434 provides no specific requirements for enforcement of its provisions, other than
through citizen suits in federal court. Therefore, enforcement costs are difficult to quantify.
However, in a proposed rule concerning the sale or distribution of tobacco products to
individuals under 18 years of age, the Department of Health and Human Services3
estimated that sting-type operations used by state governments would cost between $0.1
billion and $0.2 billion per year. Recognizing that these two issues are not strictly
comparable, an estimate of between $0.1 billion and $0.5 billion per year appears plausible
for a society with no current restrictions, and is used in this analysis. This would translate
into an estimated enforcement cost of between $0.1 billion and $0.4 billion per year under
current baseline (23% coverage) conditions. Some expenditures by the Federal government
and by state and local governments can be expected for information dissemination, though
they may well be less than the value of current resources devoted to passing controversial
state and local legislation.4 These expenditures were not quantified.
The Effects of Reduced ETS Exposure
The Health Consequences of ETS
A major component of the benefits that could be achieved from national legislation
that restricts smoking in public places is from reduced exposure of building occupants to
ETS.
2 Includes a higher cost per lounge.
3 Department of Health and Human Services, Substance Abuse and Mental Health Administration, 45
CFR Part 96, Substance Abuse Prevention and Treatment Block Grants: Sale or Distribution of Tobacco Products
to Individuals Under 18 Years of Age: Proposed Rule.
4 Even when smoking restrictions are passed at the state or local level, campaigns to nullify the
legislation or to preempt local legislation with weaker state legislation can involve the expenditure of significant
resources on both sides of the issue. No attempt was made to quantify current costs to state and local entities,
though national legislation would be expected to reduce many of these costs. For an excellent analysis of this issue
as it is manifested in California, see Macdonald and Glantz (1994).
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Exhibits ES-2a and ES-2b present information on the health consequences of ETS.
For the purpose of valuing the benefits resulting from reduced exposure to ETS due to
smoking restrictions! several conservative adjustments to these figures were made. First,
all deaths and illnesses associated with maternal smoking were excluded because the
primary route of exposure is not expected to be through ETS in public buildings. 5
Therefore, the deaths associated with spontaneous abortions, sudden infant death
syndrome, respiratory conditions in newborns, and short gestation/low birth weight
newboms were also excluded, as were the morbidity consequences of low birth weight and
neonatal intensive care.
The second conservative adjustment relates to heart disease. The American Heart
Association estimates that between 35,000 and 40,000 heart disease deaths occur ever aar
because of ETS (Taylor, 1992). This is based on studies in which estimates of the effect of
ETS on heart disease fall in the range of 32,000 to 40,000 deaths per year as presented in
Exhibit ES-2a. Because these estimates are substantial, and because £PA did not formally
assess heart disease risks in its ETS risk assessment (EPA, 1992), two conservative
adjustments to these figures were made.
• First, the low end of the range (32,000) was used as the high estimate, and this
was reduced by 50% (16,000) to obtain the low estimate.
• Second, an arbitrary additional conservative adjustment factor of 75% to this
range was applied, resulting in a base estimate of 12,000 to 24,000 heart disease deaths
per year.6
The same proportional breakdown between home (27%) and nonhome (73%)
exposure related deaths that was reported by EPA for lung cancers also applied here.
Therefore, 3,240 to 6,480 heart disease deaths per year are estimated for home exposures, and
8,760 to 17320 heart disease deaths per year are assumed to be associated with exposure
outside the home.
The Value of Benefits from Reduced ETS Exposures
The reduction in exposure resulting from smoking restrictions will result in
avoiding an estimated annual average of 7,000 to 12,900 premature deaths over the first 50
5 While the primary route of exposure is maternal smoking, it is estimated that smoking restrictions
comparable to HR. 3434 would reduce the size of the smoking population because some smokers would quit and
some future smokers would refrain from initiating the habit In addition, it is estimated that the rate of
consumption of remaining smokers would be reduced. To the extent that these changes in behavior will affect
maternal smoking, some reductions in these excluded effects would also likely occur, resulting in benefits. The
current study did not, however, quantify these potential benefits in our calculations.
6 Some adjustment may be appropriate also because there appears to have been an increase in the
survival rate of heart disease patients over me past several yean due to advances in medical technology.
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years, and approximately 7,500 to 13,000 annually thereafter.? The value of these reductions,
when using a "willingness to pay" measure8, and discounting future reductions at a rate of
3%, would range between $33 billion and $60 billion per year.?
To this has been added benefits to be achieved from improved health, mostly to
children, including reduced incidence of lower respiratory tract infections, ear infections,
and asthma. These benefits are estimated at between $2 billion and $5 billion per year, most
of which is associated with reduced asthma induction among children. For asthma, this
analysis reflects an estimated reduction of between 1,200 and 3,000 cases annually. To value
the benefits from reduced asthma induction, a willingness to pay measure associated with
chronic bronchitis,10 which is also a chronic respiratory disease was used.
Hie total benefit from reduced ETS exposure includes both the benefits of premature
deaths avoided plus the benefits of reduced illness. The total benefits due to reduced ETS
exposure is thus estimated to be $35 billion io $66 billion per year.
7 The 7,500 to 13,000 annual premature deaths avoided is achieved gradually over a period of about 20
years. It is based on the assumption that the gradual reduction in mortality risk from reduced ETS exposure
would follow the same time pattern as the reduction in mortality risk for smokers who quit smoking. Available
data suggests mat the reduction of lung cancer mortality risks for smokers who quit is gradually reduced over a 20
year period (DHHS, 1989). The decrease in mortality risk for heart disease is known to occur much more quickly
(e.g. Taylor, 1992). Therefore, this analysis assumed that the decrease in mortality risk for heart disease takes
place twice as quickly as for lung cancer.
8 Willingness to pay measures in mis case reflect the value mat persons assign to reducing their risk of
premature death. The willingness to pay measure used for reduced exposures to ETS is $4.8 million per
premature death avoided. See Appendix A-l for a discussion of this estimate.
Where possible, willingness to pay measures as opposed to medical cost savings and savings in lost
earnings are used as the value of avoiding premature death. Using medical costs and lost earnings alone would
represent an incomplete measure of the economic value individuals and society assign to avoiding mortal risk.
For example, using only medical costs and lost earnings would imply that social well being is unproved when
individuals die just after retirement-before medical costs are high and just after salary income ceases.
9 It is estimated mat smoking restrictions would induce 3% to 6% of current smokers to quit, and would
decrease by 5% to 10% the number of persons who each year become regular smokers. The smokers who quit
would eventually die of old age, so mis effect would be transitory. In addition, it would take about 50 years for the
reduction in smoking initiation rates to fully reduce the smoking population by 5% to 10%.
It is estimated mat smoking restrictions would reduce, by 10% to 15%, the number of cigarettes smoked
by the remaining smokers in a 24 hour period. It has been suggested that some smokers may increase their
consumption at home in order to make up for lost consumption outside the home. No attempt was made to
account for this possible effect on ETS exposures because this does not appear to be the general case, and
because the estimate of reduced consumption is a net reduction over the full day.
10 Based on willingness to pay measure for reducing the incidence of chronic bronchitis (Neumann, ctal.
1994), fite estimated value of avoiding chronic asthma is assumed to be $1.5 million per case.
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Increased Comfort of Building Occupants
This analysis assumes that, all else being equal, no building occupant would prefer
being exposed to environmental tobacco smoke, and that most derive benefits from a
smoke free environment. With the exception of the health, productivity, and safety effects
discussed elsewhere, these benefits are largely intangible, and include such factors as
reduced irritation and reduced environmental odor, and less annoyance with tobacco
smoke residuals left on hair and clothing. These effects are more bothersome to some than
others, but may be of considerable importance to some persons." In the present study, no
attempt was made to quantify these benefits. However, because the overall results do not
include the benefits of increased comfort, and because of the pervasive use of conservative
assumptions in this analysis, it is expected that the estimate of total benefits from reduced
ETS exposure is conservative.
Savings in the Operation and Maintenance of Buildings
Smoking in a building involves implicit operational and maintenance expenses. In
addition to emptying and cleaning ashtrays, the smoke, ashes, and accidental burns on
furniture and carpets create an additional housekeeping and general maintenance burden.
For example, the Building Owners and Managers Association (BOMA) International reports
that in a tightly monitored program, a member firm experienced a 15% reduction in
housekeeping costs when a non-smoking policy was introduced. Maintenance costs were
not covered in the monitoring program. Changes that were observed included elimination
of the need to empty or clean ashtrays; reduction in high surface dusting and the dusting of
desks and tabletops; reduced detailed vacuuming around desks of smokers; and reductions
in the cleaning of Venetian blinds and heating, ventilation, and air conditioning (HVAC )
vents. In adaition, cleaning personnel found that they spent less time moving articles on
desks in order to remove ashes. BOMA cautions that this was a tightly monitored program,
and that actual experience may only produce an average of 10 % in overall cleaning costs. v
Maintenance cost savings include less frequent replacement of furniture, reduced cost of
carpet repair savings in the repair of computer equipment operated by smokers, and
sometimes less frequent painting.
The actual savings in both housekeeping and maintenance expenses are expected to
vary from bu mg to building depending upon use (e.g., .offices versus retail stores). A
separate estimate was therefore developed for different uses: offices, mercantile and services
(retail), food service, health care, assembly, education, lodging, and warehouse/industry.
" See (or example letters to the editor in the Journal of the Medical Association of Georgia, Vol.
March 1990, pag« 273.
1994.
12 Persona] correspondence from James Dinegar, BOMA International to David Mudarri, EPA. January
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The cost saving estimates were then allocated just to the portions of those buildings for
which they would apply.13
Finally, it was recognized that the computed savings would not be realized in many
buildings for several reasons. First, some buildings already have partial smoking
restrictions, even though they do not comply with the requirements of H.R. 3434, so that
these buildings would have already experienced some savings from smoking restrictions.
Second, it was recognized that buildings for which permanent housekeeping and
maintenance personnel are fixed may not experience savings in the short term. Using
survey data to indicate proportions of establishments that experience maintenance savings,
the square feet to which savings would apply was decreased by about 40% in most cases.
For maintenance expenses, the high estimate is distinguished from the low estimate
primarily by the inclusion of items for which there was considerable uncertainty. Reduced
computer repair costs are applied only to the high estimate for offices. Savings in the
replacement of furniture are applied only to the high estimate for offices, health care and
educational facilities, and to the high and low estimates for lodging and food service
establishments. Carpet repair savings are included in the high estimate for offices and
health care, and in the high and low estimates for lodging and food service establishments.
Taking these factors into account, this analysis estimates that the operation and
maintenance savings would amount to about $4 billion to $8 billion per year.14
Effects on Productivity
On-the-Job Productivity Improvements from Reduced ETS
It is generally agreed that exposure to ETS reduces the productivity of "individual"
building occupants, probably more for nonsmokers than smokers, though no reliable basis
for quantifying this effect could be found. It is also likely that clearly defined and
implemented smoking policies will increase "organizational" productivity by reducing
potential conflicts between smokers and nonsmokers. Evidence suggests that well-run
smoking restrictions are popular among both employees and management, and that when
they are well managed and tailored to the social norms of individual worksites, they are
effective (Andrews,1983; Hocking. £LaL 1991; Hudzinski, 1990; Peterson, etal. 1988;
Sorensen. et al. 1986; Sorensen. etal. 1991; Stave, etal. 1991). Nevertheless,no basis for
quantifying effects on organizational productivity could be found.
13 For example, university classrooms do not generally allow smoking anyway, so that a smoking
restriction would result in savings only in the office spaces or other common areas in classroom buildings.
14 The housekeeping and maintenance cost savings, when compared to the cost of implementing
smoking restrictions, including smoking lounges, suggest mat some building owners may be induced to consider
implementing smoking restrictions in order to increase profits, even in the absence of smoking restriction
legislation.
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Losses in Productivity from Restrictions to Smokers*
While reduced ETS exposure would likely have some positive impact on smoker's
productivity, the inability to smoke at their work stations would likely have the opposite
effect. This could occur for two reasons. First, depending on their level of addiction, some
smokers who want to smoke, but are restricted, may become uncomfortable, and less able to
work effectively. Second, in order to smoke, smokers would have to leave the work station
and go either to a designated smoking lounge or outside to smoke. The resulting effect on
productivity would be limited because taking occasional breaks is already a normal part of
the workday for most persons. Thus, while it is likely that some decrement in productivity
would result from these two effects, it is not likely to be large relative to the productivity
gains from reduced ETS T -osure, and it would be difficult to quantify.
Net Effect on Productivity
There are both positive and negative influences on productivity. The ETS effect
would increase productivity and apply to all employees. However, some smokers would
work less effectively and some would spend more time going to and from an allowable
smoking area. This may decrease productivity, but would apply only to smokers, and only
to some portion of the smoking population. Quantitative estimates of these effects could
not be developed for this study.
Benefits from Reduced Absenteeism
In addition to considerations of on-the-job productivity, smoking restrictions would
yield productivity gains by reducing absenteeism. After accounting for differences in
socioeconomic characteristics between smokers and persons who have never smoked,
smokers are estimated to have about 50% more workdays lost than persons who have
never smoked, and former smokers are estimated to have about 30% more workdays lost
than never smokers (Manning, et al. 1991).
There is a plausible presumption that an institutional environment that restricts
smoking and that supports abstinence will reduce cigarette consumption among smokers,
increase attempts to quit and quitting success rates, and reduce the rates at which
nonsmokers take up smoking. However, in 1989, the Surgeon General found that evidence
of the effect of smoking restrictions on actual smoking behavior was considered to be
inconclusive (DHHS, 1989). Since that time, a number of studies appear to support the
conclusion that such restrictions have some of the postulated effects on smoking behavior
(see Appendix A).
Based on a review of these recent studies, it is estimated that between 3% and 6% of
current smokers would quit as a result of national legislation that restricts smo&ng. This
would result in an immediate decrease in the number of smokers and an equivalent
increase in former smokers. We also estimate that the initiation rate for new smokers
would decrease by 5% to 10%. This would ultimately result in an equivalent proportional
reduction in the number of smokers, and an equivalent absolute increase in the number of
persons who have never smoked. However, the effect of the reduced initiation rate would
April 20,1994
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occur gradually over a 50 to 60 year period. The average daily earnings including fringe
benefits of smokers is about $104, and discounting all future effects by 3% yields an
estimated savings of under $0.5 billion per year. This is quite insignificant when compared
with other effects.
Savings in Smoking-Related Fires
Most smoking-related fire injuries and property losses are in residential
environments/ which would not be subject to smoking restrictions. For example, between
1988 and 1990, there was an annual average of some 1328 smoking related fire fatalities in
residences compared to an annual average of 38 fatalities in nonresidential buildings
(Miller, 1993). Likewise, property damage due to smoking-related fires over the same
period averaged some $316 million annually for residences, compared to $115 million
annually in nonresidential buildings (Miller, 1993). As a result, the savings from smoking
restrictions would be minimal, and is estimated to be approximately $0.5 to $0.7 billion per
year. This estimate includes the effect of an estimated reduction in cigarette consumption at
home because of quitting and reduced initiation.
Benefits or Losses Regarding Smokers
Smoking restrictions comparable to those in H.R. 3434 would be expected to result in
some reduction in overall cigarette consumption. Faced with restrictions on where they
may smoke, some current smokers may quit and some may reduce overall consumption.
In addition, these restrictions would also tend to discourage many nonsmokers, mostly
teenagers,^ from becoming smokers.
These changes in behavior would result in significant improvements to the health
of smokers themselves, as well as other benefits such as increased safety and reduced
property damage from smoking-related fires. Based on the assumptions used in this
analysis, EPA estimates changes in smoking behavior would result in an average of 27,000
to 54,000 fewer premature deaths per year among smokers during the first 50 years, and
47,000 to 92,000 fewer premature deaths per year thereafter." On average, smokers who quit
or cut back would add back an average of 5 to 8 years of life otherwise lost to smoking-
15 CDC (1991).
16 The difference in death rates each year results from the different time patterns of the effects of
quitting and cutting back on consumption, and because the analysis assumed out it would take 60 years reduced
annual initiation to complete its affect on the size of the smoking population. Therefore, the 54,000 to 92,000
premature deaths reflect annual rates after 60 years for reduced initiation. In addition, mis analysis assumed
HJt 3434 would have only a "one time" effect on decisions to quit, rather than an ongoing effect Therefore, the
H.R. 3434-related quitting eventually disappears as the cohort of smokers motivated to quit by RR. 3434 dies from
old age or other causes.
April 20,1994
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related premature death. For those nonsmokers who avoid becoming smokers, life is
extended by an average of about 15 years.17
Clearly, these health benefits to smokers are highly significant, and, as a matter of
public policy, may be viewed as a benefit to society. However, there remain 45 million
smokers who purchase approximately 25 million packs of cigarettes per year, and about 1
million persons become regular smokers annually. Since persons smoke despite the risks
and costs/ one would presume that, provided these persons are rational, fully
knowledgeable, and are able to accurately assess the consequences of smoking, including
potential addiction,,the benefits of smoking to them outweigh the risks and the costs.
However, or a number of reasons, this study does not attempt to estimate the economic
value of the benefits or losses regarding smokers.
First, the economic measures traditionally applied to the health consequences of
pollution r:,ay not be appropriate to use in estimating the economic value of physical effects
of smoki- , that occur to smokers themselves. Exposure to pollution, such as ETS, is
essentially involuntary and uncompensated. Addiction arguments aside, smoking is a
voluntary activity that results in other consequences for smokers, some positive and some
negative. These other consequences are not reflected in measures of value for health risk
reductions sometimes used by EPA. Applying such health risk valuation factors to health
consequences for smokers would therefore inappropriately omit the value of all these other
costs and benefits to smokers, resulting in potentially biased measures of the welfare change
to society.
Second, arialysts disagree whether the traditional economic models one might use to
measure the welfare change to smokers can be reasonably applied, particularly given lirmts
on available data. To obtain reasonable estimates of the change in net benefits to smokers,
these traditional models require that the subjects - smokers in this case - are acting
rationally in response to a free and open marketplace. Furthermore, these consumption
decisions must either be devoid of significant price distortions such as taxes and subsidies,
or analytical corrections must be made to take account of these distortions. With respect to
the rationality requirement, questions have been raised whether the rational consumer
choice model applies given the apparent addictive nature of smoking, or to the delicate
question of smoking initiation by teenagers.18 Questions have also been raised whether the
consequences 01 ;axes (e.g., cigarette tax) and subsidies (e.g., tobacco farm subsidies,
subsidized health care) significantly distort consumer decision-making in this case.
17 See Exhibit 6-8 of the main text.
18 Note, however, that some analysts subscribe to models of "rational addiction" which have been
developed and empirically tested (Becker and Murphy,1988);(Chaloupka,1991). However, these models do not
take account of those who underestimate the strength of the addiction, or, who, for whatever reason, foil to
appreciate the magnitude of the advene consequences.
Nor do the models appropriately confront the dih,. ult question of the consequences from teenage
smoking. These models demonstrate Ihat teenagen tend to disregard me future consequences of smoking more
so than do adults (Qutloupka, 1991). Reducing teenage smoking is generally regarded as a benefit; and legislation
in most States prohibits the sale of tobacco products to teenagers.
April 20,1994
ES-12
-------
Third, EPA is concerned that currently available data are insufficient to support
using a traditional economic model to estimate the change in net benefit to smokers caused
by H.R. 3434. The reason for this is H.R. 3434 does not prohibit smoking outright/ nor does
it change the purchase price or quantity of cigarettes available. Instead, H.R. 3434 only
compels changes in the location and/or time pattern of cigarette consumption. This would
be expressed in economic terms as an increase in the transaction cost of smoking, and the
transaction cost would vary widely among smokers. Since it is unclear how the slope of the
demand curve for cigarettes might shift in response to a nonuniform increase in
transaction costs to smokers, a reliable measure of the change in net benefits to smokers
cannot be decided.
Based on the foregoing, this study makes no attempt at this time to quantify the
economic value of the consequences of H.R. 3434 to smokers themselves.
Comparing Costs and Benefits
While several elements of costs and benefits were not quantified, and bearing in
mind the limitations presented by the current analysis, two principal findings emerge.
First, it is clear that the benefits of smoking restrictions comparable to H.R. 3434 .
substantially outweigh the costs for those items quantified in our analysis. Second,
comparing the high estimate of costs with the low estimate of benefits does not change the
fundamental conclusions that benefits significantly exceed costs.
It should be noted that no attempt was made in the current analysis to evaluate the
costs and benefits of altering provisions of the legislation. Throughout the analysis, no
exception in scope or timing of the provisions of H.R. 3434 were assumed. Clearly,
changing provisions such as the scope or timing of the restrictions would affect both costs
and benefits.
Comparisons with Alternative Baselines
Given the rapid increase in public and private smoking restrictions in the last few
years, it is likely that the future will bring additional restrictions without passage of H.R.
3434. Of course, the future is always uncertain, and tobacco consumption and smoking
restrictions will be influenced in part by campaigns of tobacco and anti-smoking interests
(Samuels and Glantz, 1991, Macdonald and Glantz, 1994).
Three different baseline scenarios for the prevalence of present and future public
and private sector smoking restrictions were developed and compared. Each one assumes
that current levels of cigarette consumption are maintained into the future. The first
baseline scenario for smoking restrictions assumes that there are no current restrictions.
This is the artificial baseline used in the main text for analytic convenience. The second
scenario assumes that 23% of the population are currently covered by restrictions
comparable to H.R. 3434, and is the scenario used to characterize the costs and benefits of
H.R. 3434. The third scenario assumes that the recent increase in public and private
April 20,1994
ES-13
-------
restrictions would continue reaching a maximum level in which 75% of the population is
covered by smoking restrictions, in 10 years.
Alternative scenarios were also constructed which varied the assumption about
future baseline consumption of cigarettes, assuming that per capita consumption would
continue to decline for 10 years and 20 years, before levelling off. Similar to other major
influences such as the national educational campaigns about smoking, national legislation
restricting smoking in public buildings may contribute to continued downward trends in
cigarette consumption. Alternatively, these downward trends may continue or level off
regardless of the advent of such legislation. However, while recognizing that several issues
were not quantified in this study, sensitivity analysis indicates that/ as in the case of
alternative public and private restriction policies, varying the assumed baseline trend of
future cigarette consumption has no significant effect on the result the benefits would be
expected to exceed costs by a substantial margin.
Results using alternative baseline scenarios are summarized in Exhibit ES-3. The
first scenario presents results under an assumption that there are no restrictions currently
in place and that per capita consumption of cigarettes remains at current levels. This is the
base scenario used to calculate benefits and costs of smoking restrictions. The second
scenario differs from the first in that it assumes that 23% of the population is covered by
policies which already comply with H.R. 3434. This is the baseline we use to assess the
impact of H.R. 3434. The third scenario assumes that restrictive smoking policies will
continue to be adopted in the public and private sector without the passage of H.R. 3434,
and that these will continue and achieve a level of 75% compliance in 10 years and remain
at that-level thereafter. The fourth scenario combines an assumption of 23% existing
compliance with an assumption that per capita cigarette consumption will continue to fall
for ten years into the future at 3% per year, and then remain constant after that. The last
scenario is the same as the fourth except that per capita cigarette consumption is assumed to
fall for 20 years before it levels off.
Under all of the alternative scenarios presented in this analysis, assumptions about
the pervasiveness of future restrictions in the absence of H.R. 3434 have virtually no effect
on the findings that the benefits would exceed the costs.
A. 3% discount rate is used for all scenarios. While the absolute level of estimated
costs and benefits are differert under each scenario, our qualitative conclusions remain
unchanged.
Other Economic Considerations
The estimates of costs and benefits covered in this analysis are a subset of potential
economic consequences that policy makers may wish to consider.
April 20,1994
ES-14
-------
Restoration of Lost Income
Implementing smoking restrictive legislation nationally would result in the
restoration of approximately $31,0001? for each pre-retirement year of premature death
which is avoided because of smokers who quit, cut back, or fail to become smokers because
of H.R. 3434. On average, we estimate that each premature death avoided because of
quitting and reduced consumption would add approximately 1.4 to 4 salary earning years,
and each premature death avoided from persons who refrain from becoming smokers
would add approximately 11 salary earning years of life.20 When future values are
discounted at 3%, this analysis estimates that between $3 billion and $6 billion of lost
income Would be restored. A similar estimate was not possible for persons exposed to ETS,
though this effect should be considered. The importance of this impact is enhanced to the
extent that some children, spouses, the elderly or disabled may be dependent on such
income.
Reduced Burden on the Medical Service Industry
Every year, the average expenditure for medical services for smokers and former
smokers exceeds that of nonsmokers. However, this is partially offset by the fact that
nonsmokers live longer, and continue to consume medical services during the extra years
of life. When both of these factors are taken into account, the result is a net excess burden
on the medical service industry of about $35 billion per year due to smoking.2i Assuming
that changes in the excess medical expenditures due to smoking restrictions would be
proportional to changes smoking related premature deaths, this analysis estimates that
every reduction in annual premature death would represent an annual reduction of $85,000
for medical services. Accordingly, when future savings are discounted at 3%, H.R. 3434
would reduce annual expenditures for medical services by $2.3 billion to $4.7 billion per
year. It is not clear from our analysis what net impact reduced exposure to ETS would have
on the medical service industry.
Potential Cost to Social Security and other Pension Funds
Persons who would otherwise have died prematurely would live longer under
smoking restrictions and collect pensions and social security during those extended years.
Each premature death avoided for smokers who quit, cut back, or fail to initiate smoking
represents an extension of life of about 5 to 7 years beyond the age of 65, during which time
19 The estimated annual earnings of smokers is inflated by 20% to account for earnings after the age of 65,
based on OTA 0993).
20 Salary earning years are assumed to be years prior to Che age of 65.
21 This is estimated from information provided by Hodgson (1992) who compares excess medical costs
over me lifetime of persons who have ever smoked, and persons who have never smoked. Similar data and
procedures were also used by Manning, fit al. (1991).
April 20,1994
ES-15
-------
they would be eligible to collect a pension annuity. Data are not currently available to
support a similar estimate for ETS exposed individuals.
Reduced Revenues from Cigarette Sates and Excise Taxes
Implementation of national legislation to restrict smoking in public buildings would
reduce overall cigarette consumption by approximately 11% to 17%, and this impact would
occur within the first few years of implementation. TWs would result in a corresponding
reduction in cigarette tax revenues.*? However, these could be offset, to some extent, by the
social benefits of alternative agricultural production or other taxable uses of farmland.
Employment Dislocations
Reductions in demand for cigarettes and medical services would involve some
temporary dislocations of persons employed in these industries.
Conclusions
Given data limitations, and the uncertainties inherent in cost-benefit analysis of
public health and environmental policies, this analysis does not purport to provide
definitive conclusions about the overall merits of national smoking restriction legislation.
Nevertheless, while recognizing that several effects of H.R. 3434 including effects on
productivity, comfort from reduced exposure to ETS, and the ne' losses or gains regarding
smokers, were not quantified, this analysis demonstrates that, for those items that were
quantified, the estimated benefits of H.R. 3434 exceed the estimated costs by a substantial
amount. This analysis suggests that the net effect of these excluded items would have to
represent a loss of $39 billion to $72 billion per year for costs to exceed benefits.
As suggested in Exhibit ES4, the overall findings of substantial net benefits is not
altered by comparing high costs to low benefits, or by alternative discount rates.
Furthermore, while the magnitude of the net benefits specifically allocated to H.R. 3434 is
dependent on one's assumptions about baseline conditions, these assumptions go more to
the question of whether or not to capture these net benefits through national legislation or
by other public and/or private initiatives.
U For «i excellent comparison of what smokers pay in «xdM taxes, medical expenditures, and
contribution to retirement funds, relative to the value of the services they receive for those payments, see
Manning. ALftl (1991). However, the net monetary payments nude by or to smokers is not a usefu -idex for
measuring the overall social benefits or costs of smoking restrictions. As previously described, willingness to pay
measures are more appropriate. Also, our costs and benefits do not count transfers of costs or benefits from one
group in society to others.
April 20,1994
ES-16
-------
Exhibit ES-1: Summary ol Cost* and BwwflU*
Coot of hnptonwntlnfl Iho Uglstadon
8mottne,Bana
SrmMng Lounga
National Entanafnanl
Bonoflt* from Rodueod ExpMur* th* ET8
Valua of Pramatura Daafta AvottwJ
HomEKpaauia
• nnnrtani EipoaiiBi
!• 1 • • n 1 • • ll UmmBk. *
•llplUVail 1 laaill
Incnuaad Occupant Comfort
Swinge In OfMnttng and AUntMionco Expomo*
Howahaaplng
MiMananca
Not Chang* In PnoduetfvHy
Smtaigs In Rodueod Smokor AbMnlotlMn
Swing* In Smoking Rotated, Rr»»
Vamw of ht)urtM and Dtatha AvoUad
fTaaldanllal
NOflnWOMnlW
Property DamMaAfokted
•anaflla WMwul ttafard to Saeloja p|
****>% DtoceiMl Rrt^***
Low ErtnUiw Mill GrtfeiWoVi
(Mlllom of DoHam) .
4TO 1.417
123 350
270 703
77 385
14.M4 U.M1
559 2.016
32,229 S7.908
2,096 5.037
t •
M« 7,714
2.9S3 3.306
988 4.327
f »
172 344
449 It4
226 4S2
157 149
66 93
39.021 72.399
— *S% Dtaeount R«t»—
L«w Estimate Wall Ea9jmta
(MWonaof DotUrm)
476 1,451
123 350
275 710
77 365
31.189 91,924
530 1,911
30.555 54.978
2.095 5.037
• t
3.f9t 7,714
2.963 3.385
80< 4.327
* *
144 269
489 894
22« 452
157 149
86 93
17.297 99,179
**7* DaMount Itala-
IAW EatkMlv nft Eathnata
(Mmona ol DoHan)
469 1,464
123 360
260 729
77 385
11,988 S9.861
509 1,936
29,351 62,810
2.096 6.037
9 I
1.999 7,714
2.983 3,366
966 4f327
( *
126 266
469 (94
226 452
157 149
86 03
18.941 66,9*4
Bwwfto or LAMM Regarding Smokora
QutSmoHng
naducM ContumpUon
Total
tanuri Anna* «wr H VMr hrM
LMErtiMto
4.198
20.176
2,934
27,394
f
n ji rumirtT
8,391
38,431
5,869 [3)
51.991
6
Jtanuri taM MM M VMn
L«w EBttnata
0
30,582
15,989
44.5S9
,
HMiErianato
0
69,768 (1)
31.936 (3)
91.703 .
f
Totato may appmr to 6a grMter than KM com of (ndhMuat ftwm **• to ratrndfro
t Not amntHM. Saa taM lor dtewaton.
1. Mort of IMt Mlmta to dua to tha aMmatod v^u* of nduead arihrna Induction In chfldnm. Tha hkjh wHmato In Exhibit ES-1 to raducad by 60% banuu of uncertainty
of Ita magnRuda.
2. ComUara Juat tha abova eoatt and banffia.
3. Annual pranutw* dtatht woMid «ft*r 60 yaan. Annwrf radueflM to pnmaltirt dMrtha gnduatfr IncrMMa owr tha Hnrt 60 yaw» bafora I raachM a oonatant vah».
-------
EBMMt ES~2a: EathHataa of U.S. Nommofcar Annual MoftaHty Aaaoelatad WHh
Expoam* to Othar Paopla'a Smote
MORTALITY
Lung Cancar (ICO 162-163)
Homa ETS aourcaa
OHwr ETS aoureaa
U.S. EPAL-
3,000 Total
BOO
2,200
CENTERS FOR
DISEASE
CONTROL*
3.800*
OTHERS COMMENTS
124, 240 to 2000* ETSaGroupAcaidnagan.
ETS ounuertiallow dmfcf
300*, SOW. 5000* In smoking homa* and
offfeas. GananNy Mghar
4000* In restaurants.
b
(410-414)
BumDaatf*
Suddan Mart Daalh Syndroma
Rkspntory CondBJona, nawbon
(769-7M)
Short QaaMton. Low
(765)
TOO
2.000
BOO
11,000-12,000'.«
32,000-
40,000*."."
1200". 1SO'»
14S.OOO'*
1.BOO"
4,400«.«
4.400"--
Umkad avUanca for
cancan other than lung
HvMmca conMnuM to
mount on ETS and haart
Dua to flrw MtMad by
amoUng materials
Estimate*
maternal
baatdon
a»aiu«aid only tha taaplnaay hazards ot ETS: •*». *«s **» on> *ourea to biaaXdPwn nuna vs. nonhoma risk*.
H>aatti» to cMUran undar aga IS.
«EPA* condmted fcat maHmal amnMna H a. atrong itafc tactor far SIPS. ETS •xvowr* to tha nawbom b ateo conaMarad to ba
a risk factor tor SttS.
'Daflnad by DFranza M parinatat daattiai vMch IndudM aMbofna.
Hatarancaa
1. U.S. EPA (1992) nanifcHaiy HaaHt Eftac
Smoking: Lung Cancar and Othar Dborden. EPA/BOO«-90fl06f
2. C^rAwt lor DhaeM Control (1991). Smoking AtMbutaMa
MorMty and Year, of P* ."
-------
Exhibit E8-2b: Eattmatee of ETS-Attrlbuteblt Morbidity hi Children Du« to Homo and
Nonhoma Source*
MORBIDITY*
Low Btrth WalgM U2SOOg)
Admission to Naoratal Intenstva Can UnMa
Operations on TonsMs or AdanoMi
Tympanotomy Operations'
Episodes of Ottto Medta
Asthma Exacerbation
Asthma Induction
Phystatan Vtefts for Cough
Lower Respiratory Tract Madkma
(Pneumonia, Bronchus. BroncMoMb)
Fire-Related Injuries
HOME
U.S. EPA', , DIFrama"
56.000*
300.000 • 700,000
12,000 - 40,0000
•
135.000 - 270,000
130,000
2,366,000
536,009
2,178,000*
865.000 - 1.136,000)
350*
NONHOME
90,000*
160,000*
2.600.000*
100,000 • 300,000)
1.000 - 5.0001-h
3.400,000*
15,000 • 30.000B.I
•Aga < IB yaai». untasa noted otharwba .
"From malamal smoktng during pragnancy
"DIFranza provMas cost asllmatos of 302 m - 773 m $
4Aga < 15 yaais
•As astlmatod by U.S. EPA baaad on mufts from DFranza"
*Phystetan visfts
oAs estknalad by U.S. EPA based on taauhs from U.S. EPA1
i>Nonthmhotd modal. Z-10
'Under 16 months of aga or*y
IBroncMHs In chfldran under 16 years plus pneumonia In chMdran under S yean
"From al sources of MnoMng materials
-------
ExMMtES-3: Analysis of Altemrtto Bas»RnM*
Co*! tj| tavlMiMtfM MM LctfvMlMi
MM t^ptwyv HI nvvMvn^f
A^^^^^ fa A^B^^^pA ^^^^^^ •^•itt
law Eottauto* (1)
KOIIflffto VI VCOnOflO VZ SCMMfto 93 SCOMftO v4 VOOHAfM ffV
M* MMMMlMM tt% HMMfaHMM hi W Tflttn to% ItoflbtatlMM tf% llMtofatlMift
[ItM Ctfl. C«M| (MM Of. CwMk} (tMt C%. CM*.) riMh CWM Dwl Cuatte. CMM. OMl
It VMM « VMM
121 IS1 , 141 ' 111 101
•10
•
60*
470
•
460
— (tint on* «r oiwi|
200
ff
209
456
•
45S
3B2
•
361
U.6Tt
17.313
•1.730
W oofcnrtn uo* 3% dbjcourt not. ond MMUM tM oonw ontacomm coot of $100 uNon.
Poreoptaef
•0. ond MM
AMUMO thi
100
00
* 00
| 40
•• 20
6
moumptton NM dodnod by otxmi 3% por yoor tan 1MO to ino (DHHS. 1QW).
wnl off.
•••••A Ok 70% Bt»ttliai»t h 10 TMM
Pttr Canto CwMUMptton
4*00
4000
3600
MOO
2500
. ' 2000
V
1000
SOD
. «, «
-I 1 1
o • o • o
• o <• o
M • • r>
« S 5 •
o « o <• e
o * o
So *• r *•
e
•-•-MM
-------
Exhibft ES-4: Bemflte MImw Covte
B«**>23% RMtrietfon*
Low Estimate
High Estimate
Low Benaflls Minus High Costs
$ mHHon
3% Dtae. Rate 5% Disc, rale 7% Disc. Rate
39.023
72.356
36,056
37.287
69.170
36.311
36,041
66,684
35.057
-------
-------
The Costs and Benefits of Smoking Restrictions
An Assessment of the
Smoke-Free Environment Act of 1993
(H.R. 3434)
Introduction
In August 1993, H.R. 3434, the Smoke-Free Environment Act of 1993, was introduced
in the House of Representatives by Congressman Henry Waxman (Chairman of the
Subcommittee on Health and the Environment of the Committee on Energy and
Commerce) with more than 40 co-sponsors. This bill would require that all nonresidential
buildings regularly entered by 10 or more persons in the course of a week adopt a policy that
bans smoking inside the building or restricts it to separately ventilated and exhausted
smoking rooms. The bill would allow enforcement actions in the United States District
Courts by an individual, government, or other aggrieved entity, with allowable fines of up
to $5,000 per day.
H.R. 3434 would effectively ban or restrict smoking in most indoor environments.
As written, these environments would include such diverse establishments as office
buildings, schools and other educational establishments, theaters, restaurants, hotels,
hospitals and other health care facilities, sports arenas, retail establishments, and
manufacturing plants.
in a recent letter to Carol Browner, Administrator of the United States
Environmental Protection Agency (EPA), Congressman Waxman requested that EPA
analyze (quantitatively where possible) the compliance costs and the health and economic
benefits of H.R. 3434. Specifically, he asked that EPA assess the cost of compliance including
provisions for smoking lounges; the value of benefits resulting from reduced exposure to
environmental tobacco smoke and changes in smoking behavior; the value of increased
productivity and reduced absenteeism; savings from reduced operation and maintenance
costs; and savings in fire related injuries and property damage.
Role and Limits of Cost-Benefit Analysis
In principle/ cost-benefit analysis can be a useful tool for helping to identify those
government actions which leave society as a whole better off. It can contribute to such
assessments by providing a systematic framework for measuring and comparing the net
economic benefits of policy alternatives. Cost-benefit analysis does not by itself, however,
provide definitive answers regarding the merits of public health and environmental policy
alternatives. Rather, net benefit estimates must be combined with other information, and
weighed with other policy considerations, to formulate effective public policy. Pursuant to
this, and consistent with Executive Order 12866, EPA routinely weighs the full range of
relevant policy considerations, such as distributional effects, legal issues, and institutional
issues in making regulatory decisions. In keeping with this approach, EPA presents the
current analysis, which the Agency believes provides useful insights regarding many of the
potential costs and benefits of H.R. 3434.
-------
Summary Results
This analysis indicates that passage of H.R. 3434, or similar restrictions/ could
achieve net benefits (i.e., benefits minus costs) ranging from $39 to $72 billion per year,
excluding some potentially significant costs and benefits to smokers. For various reasons
these and other potentially significant effects of H.R. 3434 could not be characterized in
terms of economic value. Major costs reflected in these estimates include the costs of
compliance and enforcement. Major benefits include those associated with reduced
exposure to environmental tobacco smoke (ETS) am* -educed operating and maintenance
expenses. Benefits are also achieved from reduced absenteeism and reduced smoking-
related fires, but these are not significant relative to other benefits. The net effect is that
estimated benefits exceed estimated costs by $39 billion to $72 billion.
As noted above, the current analysis leaves open the question of whether smokers
themselves gain or lose due to H.R. 3434. Clearly, smoking restrictions impose a burden on
smokers. The losses in terms of time and inconvenience associated with forcing smokers to
shift the location and/or timing of their cigarette consumption, and the potential burden
associated with quitting, may be substantial. However, these losses would be offset to some
unknown extent by the benefits of improved health among smokers who quit, cut back, or
fail to start smoking in the first place. The net economic valuation of these and other costs
and benefits of smoking to smokers themselves is beyond the scope of this analysis for
reasons discussed in more detail below.
Nevertheless, it is important to emphasize that this analysis found that, of those
effects which could be quantified, the estimated benefits exceeded the estimated costs by $39
billion to $72 billion. In order to reach a finding that H.R. 3434 would impose a net
economic loss to society, the net effect of all unqualified costs and benefits — including
some important costs and benefits to smokers themselves - would have to be additional
costs of at least $39 billion per year.
Document Review
While EPA makes no commitment to revise and reissue the present study, this
document has been developed and submitted to Congress in a form intended for review by
outside experts, interested parties, and the public.
The .principal author of the study is Dr. David H. Mudarri, an economist in the
Indoor Air Division of EPA's Office of Air and Radiation. This version of the study reflects
extensive review by other EPA offices, the Office of Management and Budget, the Council of
Economic Advisors, and the Department of Health and Human Services. In addition a
previous version of this report was reviewed by several economists in the public and
private sectors.
April 20,1994
-------
General Methodology
Assessing Annual Costs and Benefits
This analysis assesses the costs and benefits that would occur each year into the
future for present and future generations. All estimates are represented as annual cost or
benefits. That is/ all costs are converted to an annual equivalent that would occur every
year into the future based on 1990 population characteristics. Varying time streams of costs
or benefits are converted to equivalent annual values using a 3% social discount rate.
Sensitivity analyses using 5% and 7% discount rates are also provided.
Throughout this analysis it is assumed that H.R. 3434 would apply to all the
previously stated buildings, at all times, without exception. It was also assumed that full
compliance would be achieved within the first year of implementation.
Choice of Baseline for Assessing Costs and Benefits
Per capita cigarette consumption has been falling steadily over the past several years.
In addition, recent survey data suggest that many establishments already have some form
of smoking policy, and the percent of establishments that report having such policies has
been increasing in the past few years (DHHS, 1992; BNA 1991). Therefore, it was necessary
to establish a baseline from which to measure the effects of H.R. 3434 from enactment
forward. This was accomplished by a three step procedure.
In the first step, the net costs and benefits are computed assuming current cigarette
consumption levels, and assuming that there are currently no restrictions. This is an
artificial baseline used for analytic convenience, but may be interpreted as a reflection of the
cost and benefit differences in a society with and without smoking restrictions comparable
to H.R. 3434.
Second, survey data were examined concerning the prevalence of smoking policies
already in place. Using assumptions about the nature of those policies as well as policies in
small establishments not covered in those surveys, an estimate was derived that 23% of the
population is covered by smoking restrictions comparable to the requirements of H.R. 3434.
Current cigarette consumption levels, and 23% coverage by existing policies are therefore
used as the baseline for assessing the effects of H.R. 3434. As a result, this study concludes
that 23% of the previously calculated cost and benefits are attributable to existing policies,
and 77% are attributable to H.R. 3434, or other future restriction policies, including private
initiatives.*
Finally, sensitivity analyses to the baseline assumptions are conducted by calculating
the changes to the costs and benefits that would result from alternative assumptions about
1 As this report was being prepared, the President signed into law the Goals 2000: Educate America Act.
This legislation restricts smoking in all federally funded primary and secondary schools and in day care centers.
Because a sensitivity analysis is presented of the alternative baseline assumptions, no specific adjustments to
account for this new law were made to the 23% baseline calculations used to assess the effect of H.R. 3434.
April 20,1994
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future trends. The specific variables tested include future trends in cigarette consumption,
and future trends in the development of public and private smoking restriction policies
which could take place in the absence of national legislation. These alternative scenarios of
potential future trends are intended to demonstrate how the absolute leveb of incremental
costs and benefits attributable to H.R. 3434 are sensitive to assumptions about the future
prevalence of smoking restrictions enacted by other public and private entities, and to
future trends in cigarette consumption.
Other Economic Impacts
Economic considerations which legislators may wish to consider go beyond just costs
and benefits assessed in this analysis. Where information from this analysis sheds light on
some of these considerations, they are briefly described.
April 20,1994
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Assessment of Costs and Benefits
In A Society With No Smoking Restrictions
In this section,the costs and benefits associated with smoking restrictions are assessed
from a hypothetical baseline in which we assume that no restrictions in the public or
private sector are currently in place. The results in this section may be interpreted as
measuring the cost and benefit differences between a society with smoking restrictions
versus a society without such restrictions. After completing the analysis using this
hypothetical baseline, the costs and benefits of H.R. 3434 are assessed under estimates of
current baseline conditions, and the sensitivity of these results is evaluated using
alternative baseline assumptions.
Section 1. Cost of Implementing Smoking Restrictions
Cost of Implementing Smoking Bans
Despite the apparent wide use of some forms of smoking restrictions, there are no
published data on the cost of compliance. While many establishments have smoking
policies, it is not common for them to develop compliance cost information. Some
preliminary data on compliance costs for worksites may be published soon as part of the
Community Intervention Trial (COMMIT) project sponsored by the National Cancer
Institute (Lewit, 1993). In the absence of specific data, estimates are developed for start-up
costs which would occur initially, and for recurrent costs associated with maintaining the
policy once it was established.
In establishing smoking bans nationally, responsible entities would incur initial
costs to develop the policy, assign responsibilities, print and distribute information, print
and post signs, remove ashtrays and cigarette vending machines, provide outdoor
receptacles, and develop compliance procedures. Initial costs include a one time increase i
participation in smoking cessation programs. Subsequent to these initial start-up costs,
establishments will incur annual costs for. policy maintenance. The estimates used in this
analysis are provided in Exhibit !•>!. For simplicity, the estimates were developed for a
prototype company with 1,000 employees.
According to Bureau of Labor Statistics (BLS) data, in 1990 there were approximately
118 million people in the employed civilian labor force (excludes military). Subtracting
approximately 8 million for those who work in farming and the construction trades leaves
110 million persons employed indoors. The 110 million figure is used as the basis for
calculating national costs of implementing smoking bans nationally.
in
national cost estimate is presented in Exhibit 1-2, Initial costs are annualized in
two ways. First, all the initial costs will be experienced in the first year or so that the policy
is initiated. The annual equivalent of that initial cost is the interest cost at the appropriate
interest rate.2 In our analysis, we use a 3% social discount rate for our calculations.
2 Since the relevant quantity is the equivalent annual cost that would occur every year, in perpetuity, this
is equivalent to borrowing the money and paying interest but no principal every year.
April 20,1994 5
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Second, the initial costs will recur when new establishments are formed. We assume a 15%
turnover rate every year, so that 15% of the initial cost will be experienced every year by
these new establishments.3
Outdoor Shelters with Smoking Bans
A few firms that have thus far established smoking bans now provide some form of
outdoor smoking shelter for smoking employees. We assume that 10% of firms that ban
smoking will provide this feature, so we included an estimate in our calculations.
A 9' x 12' free standing shelter (similar to a bus shelter) of aluminum frame with
acrylic glazing would cost about $4,800 or $44 per square foot (Means,1991). Less elaborate
structures, such as a bench under available shelter would cost considerably less. The cost of
outdoor shelters is assumed to be, on average, about the same as the cost of indoor shelters,
or about $25 per square foot. Maintenance costs are included in the cost of establishing a
smoking ban.
Costs of Smoking Lounges
Smoking Lounge Requirements
H.R. 3434 requires that specifically designated smoking lounges meet appropriate
standards for ventilation. To be properly ventilated, a smoking lounge should meet the
following requirements (EPA 1993, ASHRAE 1989).
* Air from the smoking lounge should be directly exhausted to the outside by an
exhaust fan. Air from the smoking lounge should not be recirculated to other parts
of the b.iilding. This may require that the plenum (the space between the ceiling
tiles and the next floor) be sealed and isolated from the remainder of the building.
* More air should be exhausted from the lounge than is supplied at all times. This
insure: that the area is under negative pressure, so that smoke does not drift to
surrounding spaces.
• The ventilation system should provide the smoking room with 60 cubic feet per
minute (dim) of supply air per smoker. Smoker densities of 7 persons per 100 square
feet are often assumed. This air may be supplied by air transferred from other parts
of the building such as corridors
• Nonsmokers should not have to enter the smoking room for any purpose.
Construction of separately ventilated lounges in existing buildings may require
modification of the building ventilation system to isolate return air and establish the
exhaust system. Because of the requirement that air be exhausted directly to the outside.
3 An establishment here is any new business, as distinguished from a new building. It is assumed mat
any new establishment would experience the initial costs of establishing a policy.
April 20,1994 6
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rooms with an outside wall or on the top floor are preferred. On the outside, exhaust vents
must be adequately separated from the air intake vents which supply outside air to the
building's ventilation system. The exhaust air may have to be filtered to avoid soiling on
windows and on the outside surface.
There are three options for supplying ventilation air to the smoking area. The first
is to transfer air from surrounding spaces. This may enter through grills in the door or
through a separately constructed supply duct. The second option is to supply air from the
main ventilation system, and the third option is to provide a dedicated supply air system
for the smoking area. The first option is the cheapest but also the most susceptible to
creating ventilation imbalances mat compromise the integrity of the building's ventilation
system and may generate complaints. The second option requires that the ventilation
system have sufficient capacity to satisfy the supply air requirement for the room and still
meet the demands of the rest of the system. While most systems are built with excess
capacity, a recent increase in ASHRAE requirements for outdoor ventilation (ASHRAE
1989), or higher than designed occupant densities, may reduce that excess. The last option is
the most expensive, but will offer the best guarantee that the system operates without
complaint.
Number and Size of Lounges
It remains to estimate the lounge area that would normally be supplied to satisfy the
smoking population in those establishments that choose this option. There are no
published guides to help make this estimate. Therefore, the analysis derives an estimate by
formulating an example of a site with 100 smokers. Each smoker is assumed to smoke
before work and during lunch which will be outside of the building, and will take a 15
minute break once in the morning and once in the afternoon. Each break will take 3
minutes in transit, and 12 minutes in the smoking lounge. Smokers will visit the lounge
over a two hour period, averaging 50 smokers an hour. If evenly distributed over the hour,
there would be 10 smokers in the lounge all the time. Assuming a 50 percent variance for
peak use gives an estimate of 15 smokers in peak use. Smoking lounges may be designed
for 7 smokers per 100 square feet (ASHRAE 1989). This means that about 200 square feet of
smoking lounge would be needed to satisfy a peak demand of 15 smokers. The design
parameter then is to build 200 square feet of smoking lounge for every 100 smokers to be
accommodated, or 2 square feet of lounge per smoking occupant. Exhibit 1-3 provides an
estimate of the lounge construction requirements.
Each smoker may count as a smoking occupant in different buildings. For example,
a smoker spends some time at work, some time in a restaurant, in a sports facility, etc.
Therefore, the number of potential smoking occupants rather than numbers of smokers is a
better measure for estimating the number of smoking lounges that may be built. In 1990,
there were approximately 46 million smokers in the United States, and about 65% of the
adult population was employed. Assuming the same employment rate for smokers would
give us an employed smoking population of about 30 million persons who are the smoking
occupants for the nation's workplaces. In addition, there were approximately 117 million
seat or bed accommodations in educational facilities, restaurant facilities and hospitals (DOE
1991). Assuming a capacity utilization rate of 80%, gives us approximately 100 million
April 20,1994
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accommodations, of which 25% (25 million) will be used by smokers (About 25% of the
population are smokers.). Thus, the total smoking occupant base for our calculations is
taken to be 30 million plus 25 million or 55 million smoking occupants.
Cost of Construction and Maintenance of Smoking Lounges
A significant cost element for smoking areas inside buildings is the potential cost of
ductwork. Since the area must be exhausted directly to the outside, rooms in the interior
portion of the building will require horizontal and/or vertical ducts. Vertical ducts would
be used to carry exhaust air from lower floors to the roof of the building through the cer al
core of the building. Horizontal ducts would be used to reach the central core, or to exh ;st
the air through an outside wall. The building structure can make vertical duct construe.»on
prohibitive in existing buildings. Exhausting through the exterior wall can create films of
exhaust materials on windows unless the exhaust air is properly filtered, or the exhaust air
may infiltrate back into the building under certain conditions.
The Building Owners and Managers Association International (BOMA) reports that
retrofitting ventilation systems to accommodate smoking room ventilation requirements is
very costly, if not impossible in some cases. In new buildings, the design and installation of
separate ventilation systems is reported to cost $30 - $50 per square foot (Hurwitz 1993).
Based on conversations with Digital Equipment Corporation and Connecticut
Mutual Life Insurance, Environmental Health & Engineering (EH&E) (1992) suggests that
lounges cost on the order of $40 - $50 per square foot, but could be as low as $20 per square
foot if the room is already adequately enclosed, furnishings exist, and the room can be
exhausted to a nearby exterior wall with minimum difficulty.
A firm in Dallas, Texas has made a business of providing smoking lounges to
commercial establishments (Poynter 1993). The firm avoids vertical ducts, filters the
exhaust air to avoid filming on windows, and provides a service contract to building
owners which allows them to pass on the expense to tenants. According to its advertising
literaturef the firm would charge approximately $30 per square foot up-front costs plus an
annual cost of about $25 per square foot to completely maintain the space and the
ventilation equipment. This includes the rental fee for the space.
National Cost of Compliance under the Smoking Lounge Option
The Poynter 1993 estimate for indoor lounges is somewhat lower than the other
estimates. However, it falls within the EH&E range, and is based on real market experience.
Further, it is reasonable to assume that the indoor smoking lounge option will K ised only
when the costs are sufficiently low to make this option attractive. The Poynter estimate is
used to calculate compliance cost. It is then increased by 30% to provide a high estimate.
Calculations are provided in Exhibit 1-4. An initial average cost of $25 per square foot
would be experienced by all establishments that choose to provide interior smoking
lounges to accommodate smokers. This is translated into an annual equivalent cost using a
3% discount rate, to which is added a recurrent portion which would be experienced when
April 20,1994
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old structures are torn down and new ones built. We assume an average life of 20 years (or
a turnover rate of 5% per year), so that 5% of this cost would recur annually.
The total annual cost estimates represent the national cost if every establishment
elected to comply with smoking restriction requirements using the smoking lounge option.
Proportion of Establishments Which May Choose to Provide Smoking Lounges
Once fully implemented, only 10% (low estimate) to 20% (high estimate) of
employees are expected to be serviced by smoking lounges (see Exhibit 7-3b for justification
of this assumption). There are several reasons that most entities are not expected to
provide a smoking lounge.
• Smoking lounges would have to meet stringent ventilation requirements and
could not be spaces in which nonsmokers would have reason to enter. Most existing
rooms with available outside exhaust such as rest rooms would not be allowed.
• Smoking lounges are more expensive and more complicated than smoking bans.
It is likely that smoking lounges will be chosen only when they are relatively
inexpensive and convenient.
* Smoking lounges may require exceptional diligence to insure that exhaust is
adequate, that the space is under negative pressure, and that the building's
ventilation system is balanced. Smoking luunges are generally associated with
greater complaints and with lower reported satisfaction with the smoking policy
than smoking bans, and smoking bans are becoming increasingly popular (Sorensen.
' etal. 1991,1991a, 1992; Stillman. fiUL 1992)
• Smoking lounges compete for space with other potential uses and could result in
foregone rental revenue.
Enforcement
Costs to building owners for ensuring compliance in their building is included in
the cost of implementing smoking bans. With respect to enforcement by governmental
jurisdictions, H.R. 3434 provides no specific requirements for enforcement of its provisions,
other than through citizen suits in Federal court. Therefore, enforcement costs are difficult
to quantify. Some expenditures by the Federal government and by state and local
governments can be expected for information dissemination, though they may well be less
than the value of current resources devoted to passing controversial state and local
legislation.4 These expenditures were not quantified. Information dissemination on a
< Even when smoking restrictions are passed at the state or local level, campaigns to nullify the legislation
or to preempt local legislation with weaker state legislation can involve the expenditure of significant resources on
bom sides of the issue. No attempt was made to quantify current costs to state and local entities, though national
legislation would be expected to reduce many of these costs. For an excellent analysis of mis issue as it is
manifested in California, see Macdonald and Glantz (1994).
April 20,1994
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uniform requirement at a national level would likely enjoy greater efficiencies, and some
reductions in resources currently devoted •• passing and maintaining controversial state
and local legislation, and in litigating priv . sector policies, would likely occur.
In a proposed rule concerning the sale or distribution of tobacco products to
individuals under eighteen years of age, the Department of Health and Human Services 5
estimated that sting-type operations used by state governments would cost between $0.1
billion and $0.2 billion per year. Recognizing that these two issues are not strictly
comparable, an estimate of between $0.1 billion and $0.5 billion per year appears plausible,
and is used in this analysis as the cost of enforcement in a society with no current
compliance with standards comparable to H. R. 3434. (See Exhibit S-2 for estimates of H.R.
3434 wider current baseline conditions.)
Section 2: Benefits from Reduced Exposure to Environmental Tobacco Smoke (ETS)
Morbidity and Mortality Effects of Environmental Tobacco Smoke
Lung Cancer and Other Respiratory Disorders
The Environmental Protection Agency conducted a risk assessment of the
respiratory health effects of environmental tobacco smoke (EPA 1992). The EPA report
reviewed available evidence on the health consequences and estimated lung cancer
population risks from exposure to ETS. Included in the EPA report is a summary of the
conclusions from other major reports. This summary is paraphrased below.
National Research Council (NRC). At the request of the U.S. Environmental
Protection Agency and the U.S. Department of Health and Human Services, the
National Research Council (NRC) formed a committee in 1986 to evaluate the
methods for assessing exposure to ETS and to review the literature on all of the
potential health consequences of exposure. The NRC's report concluded that
"considering the evidence as a whole, exposure to ETS increases the incidence of
lung cancer in nonsmokers." Correcting for smoker misclassification and
background ETS exposure, the NRC calculated an overall adjusted relative risk
estimate oi i .42 fur lung cancer in nonsmokers from exposure to ETS from spousal
smoking plus background st-.urces. The NRC report also suggested a link between
ETS exposure and an increa& in pulmonary symptoms and respiratory infections in
children, chronic ear infections and middle ear effusions in young children, and an
increased risk of low-birth weight babies for pregnant women exposed to prolonged
exposure to ETS (NRC, 1986).
Surgeon General Also in 1986, a report by the Surgeon General concluded that
available evidence leads to the conclusion that involuntary smoking is a cause of
5 Department of Health and Human Services, Substance Abuse and Mental Health Administration, 45
CFR Part 96, Substance Abuse Prevention and Treatment Block Grants: Sale or Distribution of Tobacco Products
to Individuals Under 18 Years of Age: Proposed Rule.
April 20,1994
10
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lung cancer/ and that the children of parents who smoke have an increased
frequency of respiratory infections, increased respiratory symptoms/ and a slightly
diminished rate of increase in lung function as the lung matures (DHHS 1986).
Other Reports. Other major reports provide similar conclusions about various
health effects from ETS exposure. The International Agency for Research on Cancer
(IARC, 1986) concluded that there was some link between environmental tobacco
smoke exposure and lung cancer. In a report supported by RJ. Reynolds, an
independent international panel of scientists (Spitzer. etal. 1990) concluded that
evidence supported a positive association between residential exposure to ETS and
the risk of lung cancer. Spitzer. et al. also concluded that there is strong evidence
that children exposed in the home to ETS have higher rates of hospitalization for
severe respiratory illness, and that exposure to ETS is related to asthma in children.
Finally, the National Institute for Occupational Safety and Health (NIOSH) (1991)
concluded that ETS meets the criteria of the Occupational Safety and Health
Administration for classification as a potential occupational carcinogen.
Heart Disease
EPA did not include an assessment of heart disease in its 1992 risk assessment of ETS
exposure. However, NIOSH (1991) reviewed recent epidemiological evidence on the link
between exposure to ETS and both lung cancer and heart disease. NIOSH (1991) concluded
that the recent epidemiological studies "point to a pattern of health effects that is similar for
both smokers and nonsmokers exposed to ETS. " With respect to heart disease, NIOSH
(1991) reviewed the evidence from several studies and concluded that the evidence
suggested a possible link between exposure to ETS and an increased risk for heart disease of
nonsmokers. The NIOSH (1991) review of the evidence is summarized in Exhibit 2-lc.
Studies reported by Hole. fitflL(1989), Helsing. gLaL (1988), and Humble. fiLaL (1990)
associated ETS exposure with an increase of heart disease among persons who never
smoked. The studies by Hole. etal. (1989) and Helsing. fiUL (1988) are large cohort
studies of men and women who live in the same household. Studies of these
cohorts demonstrated an excess of heart disease in persons who lived with smokers
and never smoked compared with persons who lived with nonsmokers and who
never smoked.- Furthermore, Hole. etal. (1989) and Humble, etal. (1990) show an
increasing risk for heart disease mortality with increasing exposure to ETS at home.
Helsing. etal. (1988) found a similar trend in women but not men.
Experimental studies support the hypothesis that ETS exposure has deleterious
effects on platelets and the endothelium and can decrease the time to onset of angina
pectoris in patients with coronary artery disease.
The evidence suggests a possible association between exposure to ETS and an
increased risk for heart disease of smokers.
i
Several studies have estimated the population risk of heart disease from ETS
exposure. Using a relative risk of 1.30 for ETS-exposed nonsmokers relative to unexposed
April 20,1994
11
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nonsmokers. Wells (1988) estimated that 32,000 deaths occur each year to nonsmokers from
exposure to ETS. Glantz and Parmley (1991) reviewed the epidemiological studies since
1984, including the studies reviewed by NIOSH. They estimated a 30% increase in risk of
death from ischemic heart disease or myocardial infarction in nonsmokers exposed to ETS
at home, resulting in an estimated 37,000 heart disease deaths per year. They also noted a
positive dose response relation between the amount of smoking by the spouse and the risk
of heart disease in the nonsmoking spouse. Steenland (1992) analyzed available literature
and predicted that exposure to ETS solely from the one's smoking spouse could cause 15,000
to 19,000 ischemic heart disease deaths per year, and estimated overall that 35,000 to 40,000
cardiovascular disease deaths per year were due to ETS exposure.
In a recent position paper, the American Heart Association reviewed the available
evidence reported above, including evidence on the mechanisms for inducing heart disease
(Taylor, A.E. eLfll 1992). They concluded that the risk of heart disease is increased by about
30% among those exposed to ETS at home and could be much higher in those exposed at
the workplace, where higher levels of ETS may be present. In its position paper, the
American Heart Association adopts the Steenland estimate of 35,000 to 40,000 ETS-related
cardiovascular disease deaths per year (Taylor, etq). 1992).
Base Estimates of Population Risk Used for Calculating Impacts
Restrictions akin to those in H.R. 3434 eliminate almost all nonresidential exposure
to ETS. Various time-activity pattern studies suggest people spend about 28% of their time
out of the home. About .8% of people's time is spent at work, about 2% outdoors, 4% in
transit and 4% in other indoor environments (EPA, 1989). H.R. 3434 would apply to work
and other indoor environments, but would only partially affect in-transit exposures.
Assuming that between half and three quarters of in-transit exposures are already
controlled, and that outdoor exposures are insignificant, this study concludes that H.R. 3434
would apply to approximately 90% of nonresidential exposure to ETS.
Exhibit 2-la and Exhibit 2-lb summarize estimates of U.S. mortality and morbidity
associated with ETS exposure. Using this table as the basis for discussion, the mortality and
morbidity estimates to be used in'the national cost calculations are summarized below.
Long Cancer. EPA estimates that 3,000 deaths occur each year from lung cancer due
to ETS exposure. Of that number, 73% or 2/200 deaths per year are due to exposure
outside of the home.
Other (Nonlung) Cancers. There is insufficient evidence to support inclusion of
nonlung cancers in this estimate.
Heart Disease. Reported estimates for the effect of ETS on heart disease fall in the
range of 32,000 to 40,000 heart disease deaths per year. Because these estimates are
substantial, and because EPA (1992) did not specifically address heart disease in its
risk assessment, two conservative adjustments are made to these figures.
April 20,1994
12
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• First, the low end of the range (32,000) is used as the high estimate, and this is
reduced by 50% (16,000) to obtain the low estimate.
• Second, an arbitrary additional conservative adjustment of 75% is made to
this range, providing a base estimate of 12,000 to 24,000 heart disease deaths
per year6.
The same proportional breakdown between home (27%) and nonhome (73%)
exposure-related deaths as was reported by EPA for lung cancer is also used for heart
disease. Therefore, 3,240 to 6,480 deaths per year are estimated for home exposures,
and 8,760 to 17,520 are assumed to be associated with exposure outside the home.
Burn Deaths. Burn injuries and deaths are estimated elsewhere in this report.
Other Mortality. Studies of the mortality due to ETS exposure from spontaneous
abortion and sudden infant death syndrome respiratory conditions in infants, and
short gestation and low birth weight are based on maternal smoking. These effects
are not included in the estimates presented in this study.
Morbidity. Studies of low birth weight and admission to neonatal intensive care
units-are based on maternal smoking and are also not included in the current
estimates, however, the remaining morbidity effects are included.
Estimated Mortality and Morbidity Effects Of Reduced Exposure to ETS
Home Versus Nonhome Exposures
While smoking restrictions would apply only to nonhome environments, it is
estimated in Section 6 below that between 3% and 6% of the smoking population would
quit smoking as a result of comprehensive smoking restrictions. It is expected that this will
result in an immediate reduction of 3% to 6% of home exposures, and result in a
commensurate reduction in premature deaths due to ETS exposures in the home.
However, those who quit will eventually die of old age or other causes, so this effect is
transitory and will gradually dissipate over a period of some 50 years. Offsetting this is an
estimated reduction in the number of persons who take up smoking each year. In Section
6, a reduction of 5% to 10% in the rate at which new smokers enter the smoking population
is assumed. As fewer persons enter the smoking population each year, the size of the
population decreases, reaching a maximum reduction of 5% to 10% in about 60 years. The
net effect of quitting and reduced initiation is an average annual reduction of between 4.2%
6 Some adjustment may be appropriate also because there appears to have been an increase in the
survival rate of heart disease patients over the past several years due to advances in medical technology.
April 20,1994
13
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and 8.5% in the smoking population (Exhibit 2-3). This is assumed to translate into an
equivalent reduction in home exposure to ETS.?
The greatest reduction in exposure to ETS will come as a direct result of smoking
restrictions in nonresidential buildings. Such smoking restrictions in non-residential
buildings are expected to reduce nonhome exposures by 90%.
Proportional Reductions in Mortality Risk
The impact of reduced exposure on mortality will not be immediate. It is assumed
that the mortality risk for persons will fall over time in the same proportion as the
reduction in the mortality risks of former smokers which gradually fall from the time they
quit smoking. Exhibit 2-2 presents the proportional reductions in mortality risk (PRMR)
from the time of reduced exposure. Calculations are based on the reduction of cancer
mortality risk for male smokers since the time of quitting. Heart disease risks are assumed
to fall twice as fast. Accordingly, it is assumed that full recovery from excess mortality risk
of persons exposed to ETS is accomplished in 20 years.
Estimated Annual Benefits from Mortality and Morbidity Effects
Value of Premature Deaths Avoided From Reduced Exposure to ETS
Based on the proportional reductions in mortality risks and the assumption that
home exposures would decrease by 4.2% to 8.5%, and that nonhome exposures would be
reduced by 90%, the number of premature deaths avoided due to reduced exposure to ETS is
calculated. Exhibit 2-4 provides estimates of premature deaths avoided in ten year
increments, and for 50 year totals. The largest benefits in terms of premature deaths
avoided occurs as a result of reductions in nonhome exposures.
"Willingness to pay" measures are used to value the premature deaths avoided due
to reduced ETS exposure. Willingness to pay measures assess the value that persons assign
to reducing their risk of premature death. The willingness to pay measure used for reduced
exposures to ETS is $4.8 million per premature death avoided. * (See Appendix A-l for a
discussion of this estimate.)
7 Estimates are also presented in Section 6 that smoking restrictions will reduce, by 10% to 15%, the
number of cigarettes smoked per smoker in • 2- hour period. It has been suggested mat some smokers may
increase their consumption &: home in order to make up for lost consumption outside the home. No attempt was
made to account for mis possible effect on ETS exposures because this does not appear to be the general case,
and because the estimate of reduced consumption used herein is a net reduction over the full day.
8 Where possible, w*; rely on willingness to pay measures as opposed to medical cost savings and savings
in lost earnings as the value ot avoiding premansre death. Using medical costs and lost earnings alone would
reprat nt an incomplete measure of the economic value that individuals, and society, assign to avoiding mortal
risk. -•••>'• example, using only medical costs and lost earnings would imply mat social welfare is improved when
individuals die just after retirement — before medical costs are high and just after salary earnings cease.
April 20,1994
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As shown in Exhibit 2-4, the reduction in home and nonhome exposures to ETS
due to the introduction of smoking restrictions in a society with no restrictions would
result in avoiding an average 9,000 to 17,000 premature deaths per year (Exhibit 2-4), The
value of these reductions, when using a willingness to pay measure, and discounting future
reductions at a rate of 3%, would range from $39 billion to $71 billion per year (Exhibit 2-6).
(See Exhibit 5-2 for estimates related to H.R. 3434 under current baseline conditions.)
Value of Morbidity Effects from Reduced Exposure to ETS
The estimated reductions in home and nonhome exposures result in reduced -
morbidity as well as mortality. Morbidity effects from smoking restrictions are shown in
Exhibit 2-6. Reductions in the incidence of these effects are assumed to be immediate, with
no significant time delay, and are proportional to the reductions in exposure previously
discussed. In a society with no current restrictions, the value of reduced morbidity from
smoking restrictions would be between $2.7 billion and $6.5 billion .per year. (See Exhibit S-
2 for estimates related to H.R. 3434 under current baseline conditions.) This value is
dominated by the value of reduced cases of asthma induction, which is a chronic illness.
For this illness, a reduction of between 1,400 and 4,000 cases annually is estimated. To value
the benefits from reduced asthma induction, a willingness to pay measure associated with
chronic bronchitis9 was used.
Section 3. Savings in Operating and Maintenance Expenses
Smoking in a building involves implicit operational and maintenance expenses. In
addition to emptying and cleaning ashtrays, the smoke, ashes, and accidental burns on
furniture and carpets create an additional housekeeping and general maintenance burden.
For example, BOMA reports that in a tightly monitored program, a member firm
experienced a 15% reduction in housekeeping costs when a non-smoking policy was
introduced. Maintenance costs were not covered in the monitoring program. Changes that
were observed included elimination of emptying or cleaning ashtrays; reduction in high
dusting and the dusting of desks and tabletops; reduced detailed vacuuming around desks
of smokers; and reductions in cleaning of Venetian blinds and heating, ventilating and air-
conditioning (HV AC) vents. In addition, cleaning personnel found that they spent less
time moving articles on desks in order to remove ashes. BOMA cautions that this was a
tightly monitored program, and that actual experience may only produce an average of 10%
in overall housekeeping costs." Unit cost estimates for smoking and nonsmoking interior
spaces cleaning and maintenance are provided in Exhibit 3-1.
Maintenance cost savings include less frequent replacement of furniture, and repair
of carpets, fewer repairs of computer equipment operated by smokers, and sometimes less
frequent painting. For maintenance expenses, the high estimate is distinguished from the
9 Based on willingness to pay measure for reducing incidence of chronic bronchitis (Neumann, ctal.
1994), we estimated the value of avoiding chronic asthma to be $15 million per case.
J0 Personal correspondence from James Dinegar, BOMA International to David Mudarri, EPA. January
1994.
April 20,1994 15
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low estimate mostly by the inclusion of items for which there was considerable uncertainty.
Reduced computer repair costs are applied only to the high estimate for offices. Savings in
the replacement of furniture are applied only to the high estimate for offices, health care
and educational facilities, and to the high estimate for lodging and food service
establishments. Carpet repair savings are included in the high estimate for offices,
mercantile and service, health care, assembly, and education, and in the low estimates for
lodging and food service establishments. Detailed estimates for maintenance are provided
in Appendix B-l.
The actual savings in both housekeeping and maintenance expenses would vary
from building to building depending upon use (e.g., offices versus retail stores). To provide
an estimate of the impact of smoking restrictions on housekeeping and maintenance
operations, we developed separate prototype cleaning and maintenance savings estimates
for establishments representing different building uses: office, mercantile and service, food
service, health care, assembly, education, lodging, and warehouse and industrial buildings.
The analysis reflects the assumption that the computed savings would not be
realized in many buildings. For example, only 43% to 60% of firms with smoking bans
report such savings (Carroll, 1990), There are many reasons for this. Firms differ in their
needs for cleanliness (e.g. hotels may be more sensitive than offices), some establishments
already have partial restrictions, and some establishments have rapidly changing personnel
needs, calling for frequent refurbishing activities not related to smoking. Of course, many
establishments may experience savings, but may not notice. Finally, and perhaps most
importantly, many establishments have permanent cleaning and maintenance personnel
are paid fixed salaries, while others may have contractual arrangements that would need to
be renegotiated in order for the savings to be realized.
To estimate the square feet of floor area to which estimated savings would apply,
two downward adjustments were made. First, these estimates are based only on that
portion of the spaces for which the items would apply. For example, persons normally do
not smoke in university classrooms, even in the absence of formal smoking restrictions, so
savings would result only in the office spaces or other common areas in classroom
buildings. Second, using survey data the total commercial square feet for each building use
was reduced by about 40% in most cases. These two adjustments were used to arrive at an
estimate of the applicable square feet to which estimated savings would apply. The results
of these adjustments and the associated savings for each building use category are presented
in Exhibit 3-Z
Using the above described procedures, total savings shown in Exhibit 3-2 suggest that
a society with no prior restrictions would experience a national savings of between $3.9
billion and $4.4 billion per year in housekeeping, and $1.3 billion to $5.6 billion in
maintenance, resulting in a total savings of between $5 billion and $10 billion per year. (See
Exhibit 5-2 for estimates related to H.R. 3434 under current baseline conditions.)
April 20,1994
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Section 4. Increased Productivity and Decreased Absenteeism Resulting from
Smoking Restrictions
Effects on Productivity
On-the-Job Productivity Improvements from Reduced ETS. It is generally agreed
that exposure to ETS reduces the productivity of "individual" building occupants, probably
more for nonsmokers than smokers, though no reliable basis for quantifying this effect
could be found. It is also likely that dearly defined and fairly implemented smoking
policies will increase "organizational" productivity by reducing potential conflicts between
smokers and nonsmokers. Evidence suggests that well-run smoking restrictions are
popular among both employees and management, and that when they are well managed
and tailored to the social norms of individual worksites, they are effective (Andrews. 1983;
Hocking, etal. 1991; Hudzinski, 1990; Peterson. fiLal 1988; Sorensen. et al. 1986; Sorensen. fit
aj. 1991; Stave. fiLal. 1991). Nevertheless, no basis for quantifying effects on organizational
productivity could be found.
Losses in Productivity from Restrictions to Smokers. While reduced ETS exposure
would likely have some positive impact on smokers' productivity, the inability to smoke at
their workstations would likely have the opposite effect. This could occur for two reasons.
First, depending on their level of addiction, some smokers who want to smoke, but are
restricted, may become uncomfortable, and less able to work effectively. Second/ in order to
s moke, smokers would have to leave the workstation and go either to a designated
smoking lounge or outside to smoke. The resulting effect on productivity would be limited
because taking occasional breaks is already a normal part of the workday for most persons.
Thus, while it is likely that some decrement in productivity would result from these two
effects, it is not likely to be large relative to the productivity gains from reduced ETS
exposure, and it would be difficult to quantify.
Net Effect on Productivity. There are both positive and negative influences on
productivity. The ETS effect would increase productivity and apply to all employees.
However, some smokers would work less effectively and some would spend more time
going to and from an allowable smoking area. This may decrease productivity, but would
apply only to smokers, and only to some portion of the smoking population. Quantitative
estimates of these effects could not be developed for this study.
Benefits from Reduced Absenteeism
Several studies suggest that smokers have a greater number of sick leave absences
from work man nonsmokers or former smokers. Using data from the 1979 Report of the
Surgeon General which estimated that 81 million working days were lost to smoking, and
dividing by'the number of smokers,, Kristein (1983) estimated the excess days lost due to
smokers to be 2 days per year. Rice. fiLal (1986) presents data from the supplement to the
1979 National Health Interview Survey showing an average of 4.9 work-loss days per
employed person per year. Non-smokers average 4.3 work-loss days while current smokers
and former smokers combined average 5.4 work-loss days (or 25% more than non-
smokers). Jackson, etal. (1989) also report on other studies which showed 1.5 - 2.2 excess
April 20,1994
17
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workdays lost per month for smokers compared with ex-smokers. Unpublished data from
the 1991 National Health Interview Survey show a difference in the reported mean days
lost of 1 day between smokers and former smokers, and 1.7 days between smokers and
never smokers.
The difficulty in making direct comparisons between the absentee rates of smokers
and nonsmokers is that smokers are generally less educated, have lower incomes, are more
likely to be in blue collar jobs, and are more likely to be alcohol users. These factors could
account for some or all of the differences. However, recent evidence suggests otherwise.
Reporting on a study of an eastern North Carolina pharmaceutical company, and using a
time-series control group design, Jackson, ffal. (1989) report a significant difference between
current smokers and ex-smokers, and between smokers before and after cessation.
Likewise, Manning._£taL_(1991) examined data from the 1983 National Health Interview
Survey and concludes that after controlling for age, sex, race, and education, former
smokers had 31% more work-loss days and current smokers had 52% more work day :ost
per year than never smokers.
The 1993 NHIS data show a mean value in days lost from work of 3 days for never
smokers. We will use Manning. fiLaL's results to compute days lost for smokers and former
smokers since they controlled for confounding variables. Thus, there are associated 0.9
(3 x .31) absentee days per year saved for each smoker who has quit and 1.5 (3 x .52) absentee
days per year for each potential smoker who has refrained from becoming a smoker.
Results are shown in Exhibit 4-1.
m Section 6 below, it is estimated that between 3% and 6% of current smokers
would quit as a result of national legislation that restricts smoking, resulting in an
immediate decrease in the number of smokers and an equivalent increase in former
smokers. It is also assumed that the initiation rate for new smokers wouk decrease by 5%
to 10%, resulting ultimately in a proportional reduction in the number of smokers, and an
equivalent absolute increase in the number of persons who have never smoked. However,
the impact of the reduced initiation rate would gradually take place over a 60 year period.
*
Finally, the estimated value of excess absences per smoker or former smoker is
presented in Exhibit 4-2. The average value of each day lost is taken to be approximately
$104 per day. This is the weighted average of the median daily earnings of white collar, blue
collar, and service workers (weighted by the proportion of the smoking population in each
of these categories). The reported earnings are inflated by 24% to account for fringe
benefits.n
Given that a smoker's - rage daily earnings including fringe benefits is about $104,
and discounting all future effects by 3% yields an estimated savings of under $0.5 billion per
year (Exhibit 4-3). This is quite ^significant when compared with other effects. (See Exhibit
S-2 for estimates related to H.& 3434 under current baseline conditions.)
11 The daily earnings are the BLS median weekly earnings divided by 5. The smoking prevalence rates by
labor category are given in DHHS1989.
April 20,1994
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Section 5: Savings in Smoking-Related Fires
Smoking is the leading cause of fire deaths in the United States. According to the
National Fire Protection Association (NFPA), smoking materials were the cause of more
than 200,000 fires per year during the decade of the 1980s (Miller 1993). Smoking-related
fires refer to those caused by lighted tobacco products, and not cigarette lighters or matches.
Most smoking-related fire injuries and property losses are in residential
environments, which would not be subject to smoking restrictions. For example, between
1988 and 1990, there was an annual average of some 1328 smoking-related fire fatalities in
residences compared to an annual average of 38 fatalities in non-residential buildings
(Exhibit 5-1). Likewise, property damage due to smoking-related fires over the same period
averaged some $316 million annually for residences, compared to $115 million annually in
non-residential buildings.
This study estimates that smoking restrictions comparable to H.R. 3434 would
eliminate 90% of the smoking-related fires in the non-residential sector with smoking bans.
A 50% reduction in the nonresidential sector with smoking lounges is assumed. Further,
because smoking restrictions are postulated to reduce the smoking population through
quitting and reduced initiation, a proportional decrease in residential smoking-related fires
is also estimated. Estimated reductions in injuries, deaths, and property damage from
smoking restrictions in a society having no such restrictions is presented in Exhibit 5-2.
Because a large portion of smoking related fatalities is in residences, the annual benefits
from smoking restrictions in public buildings is minimal, and would be on the order of
$0.6 billion to $0.9 billion per year (Exhibit 5-3). (See Exhibit S-2 for estimates related to H.R.
3434 under current baseline conditions.)
April 20,1994
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Section 6: Impacts of Smoking Restrictions on Smokers
The Health and Economic Consequences of Smoking
In 1990, smoking caused an estimated 419,000 deaths in the United States (CDC,
1993a). Of these, approximately 116,000 were caused by cancers of the lung, trachea, or
bronchus; 134,000 were caused by heart disease; and 74,000 were caused by respiratory
diseases. Significant morbidity consequences are also associated with smoking. Smoking is
dearly a major cause of health impairment and death. However, about 25 billion packs of
cigarettes are sold each year. This means that individuals, with some knowledge of the
risks of smoking, make a conscious choice to smoke, despite the expense and the
consequences. Therefore, evaluating the social costs and benefits related to smokers is
significantly different from evaluating the social consequences of exposure to ETS or other
pollutants.
This subject is approached first by estimating the effects which would result from
smoking restrictions on die behavior of smokers and the resulting effects on health. Issues
concerning the valuation of these effects are then discussed.
The Impact of Smoking Restrictions on Smoking Behavior
Several parameters which describe the smoking population and its smoking
behavior are relevant to assessing the health effects of smoking restrictions. Smoking
restrictions may increase the rate at which individuals quit smoking and thereby reduce
smoking prevalence, and it may reduce dgarette consumption by those who do smoke.
Both of these factors will reduce the per capita consumption of cigarettes, but the impact on
health will be less than proportional to this reduction. Those who quit smoking become
former smokers. The relative risk of health impairment of former smokers is less than it is
for smokers, but greater than it is for persons who have never smoked (never smokers).
Similarly, the relative risk for smokers is reduced by theu average consumption, but it is
not eliminated. Those who quit or reduce consumption will enjoy a longer life expectancy,
but the result in annual death rates will take time to develop as the population ages.
Smoking restrictions may also reduce the rate at which nonsmokers take up
smoking. Since most persons who initiate smoking do so at a young age, the full impact of
this will be manifested over tht long term. However, it will have a greater impact on
health because the risk of health impairment for persons who never smoked is less than it
is for smokers or former smokers.
The Effect of Smoking Restrictions on Smoking Prevalence
There is a plausible presumption that an institutional environment that restricts
smoking and that supports abstinence will reduce dgarette consumption among smokers,
increase attempts to quit improve quitting success rates, and reduce the rates at which
nonsmokers take up smoking. However, in 1989, the Surgeon General found that evidence
of the effect of smoking restrictions on actual smoking behavior was considered to be
inconclusive (DHHS 1989). Since that time, a number of studies appear to support the
April 20,1994
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conclusion that such restrictions have some of the postulated effects on smoking behavior,
and that these effects are potentially more powerful than other antismoking efforts. These
studies are summarized in Appendix A-2 .
%
Almost all of these studies relate to smoking restrictions in the workplace where
smoking behavior was compared before and after institution of a smoking policy. A few
studies also compared worksites with smoking restrictions to worksites without smoking
restrictions. Only two studies dealt substantively with the effect of smoking restrictions on
the decision of nonsmokers to take up smoking (smoking initiation rates). Most studies
examined changes in smoking prevalence and the proportion of smokers who quit (quit
rates). A few studies also provide data on the extent to which smokers change their
consumption habits.
Effect of Smoking Restrictions on Quit Rates&
A review of recent studies of the impact of smoking policies on smoking behavior
reveals a wide range of potential effects on quitting behavior, including some studies that
show no effect at all. Some authors have offered an explanation of this phenomenon
(Sorensen and Pechacek, 1989; Stillman. sLaH 1990; Woodruff, eial 1993). Increased quit
rates and decreased rates of smoking prevalence that appear to follow the introduction of
restrictive smoking policies may reflect the acceleration of quitting behavior around the
time the policies are introduced. Since the quit rates are highest among those who
otherwise planned to quit and have in the past atter ipted to quit, it is possible that smoking
restrictions result in a rapid increase in quitting followed by a leveling off. Depending upon
the time frame in which the changes in behavior are measured, one could observe a wide
range of quit rates all reflecting the same basic phenomenon. For example, if behavior was
measured just before and then again after the policy, but smokers had already adjusted their
behavior in anticipation of the policy was initiated, their reaction would not be measured
and changes in behavior would appear to be minimal. Likewise, if behavior was measured
just before smokers adjusted their behavior and then soon after, a rather substantial effect
would be observed. However, if sufficient follow-up studies were not conducted, one could
not tell whether the higher quit rates that were measured were actually maintained over
the long term. This analysis adopts this as a plausible explanation of the wide range of
behavioral changes observed to date, and incorporates the following derivation of the effect
of H.R. 3434 on quitting.
The first step in deriving the quit rate effect of smoking restrictions is to review quit
rates reported following implementation of existing workplace smoking restrictions.
Recent studies suggest gross quit rates range from 9% to 17% (Exhibit 6-1). These gross quit
rates must be adjusted, however, to take account of several factors.
Second, some smokers who quit eventually renew their habit. Historical data
suggest this relapse rate is approximately 50% (CDC 1993b). Therefore, to develop an
estimate of the quit rate effect of national legislation, the gross workplace quit rate must be
period.
April 20,1994
12 The term quit rate refers to the proportion of smokers who become former smokers in a given time
21
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adjusted to net out historical average quit rates observed in the absence of smoking
restrictions Data suggest this rate is approximately 2.5% (CDC, 1993b). Therefore, to
develop an estimate of the quit rate effect of comprehensive national legislation, the
estimated gross workplace quit rate must be adjusted to take account of relapse. For the
current analysis/ the relapse rate is lowered to 30% to reflect the characteristics ef
comprehensive nation-wide restrictions. Specifically, the pervasiveness of nationwide
restrictions is expected to reduce overall relapse rates and their implementation is expected
to lead to substantial increases in stop-smoking support services and other support
programs which would further lower the relapse rate, particularly among workers. Quit
rates and relapse rates for smokers not subject to workplace restrictions, however, ar<
assumed herein to remain at long term historical average levels.
Third, an adjustment must be made to account for portions of the adult smoking
population who are retired or not employed. This analysis assumes that the smoking
behavior of these individuals would not be affected by national legislation. Since
approximately, 60% of the adult population is employed, the quit rates estimated for
employed persons is reduced by about 40%.
Finally, an assumption must be made regarding the persistence of the effect of
national legislation on decisions to quit. Plausible arguments can be made that nation-wide
restrictions would have an on-going influence on decisions to quit and on the success of
attempts to quit. However, consistent with the preceding discussion of quit rate persistence,
the current analysis adopts the conservative assumption that national legislation would
lead to only a "one-time" increase in net quit rates among the cm-rent population of
smokers.
As shown in Exhibit 6-1, the estimated net quit rates resulting from the above
approach ranges from 4% to 8% for employed individuals, and from 3% to 6% of the total
current adult smoking population. This net quit rate includes those individuals who are
retired or otherwise not employed.
Effect of Smoking Restrictions on Initiation Rates
Most persons who become regular smokers do so as teenagers or young adults.
About 75% of adults who have ever been regular cigarette smokers report that they tried
their first cigarette before the age of 18 and about half of them had become regular smokers
by that time. Cigarette smoking among U.S. youth appears to have declined sharply in the
late 1970s and stabilized in the 1980s (CDC, 1991).
Wasserman, ** al. (1991) estimated that legislation that substantially restricts
smoking in the workplace would reduce cigarette consumption by teenagers by 41%, and he
reports that most of this would result from the effects of reduced initiation among
nonsmoking teenagers. .If this is interpreted to mean about three fourths of the effect is due
to reduced initiation, the 41% reduction would translate into roughly a 31% reduction in
initiation. Likewise (Woodruff. fiLal* 1993), when comparing worksites having a few
smoking restrictions with those having a smoking ban. reported a 43% difference (37%
versus 21%) in the proportion of occasional smokers who become regular smokers.
April 20,1994
22
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EPA believes that these studies are not adequate to support the inclusion of a
substantial reduction of initiation rates in this analysis. Consistent with the conservative
approach to estimating the effect of smoking restrictions on smoking behavior, this analysis
assumes that smoking restrictions comparable to H.R. 3434 would reduce initiation rates by
only between 5% and 10%. However, unlike the temporary increase in quit rates which
would have an immediate impact on smoking prevalence, the effect of reduced initiation
would be to gradually reduce the size of the smoking population, and would take more
than a generation to reach the majority of its impact. Nevertheless, those who fail to
initiate smoking remain nonsmokers, rather than former smokers, so that the health
impact of reduced initiation is greater.
Effect of Smoking Restrictions on Cigarette Consumption
With respect to reductions in consumption by smokers who continue to smoke after
national legislation is enacted, this analysis relies on recent studies that estimate that
workplace restrictions reduce consumption by 18% to 34% (Exhibit 6-1). These estimates are
of reduced consumption by smokers who continue to smoke and do not reflect double-
counting of reductions in aggregate consumption by smokers who quit. Consistent with.the
assumption that only the smoking behavior of employed persons would be affected by
national legislation, this analysis estimates that the effect of national legislation would be to
reduce consumption rates of smokers by about 10% to 15%.
Net Effect of Smoking Restrictions
Based on the assumptions of a one time increase in quit rates and of a reduction in
the relapse rate for those who quit, this analysis projects a 3% to 6% decrease in the number
of smokers, and a corresponding increase in the number of former smokers. This effect
will influence health and death incidence rates, but they will be less than if this were a
reduction in the number of persons who had ever smoked. The smokers who remain will
be less able to quit, and it is assumed that quit rates and relapse rates for those who remain
smokers will be no different than historic levels. However, smokers who continue to
smoke will reduce their consumption of cigarettes by approximately 10% to 15%. If
initiation rates were not affected, the population of smokers would gradually increase to the
level they would be without the passage of smoking restriction legislation. However, the
reduction in initiation rates will gradually reduce the population of smokers by about 5% to
10%, resulting in a corresponding increase in the number of those who never smoke.
Health Effects of Smoking Restrictions on Smokers
The reductions in smoking-related premature deaths result from the elevation of
quit rates, and reductions in consumption and initiation. The effect on premature death
rates depends on the disease, the age of the smoker, and the length of time this change of
behavior has been in effect. While a completely rigorous treatment of these effects is
beyond the scope of this assessment, simplified assumptions were used to account for these
effects and the varying time stream in which these effects occur.
April 20,1994
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The influence of changing of quit rates on the number of annual deaths due to
smoking is calculated in Exhibit 6-2 and Exhibit 6-3. The reductions in mortality ratio for
smokers who quit rise with years of abstinence and are provided in DHHS 1990. From this,
the percent reduction in mortality ratio (PRMR) for each ten year increment in the time of
abstinence is calculated, as presented in Exhibit 6-2. Hie number of deaths due to smoking
for each age group of the population is estimated using data from OTA (1985) and OTA
(1993). This is used as a baseline, and the age distribution and the calculated death rates are
assumed to remain constant over time in the absence of smoking restrictions. Given the
PRMR, the proportion of smokers who quit, and the age of the smoking population, a time
stream of premature deaths avoided from quitting is calculated (Exhibit 6-3). This analysis
shows that in a society with no smoking restrictions, quitting due to the imposition of
smoking restrictions would result in avoiding an annual average of between 5,000 and
11,000 premature deaths per year in the first 50 years. ((See Exhibit 5-2/or estimates, related
to H.R. 3434 under current baseline conditions.) Beyond 50 years, however, the cohort of
quitters would have succumbed to death from old age or other causes, resulting in no
further effects.
We assume that all persons who initiate smoking are under the age of 35. We use
this assumption to calculate the reduction in smoking prevalence over time, given our
estimate of reduced initiation. Premature deaths avoided are assumed to be proportional to
smoking prevalence in each age group. From this, we calculate the time stream of
premature deaths avoided from reduced initiation (Exhibit 6-4). We estimate that, in a
society with no smoking restrictions, reduced initiation from smoking legislation would
result in an average decrease in premature deaths of between 4,000 and 8,000 per year in tl.e
first 50 years, approximately 18,000 per year between the 50th and 60th year, and
approximately 20,000 every year thereafter. ((See Exhibit $-2 for estimates related to H.K.
3434 under current baseline conditions.)
Based on the data presented in DHHS (1989), and DHHS (1990), the mortality ratio
for lung cancer appears to be approximately proportional to the number of cigarettes
smoked. This proportional relationship is representative of other diseases also, and it is
further assumed that the PRMR with years since the time of reduction follows the same
pattern as that calculated for quitting (Exhibit 6-2). Using these assumptions, the PRMR for
reduc .. consumption and the corresponding premature deaths avoided due to reduced
cons: ption are calculated in Exhibit 6-5. Relative to a society with no smoking
restrictions, reduced consumption from smoking legislation would be estimated to result in
an annual average decrease in premature deaths of between 26,000 and 51,000 per year in
the fir 50 years, and approximately 40,000 every year thereafter. ((See Exhibit S-2 for
estimates related to H.R. 3434 under current baseline conditions,)
Ufe Expectancies and Life Yean Recovered from Smoking Restrictions
Premature deaths of young or middle aged persons may be regarded differently than
premature deaths of persons in their late 60s. Therefore, an important dimension of the
effects of smoking restrictions is an assessment of the life years restored as a result of
avoiding premature deaths.
April 20,1994
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In Exhibit 6-6 survival probabilities and probabilities of death are estimated for
persons who have ever smoked and persons who have never smoked using data provided
by Hodgson (1992), and using the age distribution of smokers and former smokers. The
years lost by premature death to the age of 65 and to life expectancy are then calculated as
shown in Exhibit 6-7.
in Exhibit 6-8, the life years extended to age 65 and to life expectancy are estimated
and reported by type of smoking behavior impact. Accordingly, it is estimated that those
who the average yearly expenditure for medical services for smokers and former smokers
exceeds that of nonsmokers. However, this is partially offset by the fact that nonsmokers
live longer, and continue to consume medical services during the extra years of life. When
both of these factors are taken into account, the result is a net excess burden on the medical
service industry of about $35 billion per year due to smoking.13 Implementing smoking
restrictive legislation would reduce this excess burden on the medical service industry by
reducing the number of smokers and former smokers. Assuming that medical
expenditures are proportional to smoking-related premature deaths, every reduction in
annual premature deaths avoided by virtue of some smokers quitting, cutting back, or
failing to initiate smoking, would represent a reduction of $85,000 per year for medical
services.
Net Effect of Smoking Restrictions on Premature Deaths and Medical Expenses
The results of this analysis suggest that smoking restrictions, relative to a society
with no restrictions, would result in significant reductions in premature deaths per year
from persons quitting, cutting back, or declining to initiate smoking. These reductions
would both extend lives of those affected by 4 to 8 years for those who quit or reduce
consumption, or by 15 years for those who decline to smoke. When future values are
discounted by 3%, it is estimated that for a society with no current restrictions, this would
result in a reduction of approximately $3 billion to $4 billion in expenditures for medical
services per year. Comparable reductions related to implementation of H.R. 3434 would be
about 77% of these values or $2.3 billion to $4.7 billion in reduced medical expenditures per
year. (See summary of costs and benefits of H.R. 3434 below.).
Value of Benefits or Losses Regarding Smokers
This analysis assumes that, faced with restrictions on where they may smoke, some
current smokers would quit and some would reduce overall consumption. In addition,
these restrictions would also tend to discourage many nonsmokers, such as teenagers, from
becoming smokers.
These changes in behavior would result in significant improvements to the health
of smokers themselves, extension of their life expectancy due to the avoidance of
13 This is estimated from-information provided by Hodgson (1992) who compares excess medical costs
over the lifetime of ever smokers and never smokers. Similar data and procedures were also used by Manning fit
25
April 20,1994
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premature death, and reductions in medical expenses during their lifetime, as well as other
benefits such as increased safety and reduced property damage from smoking-related fires.
Clearly, these health benefits to smokers are highly significant. However, there
remain 46 million smokers who purchase approximately 25 billion packs of cigarettes
annually, and about 1 million persons become regular smokers each year. Since smokers
do this despite the risks and costs, one would presume that, provided these persons are
rational, fully knowledgeable, and are able to accurately assess the consequences of smoking,
including potential addiction, the benefits of smoking to them outweigh the risks and costs.
Hov ever, for a number of reasons, this study does not attempt to estimate the economic
value of the benefits or losses Carding smokers.
First, EPA is concerned that the economic measures traditionally applied to the
health consequences of pollution may not be appropriate to use in estimating the social
value of physical effects of smoking that occur to smokers themselves. Exposure to
pollution, such as ETS, is essentially involuntary and uncompensated. Addiction
arguments aside, smoking is a voluntary activity that results in other consequences for
smokers, some positive and some negative. These other consequences are not reflected in
measures of value for health risk reductions sometimes used by EPA. Applying traditional
health risk valuation factors to health consequences for smokers would therefore
inappropriately omit the value of all these other costs and benefits to smokers, resulting in
potentially biased measures of the value change to society.
Second, analysts disagree whether the traditional economic models one might use to
measure the welfare change to smokers can be reasonably applied, particularly given limits
on available data. To obtain reasonable estimates of the change in net benefits to smokers,
these traditional models require that the subjects, smokers in this case, are acting rationally
in response to a free and open marketplace. Furthermore, these consumption decisions
must either be devoid of significant price distortions such as taxes and subsidies, or
analytical corrections must be made to take Account of these distortions. With respect to the
rationality requirement, questions have been raised whether the rational consumer cho ce
model applies given the apparent addictive nature of smoking.*4 Questions have also
been raised whether the consequences of taxes (e.g., cigarette tax) and subsidies (e.g., tobacco
farm subsidies, subsidized health care) significantly distort consumer decision making in
this case.
Third, EPA is concerned that currently available data are insufficient to support
using a traditional economic model to estur
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be expressed in economic terms as an increase in the transaction cost of smoking, and the
transaction cost would vary widely among smokers. Since it is unclear how the slope of the
demand curve for cigarettes might shift in response to a nonuniform increase in
transaction costs to smokers, a reliable measure of the change in net benefits to smokers
cannot be derived.
Based on the foregoing, this study makes no attempt at this time to express the
health consequences of H.R. 3434 to smokers themselves in social value terms.
Summary of Costs and Benefits With Reference To A Society With No Smoking
Restrictions
This completes the assessment of smoking restrictions using our analytic baseline of
a society with no restrictions. The results of this analysis are summarized in Exhibit S-l,
and may be interpreted as the costs and benefits of smoking restrictions in a society where
no such restrictions exist. This summary analysis forms the basis for estimating the effects
that H.R. 3434 would have on current society, which is the subject of the remaining portion
of this report.
April 20,1994
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Cost and Benefits of H.R. 3434
Based on Current Conditions
S-l summarizes the costs and benefits of smoking restrictions that would occur on a
society with no current smoking restrictions. However, to assess the impact of H.R. 3434,
the level at which current restrictions already exist must first be assessed.
Baseline Estimate of Compliance
Establishments with Existing Smoking Policies. Many establishments already have
some form of smoking policy. The National Survey of Worksite ..Health Promotion
Activities collected information on worksite smoking policies. In 1992, 59% of worksites
covering more than 50 employees had a formal smoking policy that either banned
smoking, or restricted smoking to separately ventilated areas (DHHS, 1992), This represents
a substantial increase since 1985 when only 27% of the worksites reported such policies.
Exhibit 7-1 provides data from the 1992 survey (DHHS, 1992). In general, larger worksites
were more likely to have such policies than smaller worksites. The 1992 survey covered a
wide variety of establishments in the following categories: manufacturing; wholesale and
retail; services; transportation, communications, and utilities; finance, insurance, and real
estate; and agriculture, mining, and construction establishments.
The Bureau of National Affairs and the Society for Human Resource Management
have conducted surveys since 1985 of members of the American Society for Personnel
Administration concerning workplace smoking policies. Organizations spanned a wide
range of manufacturing and commercial enterprises (BNA, 1986). In 1991, 85% of
responding firms had smoking policies designed to address employee health and comfort,
up from 5% in 1987 and 36% in 1986. Total bans on smoking existed in 34% of the firms,
compared with 7% in 1987 and just 2% in 1986 (BNA, 1991).
Many state and local laws require some form of smoking restriction in different
indoor environments, but for the most part, these are not very restrictive. Exhibit 7-2
summarizes 1993 data (unpublished) from the Centers for Disease Control, Office of
Smoking and Health on the types of state laws restricting smoking. At the time the data
were collected, no states had laws banning smoking in public places or restricting smoking
to separately ventilated areas. Since that time, Vermont has passed such a law, and similar
laws exist in some local jurisdictions. However, requirements for designated smoking areas
(not separately ventilated) in public places exist in 40 of the 53 states and territories, and 31
states or territories have similar restrictions for restaurants.
It is clear from the above that not all entities subject to H.R. 3434 would suffer the
full cost burden of compliance. Those that already comply would suffer no burden, and
others that partially comply may suffer only a partial burden. These issues are incorporated
into the assessment method described below.
Current Compliance Estimates. DHHS (1992) estimated that 59% of working
establishments with 50 or more employees have restrictive smoking policies which either
ban smoking or restrict it to separately ventilated areas. The BNA survey suggests that 34%
April 20,1994
28
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completely ban smoking. Data from these surveys show a clear trend toward the
establishment of smoking policies in general, and total smoking bans in particular, among
American business enterprises. However, the figures may overstate the proportion of
building spaces actually covered by such policies. Coverage is inversely correlated with the
size of firms (Exhibit 7-1). The DHHS survey did not include firms under 50 employees.
While the BNA survey did not apparently exclude such firms, smaller firms are unlikely to
have personnel administrators as those who were surveyed.
DOE (1991) provides data which suggests that 55% of employees in commercial
establishments are in buildings with less than 50 employees. Given this, the proportion of
employees currently covered by various smoking restrictions under various assumptions
about the policies of small firms are estimated. The results are presented in Exhibit 7-3a.
For example, there is widespread opinion among those involved in the smoking issue that
only a portion of small firms have a formal smoking policy. Lewit (1993) showed that the
compliance rate by small establishments (under 50 employees) to a New Jersey law was less
than half the compliance rate for larger establishments. If one assumes that 10% of small
establishments have smoking policies of the type reported in the DHHS survey, there
would be 32% (vs. 59%) of all employees covered with restrictive smoking policies, and 21%
(vs. 34%) would be under a smoking ban. The difference (11%) would have smoking
allowed in separately ventilated areas. The results only slightly change with alternative
assumptions about small firms.
This study therefore assumes that about 32% of employees are covered by restrictive
smoking policies that either ban or restrict smoking to a separately ventilated area. This is
composed of 21% which completely ban smoking, and 11% which allow smoking only in
separately ventilated areas. It is generally believed that most of the survey responses which
indicate separate ventilated smoking areas do not meet the stringent separate ventilation
requirement of H.R. 3434 (see discussion in Section 2). Assuming that the 10% of
employees with ventilated smoking areas is composed of one fifth (2%) with adequate
ventilation, 23% (21% + 2%) of all establishments are estimated to already be in compliance
with standards comparable to the requirements of H.R, 3434 (Exhibit 7-3a). Using the same
distribution of employees covered by bans and lounges, we estimate that about 80% to 90%
will be covered by a ban, and 10% to 20% by a lounge after H.R. 3434 is implemented
(Exhibit 7-2b). However, as indicated in Section 1, a small portion of those under a smoking
ban are likely to be serviced by some form of outdoor smoking shelter. The actual degree of
compliance may well be less than this estimate because of the way in which respondents
answer questions about their policies. For example, Rigotti (1992) reports that when
assessing compliance with a local smoking ordinance in Brookline, MA, self-reported
prevalence of smoking policies greatly exceeded that directly observed.
Summary Comparison of Costs and Benefits Of H.R. 3434 Based on Current
Conditions-
Exhibit S-2 summarizes the estimated costs and benefits of implementing national
legislation such as H.R. 3434, using a baseline estimate that 23 percent of the population is
already subject to such restrictions. Current levels of cigarette consumption are also used to
April 20,1994
29
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assess costs and benefits under this baseline. The following sections provide additional
detail of these results.
-...:. Costs of Implementing Smoking Restrictions
Policy Implementation and Smoking Lounges
The analysis shows that costs of implementing legislation such as H.R. 3434 appear
to be quite low relative to the benefits that would be achieved. Establishments would
experience costs of establishing a policy/ communicating the policy to employees or
clientele, posting signs, assuring compliance, and sometimes offering smoking cessation
services. These activities would cost between $0.1 billion and $0.4 billion.
The main determinant of cost is the expenditure associated with the construction
and maintenance of smoking lounges. Smoking lounges meeting the strict requirements of
H.R. 3434 would have to meet stringent standards concerning ventilation and other
provisions to insure that the air in the lounge does not enter other parts of the building. In
addition, smoking policies involving smoking lounges are generally associated with greater
complaints and with lower reported satisfaction than smoking bans, and smoking bans are
becoming increasingly popular (Sorensen. eial. 1991; 1991a, 1992; Stillman. etal. 1991).
Finally, the structural features of many existing buildings make it infeasible or cost
prohibitive to construct a smoking lounge which would meet the requirements of H.R.
3434.. While the extent to which smoking lounges will be relied upon to comply with this
legislation is ui.certain, for the reasons mentioned above, this analysis estimates that only
10% to 20% of establishments would opt for smoking lounges.
The total cost of implementation by the public and private sector is estimated to
be approximately $0.4 billion (10% smoking lounge) to $1.4 billion^ (20% smoking lounge)
per year.
Enforcement Costs
Some expenditures by the Federal government and by state and local governments
can be expected for information dissemination, though they may well be less than the value
of current resources devoted to passing controversial state and local legislation.16 Costs to
building owners for insuring compliance in their building is included in the cost of
implementing smoking policies. With respect to enforcement by governmental
jurisdictions, H.R. 3434 provides no specific requirements for enforcement of its provisions,
other than through citizens suits in federal court. Therefore, enforcement costs are difficult
W Includes a higher cost per lounge.
1* Even when smoking restrictions are passed at the state or local level, campaigns to nullify the
legislation or to preempt local legislation with weaker state legislation can involve the expenditure of significant
resources on both sides of the issue. No attempt was made to quantify current costs to state and local entities,
though-ational legislation would be expected to reduce many of these costs. For an excellent analysis of this issue
as it is manifested in California, see Macdonald and Glantz (1994).
April 20,1994
30
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to quantify. Based on an estimate in a proposed rule concerning the distribution of tobacco
products to individuals under the age of 18, an estimate of between $0.1 billion and $0.4
billion per year appears plausible/ and is used in this analysis as the cost of enforcement of
legislation comparable to H. R. 3434 under current baseline conditions.
Health Benefits from Reductions in Environmental Tobacco Smoke (ETS)
The Health Consequences of ETS
A major component of the benefits hich could be achieved from national
legislation that restricts smoking in public ^ aces is from reduced exposure of building
occupants to ETS.
Exhibit 2-1 presented information on the health consequences of ETS. For the
purpose of valuing the benefits resulting from reduced exposure to ETS due to smoking
restrictions, several conservative adjustments to these figures were made before making an
assessment of the value of benefits resulting front reduced ETS exposure. The reduction in
exposure resulting from smoking restrictions comparable to H.R. 3434 is estimated to result
in an average reduction of 7,000 to 12,900 premature deaths per year over the first 50 years,
and approximately 7,500 to 13,000 per year thereafter. The value of these reductions, when
using a "willingness to pay" measure, and discounting future reductions at a rate of 3%,
would range between $33 billion and $60 billion per year.
To this has been added benefits to be achieved from improved health, mostly to
children, including reduced incidence of lower respiratory tract infections, ear infections,
and asthma. These benefits are estimated at between $2 billion and $5 billion per year, most
of which is associated with reduced asthma induction among children.. For asthma, this
analysis reflects an estimated reduction of between 1,200 and 3,000 cases annually. To value
the benefits from reduced asthma induction, we used a willingness to pay measure
associated with chronic bronchitis, which is also a chronic respiratory disease.
The total benefit from reduced ETS exposure includes both the benefits of premature
deaths avoided plus the benefits of reduced illness. The total benefits due to reduced ETS
exposure is thus estimated to be $35 billion to $66 billion per year.
Increased Coaifort of Building Occupants: This analysis assumes that, all else being
equal, no building occupant would prefer being exposed to environmental tobacco smoke,
and that most derive benefits from a smoke free environment. With the exception of the
health, productivity, and safety effects discussed elsewhere, these benefits are largely
intangible, and include such factors as reduced irritation and reduced environmental odor,
and less annoyance with tobacco smoke residuals left on hair and clothing. In the present
study, no attempt was made to quantify these benefits. However, because the overall results
do not include the benefits of increased comfort, and because of the pervasive use of
conservative assumptions in this analysis, it is expected that the estimate of total benefits
from reduced ETS exposure is conservative.
April 20,1994
31
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Savings in the Operation and Maintenance of Buildings
Smoking in a building involves implicit operational and maintenance expenses. In
addition to emptying and cleaning ashtrays, the smoke, ashes, and accidental burns on
furniture and carpets create an additional housekeeping and general maintenance burden.
For example, the BOMA reports that in a tightly monitored program, a member firm
experienced a 15% reduction in housekeeping costs when a non-smoking policy was
introduced. Maintenance costs were not covered in the monitoring program.
The actual savings in both housekeeping and maintenance expenses are expected to
vary from building to building depending upon use (e.g., offices versus retail stores). A
separate estimate was therefore developed for different uses. The cost saving estimates
were then allocated just to the portions of those buildings for which they would apply.
Finally, it was recognized that the computed savings would not be realized in many
buildings. Using survey data to indicate proportions of establishments that experience
maintenance savings, the square feet to which savings would apply was decreased by about
40% in most cases.
Taking these factors into account, this analysis estimates that the savings in
operating and maintenance costs would amount to about $4 billion to $8 billion per year.i?
Effects on Productivity
On-the-Job Productivity Improvements from Reduced ETS. It is generally agreed
that ETS reduces the productivity of "individual" building occupants, and that dearly
defined and fairly implemented smoking policies will increase "organizational"
productivity by reducing potential conflicts between smokers and nonsmokers. While
reduced ETS would likely have some positive impact on smoker productivity, the inability
to smoke at their work station would likely have the opposite effect.
The ETS effect would increase productivity and apply to all employees. However,
some smokers would work less effectively and some would spend more time going to and
from an allowable smoking area. This may decrease productivity, but would apply only to
smokers, and only to some proportion of the smoking population. Quantitative estimates
of these effects could not be developed for this study.
Benefits from Reduced Absenteeism
After accounting for differences in socioeconomic characteristics between smokers
and persons who have never smoked, smokers are estimated to have about 50% more
11 The housekeeping and maintenance cost savings, when compared to the cost of implementing
smoking restrictions, including smoking lounges, suggest mat some building owners may be induced to consider
implementing smoking restrictions in order to increase profits, even in the absence of smoking restriction
legislation.
April 20,1994
32
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workdays lost than persons wno have never smoked, and former smokers are estimated to
have about 30% more workdays lost than never smokers (Manning, etal. 1991).
Based on a review of recent studies, it is estimated that between 3% and 6% of
current smokers would quit as a result of national legislation that restricts smoking. This
would result in an immediate decrease in the number of smokers and an equivalent
increase in former smokers. The initiation rate for new smokers is also estimated to
decrease by 5% to 10%. This would ultimately result in an equivalent proportional
reduction in the number of smokers , and an equivalent absolute increase in the number of
persons who have never smoked. The average daily earnings including fringe benefits of
smokers is about $104, and discounting all future effects by 3% yields an estimated savings
of under $0.5 billion per year.
Savings in Smoking-Related Fires
Most smoking-related fire injuries and property losses are in residential
environments, which would not be subject to smoking restrictions. As a result, the savings
from smoking restrictions would be minimal, and is estimated to be approximately $0.5 to
$0.7 billion per year. This estimate includes the effect of an estimated reduction in cigarette
consumption at .home because of quitting and reduced initiation.
Social Benefits or Losses Regarding Smokers
Smoking restrictions comparable to those in H.& 3434 would be expected to result in
some reduction in overall cigarette consumption. Faced with restrictions on where they
may smoke, some current smokers may quit and some mav reduce overall consumption. In
addition, these restrictions would also tend to discourage many nonsmokers, mostly
teenagers),18 from becoming smokers.
These changes in behavior wouid result in significant improvements to the health
of smokers themselves, as well as other benefits such as increased safety and reduced
property damage from smoking-related fires. Based on the assumptions used in this
analysis, EPA estimates changes in smoking behavior would result in an average of 27,000
to 54,000 fewer premature deaths per year among smokers during the first 50 years, and
47,000 to 92X100 fewer premature deaths per year thereafter." On average, smokers who quit
or cut back would add back an average of 5 to 3 years of life otherwise lost to smoking-
M CDC (1991).
W The difference in death rates each year results from the different time patterns of the effects of quitting
and cutting back on c mttumption, and because die analysis assumed that it would take 60 years reduced annual
initiation to complete it* effect on me size of the Biasing population. Therefore, the 54*000 to 92,000 premature
deaths reflect annual rates after 60 years for reducea initiation. In addition, this analysis assumed H.R. 3434 would
have only a "one time" effect on decisions to quit, rather than an ongoing effect Therefore, the HR, 3434-nUtod
quitting eventually disappears as the cohort of smokers motivated to quit by H.R. 3434 dies from old age or other
causes.
April 20,1994
33
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related premature death. For those nonsmokers who avoid becoming smokers, life is
extended by an average of about 15 years.
Clearly, these health benefits to smokers are highly significant. However, for a
number of reasons this study does not attempt to interpret the social value of these changes.
First, the economic measures traditionally applied to the health consequences of pollution
may not be appropriate to use in estimating the social value of physical effects of smoking
which occur to smokers themselves. Exposure to pollution, such as ETS, is essentially
involuntary and uncompensated. Addiction arguments aside, smoking is a voluntary
activity which results in other consequences for smokers, some positive and some negative.
These other consequences are not reflected in measures of value for health risk reductions
sometimes used by EPA. Applying such health risk valuation factors to health
consequences for smokers would therefore inappropriately omit the value of all these other
costs and benefits to smokers, resulting in potentially biased measures of the welfare change
to society.
Second, analysts disagree whether the traditional economic models one might use to
measure the welfare change to smokers can be reasonably applied, particularly given limits
on available data. To obtain reasonable estimates of the change in net benefits to smokers,
these traditional models require that the subjects, smokers in this case, are acting rationally
in response to a free and open marketplace. Furthermore, these consumption decisions
must either be devoid of significant price distortions such as taxes and subsidies, or
analytical corrections must be made to take account of these distortions. With respect to the
rationality requirement, questions have been raised whether the rational consumer choice
model applies given the apparent addictive nature of smoking.zo Questions have also been
raised whether the consequences of taxes (e.g., cigarette tax) and subsidies (e.g., tobacco farm
subsidies, subsidized health care) significantly distort consumer decision making in this
case.
Third, EPA is concerned that currently available data are insufficient to support
using a traditional economic model to estimate the change in net benefit to smokers caused
by H.R. 3434. The reason for this is that H.R. 3434 does not prohibit smoking outright, nor
does it change the purchase price or quantity of cigarettes available. Instead, H.R. 3434 only
compels changes in the location and/or time pattern of cigarette consumption. This would
be expressed in economic terms as an increase in the transaction cost of smoking, and the
transaction cost would vary widely among smokers. Since it is unclear how the slope of the
demand curve for cigarettes might shift in response to a nonuniform increase in
transaction costs to smokers, a reliable measure of the change in net benefits to smokers
cannot be decided.
2° Note, however, that some analysts subscribe to models of "rational addiction" which have been
developed and empirically tested (Becker and Murphy,1988); (Chaloupka,1991). However, these models do not
take account of those who underestimate the strength of the addiction or who, for whatever reason fail to
appreciate the magnitude of the adverse consequences. Nor do the models appropriately confront the difficult
question of the social consequences from teenage smoking. These models demonstrate mat teenagers tend to
disregard the future consequences of smoking more so than adults (Chaloupka, 1991).
April 20,1994
34
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Based on the foregoing, this study makes no attempt at this time to express the
health consequences of H.R. 3434 to smokers themselves in social value terms. Future
versions of this analysis may make such an attempt if these analytical problems and data
limitations are resolved.
Comparing Costs and Benefits of H.R. 3434
Bearing in mind the limitations presented by the current analysis two principal
findings emerge from this analysis. First, it is clear that, for those items quantified in this
study, the benefits of smoking restrictions comparable to H.R. 3434 substantially outweigh
the costs. Second, comparing the high estimate of costs with the low estimate of benefits
does not change the fundamental conclusions that benefits significantly exceed costs.
It should be noted that no attempt was made in the current analysis to evaluate the
costs and benefits of altering provisions of the legislation. Throughout this analysis, no
exception in scope or timing of the provisions of H.R. 3434 were assumed. Clearly, changing
provisions such as the scope or timing of the restrictions would affect both costs and
benefits.
Comparisons with Alternative Baselines
Given the rapid increase in public and private smoking restrictions in th? last few
years, and the downward trend in cigarette consumption, it is likely that the future will
bring additional restrictions, and consumption may continue to fall without passage of H.R.
3434. Of course, the future is always uncertain, and tobacco consumption and smoking
restrictions will be influenced in part by campaigns of tobacco and anti- smoking interests
(Samuels and Glantz, 1991, Macdonald and Glantz, 1994).
Alternative scenarios were also constructed which varied the assumption about
future baseline consumption of cigarettes. Similar to other major influences such as the
national educadonal campaigns about smoking, national legislation restricting smoking in
public buildings may contribute to continued downward trends in cigarette consumption.
Alternatively, these downward trends may continue or level off regardless of the advent of
such legislation. However, sensitivity analysis indicates that, as in the case of alternative
public and private restriction policies, varying the assumed baseline tre.id in future
cigarette consumption has no significant effect on the result that social benefits would be
expected to exceed costs by a substantial margin.
Results using alternative baseline scenarios are summarized in Exhibit S-3. A
graphic display is presented in the exhibit. The first scenario presents results under an
assumption'that there are no restrictions currently in place and that per capita consumption
of cigarettes remains at current levels. This is the base scenario used to calculate benefits
and costs of smoking restrictions. The second scenario differs from the first in that it
assumes that 23% of the population is covered by policies which are comparable to those in
H.R. 3434. This is the baseline used to assess the impact of H.R. 3434. The third scenario
assumes that restrictive smoking policies will continue to be adopted in the public and
April 20,1994
35
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private sector without the passage of H.R. 3434, and that these will continue and achieve a
level of 75% compliance with standards comparable to requirements of H.R, 3434 in 10 years
and remain at that level thereafter. The fourth scenario combines an assumption of 23%
existing coverage with an assumption that per capita cigarette consumption will continue
to fall for ten years into the future at a 3% per year, and then remain constant after that.
The last scenario is the same as the fourth except that per capita cigarette consumption is
assumed to fall for 20 years before it levels off.
Under all of the alternative scenarios presented in this analysis, assumptions about
the pervasiveness of future restrictions in the absence of H.R. 3434 have virtually no effect
on the findings that, for the items quantified in this study, the social benefits would exceed
the costs.
A 3% discount rate is used for all scenarios. While the absolute level of estimated
costs and benefits are different under each scenario, our qualitative conclusions remain
unchanged.
Other Economic Considerations
The estimates of costs and benefits covered in this analysis are a subset of potential
economic consequences that policy makers may wish to consider.
Restoration of Lost Income: Implementing smoking restrictive legislation
nationally would result in the restoration of approximately $31,00021 for each pre-
retirement year of premature death which is avoided because of smokers who quit, cut back,
or fail to become smokers because of H.R. 3434. On average, we estimate that each
premature death avoided because of quitting and reduced consumption would add
approximately 1.4 to 4 salary earning years, and each premature death avoided from persons
who refrain from becoming smokers would add approximately 11 salary earning years of
life.22 When future values are discounted at 3%, this analysis estimates that between $3
billion and $6 billion of lost income would be restored. A similar estimate was not possible
for persons exposed to ETS, though this effect' should be considered. The importance of this
impact is enhanced to the extent that some children, spouses, the elderly or disabled may be
dependent on such income.
Reduced Burden on the Medical Service Industry:- Every year, the average
expenditure for medical services for smokers and former smokers exceeds that of
nonsmokers. However, this is partially offset by the fact that nonsmokers live longer, and
continue to consume medical services during the extra years of life. When both of these
factors are taken into account, the result is a net excess burden on the medical service
21 The estimated annual earnings of smokers is inflated by 20% to account for earnings after the age of 65,
based on OTA 0993).
22 Salary earning years are assumed to be years prior to die age of 65.
April 20,1994 36
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industry of about $35 billion per year due to smoking. 23 Assuming that changes in the
excess medical expenditures due to smoking restrictions would be proportional to changes
in smoking-related premature deaths, this analysis estimates that every reduction in
arciual premature death would represent an annual reduction of $85,000 for medical
services. Accordingly/ when future savings are discounted at 3%, H.R. 3434 would reduce
annual expenditures for medical services by $2.3 billion to $4.7 billion per year. It is not
dear from our analysis what net impact reduced exposure to ETS would have on the
medical service industry.
Potential Cost to Social Security and other Pension Funds; Persons who would
otherwise have died prematurely would live longer under smoking restrictions and collect
pensions and social security during those extended years. Each premature death avoided for
smokers Who quit, cut back, or fail to initiate smoking represents an extension of life of
about 5 to 7 years beyond the age of 65, during which time they would be eligible to collect a
pension annuity. Data are not currently available to support a similar estimate for ETS
exposed individuals.
Reduced Revenues from Cigarette Sales and Excise Taxes: Implementation of
national legislation to restrict smoking in public buildings would reduce overall cigarette
consumption by approximately 11% to 17%, and this impact would occur within the first
few years of implementation. This would result in a corresponding reduction in cigarette
tax revenues.** However, these could be offset, to some extent, by the social benefits of
alternative agricultural production or other taxable uses of farmland.
Employment Dislocations: Reductions in demand for cigarettes and medical
services would involve some temporary dislocations of persons employed in these
industries.
Conclusions
Given data limitations, and the uncertainties inherent in cost-benefit analysis of
public health and er ronmental policies, this analysis does not purport to provide
definitive conclusion about the overall merits of national smoking restriction legislation.
Nevertheless, while recognizing that several effects of H.R. 3434 including effects on
productivity, comfort from reduced exposure to FT7 and the net losses or gains regarding
smokers, were not quantified, this analysis demot r^s that, for those items that were
quantified, the estimated benefits of H.R. 3434 exce* • estimated costs by a substantial
23 This is estimated from information provided by Hodgson (1992) who compares excess medical costs
over the lifetime of parsons who have ever smoked, and persons who have never smoked. Similar data and
procedures were also used by Manning. «tat. (1991).
2* For an excellent comparison of what smokers pay in excise •axes, medical expenditures, and
contribution to retirement hinds, relative to me value of the services • -v receive for tht<«i payments, see
Manning. daJL (1991). However, the net monetary payments made to to smokers is1 .: a useful index for
measuring me overall social benefits or costs of smoking restrictions. *u previously described, -willingness to pay
measures are more appropriate: Also, our costs and benefits do not count transfers of costs or benefits from one
group in society to others.
April 20,1994 37
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amount. This analysis suggests that the net effect of these excluded items would have to
represent a loss exceed $39 billion to $72 billion per year for costs to exceed benefits.
As suggested in Exhibit S-4, the overall findings of substantial net benefits are not
altered by comparing high costs to low benefits, or by alternative discount rates.
Furthermore, while the magnitude of the net benefits specifically allocated to H. R. 3434 is
dependent on one's assumptions about baseline conditions/ these assumptions go more to
the question of whether or not to capture these net benefits through national legislation or
by other public and/or private initiatives.
April 20,1994
38
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>
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R-3
-------
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R-5
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R-7
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Exhibit 1-1: Policy Development and Implementation Costs (1000 Employees)
BaseaNo Restriction*
Initial Coat
Policy
Managerial Personnel
Legej Personnel
Administrative Personnel
Total |2)
Potey Distribution
Printing
Adrrintelrallve Personnel
Total
Policy Implementation
No SmoWng Signs [3\
Maintenance Personnel
Total
Outdoor Receptacles (4]
Maintenance Personnel
Total
Smoking Cessation [5}
Total Initial Cost
Annual Cost
Policy Maintenance
CompHanoa
Managerial
Administrative
Other
Olher
Maintenance Personnel
Total Annual Cost
Unit*
hours
hours
hours
paQ»
hours
signs
hours
receptacle
hours
partldpanls
Cost/Unit [1]
20.00
21.00
12.00
0.05
12.00
25.00
16.00
130.00
16.00
75.00
Number of Units
Low High
5 10
2 8
15 25
1 ,000 2,000
4 8
20 30
4 6
5 10
3 6
38 50
Cost
Low <$> High <$>
100 200
42 188
. 180 300
322 068
i
50 100
46 96
• 8 1*8
500 750
64 96
864 646
650 1,300
40 96
0*0 1,396
2,613 3,760
4.487 0.880
hours
hours
hours
hours
20
12
20
12
16
10 30
15 100
3 6
5 10
3 6
200 600
180 1,200
!• f's .
60 , 120
60 120
52 96
592 2.136
1. Unit labor costs are approidmated using BLS Median Wsetdy Earnings Inflated by 24% to account tor (ring* twntfila. Maintenance labor hours are ,
estimated using Maans Building Cost Data and the Engineered Performance Standards. Janitorial Handbook.
2. Five response* to fatted aurvay suggest a coat range ol ISO to $200. median - $100. Size ol firms in whole survey ranged from 30 W 1800 emptcyaer
median -240 and mean - 512 (Lewtt, 1994).
3. No smoking signs In Gralngar.1992 am $10.00. The $25 figure Is from Lewit. 1994, who also suggests a median cost of about $300 based on company
responses.
4. The cost of outdoor recaptlcals is tram Grainger 1992. However. Lewit (1994) suggests that outdoor receptteato at entrances cost $25 esch. with total
costs for firms ranging from $25 to $1200.
5. Assumes 25% of employees are amolwrt, end that 10% (tow) and 20% (high) wiH participate in such programs directly as a result ol instituting smoking
restrictions, but that this will be a one time Increase In participation.
-------
Exhibit 1-2: Cost of Implementing Smoking Bans
Bass=No Restrictions
Low Estimate
Estimate
Initial Cost
Total
Initial Cost
Poicy Maintenance
10% with Outdoor Shelter
Total
Cost per
1000 Emp.
$4.487
ififi9
$6,856
$2,136
Employees
(millions)
110
110
110
Total Cost
(million)
494
754
235
Recurrent
Portion
74
113
Amortized
Portion 11]
25
38
Total
Annual
99
15ft
151
235
69
455
1. * • sHzed capital cost without Urns Hmtt Is equivalent to borrowing funds and paying the Interest
every year, but not Ins principal. For convenience, a single dteoount (Interest) rat* ot S% Is used lor
these calculations.
2. Figure to for 5% discount (Interest} rate (see Exhibit 1-4)
Exhibit 1-2a: National Cost of Indoor Lounges
BaseaNo Restrictions
Total Annual Cost
Alwtth Lounges
10% w Lounges
20% w Lounges
3%
Low Estimate High Estimate
($ million) (S million)
3.509 4.562
351
912
5%
Low Estimate High Estimate
($ million) {$ minion)
3575 4.649
356
930
7%
Low Estimate High Estimate
($ mfWon) ($ million)
3641 4733
364
947
Exhibit 1-3: Smoking Lounge Design (100 smokers)
Lounge Density (ASHRAE. 1989)
Smoton Served by Lounge
Time Frame
Smokers per Hour
Break time per smoker
Expected Lounge Occupancy
Construction Requirements per
Smoking Occupant Served
Average Peak Square Feet Par
Lounge Occup.
100 Smokers
2 hours
50 smokers
12 minutes
10 smokers 15 smokers
200
2
-------
Exhibit 1-4: Cost of Building Smoking Lounges
BeteaNo Rwtrtctiont,
Smoton
Smokhig Occupants
Occupants aervtoed
Wow Lounge*
3% Discount
7%0tocount
Outdoor Lounges
3% Discount
5*Dbcounl
7* Discount
Annual Coats
Total Annual Coet
Persons Square Feet per WffalCos)
(million) Occupant per Square Foot
48
55
55
55 2 30
5.50 2 25
Total
Cost
(S mMon)
3300
275
Ftocumnt
Portion
(2O%1
SCO
55
Amortized
Portion
00
165
231
*
14
10
AmuaHzed
MtWcost
<$ mlHton)
759
825
891
03
69
74
Coslper Annual Coat
Sq.R.
(S mMton)
25 2750
LowEstbnale
(S mflRon)
3509
3575
3641
63
69
74
HtghE3t.l1]
(S niflMon)
4562
4640
4733
127
138
140
1. High «sHrml» to 30% Motor than tow estimate (see wxl) lor Indoor lounges, and 100% higher tor outdoor lounges
based on Lewd (1994).
Exhibit 1-5: Total National Implementation (wfth Smoking Lounge) and Enforcement Costs
RMtrlcfloM
3% 5%
7%
Imptementttten (w*b
Smoking Lounge)
Enforcement
Total
Low Estimate Htah Estimate
510 1.367
100 500
610 1.867
Low Estimate High Estimate
517 1.384
100 500
017 1.884
Low Estimate High Estimate
524 1,401
100 500
624 1.901
-------
E*ilbK 2-U: EttMMt** ol U.S. NoMHMkw Amu**
ExpQMIN to OttMT
MORTALITY
Lung Cnow {ICO 1«-«3)
Horn* ETS wurett
OttwrETSsoureM
W.S.
3.000 ToW
mo
1200
CENTERS FOR
DISEASE
3.800"
OTHERS
124. 240 to 2000*
300*. 30007. 5000*
4000*
COMMENTS
ETS«n.
ETS oonoMtMkNw «Mtar
In MioMng homM «id
ofltoM. Gcnwaly Wghw
hi
CMNrdncon
11,000-12.000*" Umt*4
cantors OBMT than
(41IM14)
BumDMttw
SpontuwoM Abortion*
Sudeten MM* DM* SyndratM
CondMom, n*wbom
42.000-
40JDOOMM1
Evldanc*
MM it on ETS
to
700
2JOOO
POO
145.000"
1.900*4
Dw to Dm MtMwl by
wnoMnQ mMMtah
MM DBMQ OH
tol smoUng
4.400" «
(769-780)
Snort GMUHon, Uow
(70S)
•EPA1 ovataatod only MM mufcatojy humto d ETS; abo. «M t» only vourc* to bnukdown hoiM v». nonhoiM iMo.
fioattift -to cnkhvn indat anv to.
*€?A1 conctoi»d hal •irtimal a^ofc^ te • afctwg itoh factor «or SPS. ETS MMMOIW to th» naobom b abo consttteryd to bo
OFmwm M BOrinttil dwA», «Mch kd
1.
4.
5.
S.
7.
0.
9.
10,
11.
12.
13.
14.
Elh
U.S. EPA (1W2> f»n*ifcyy
SmoUng: Lung CMMC ml OMiw Dbonton*
Cenrtra lor DboM* Central (19»t) SffioUna
MmMty wdYMnalPolMMUoliHi-U^.19U. MMWR 40«-71
ModHftd by COC fcom N^tontl RvMNdi Couid (19BB).
EnvironmwM Tobooco Snota: Monuring Expwura* and Mowtlng tiuMi Mods. WwWn^on. D-C.
AiundM (1W7)
Vutuc <1984)
Wlgto (1987)
Wefc (1BW)
R«pao> and Lowry <10S6)
RUM*! « « (1006)
GI»tt,SandPmrt^;iW11. PMrtM Smcklng Md HMrt
Dtooas*: EpUMMotogy. Phyrtotooy «id DtodMmbUy. arcuMion 83:1-18
Stoontand. K (1M2V Pmlw SmoUng «nd ttw Risk ol H«rt
DbMO*. JAMA2o7^44«
Adapted by COC fram FMtonjI EmnjMKy MamgMn^f Agmcy. 1SW
Mfcr. AX. (1893). Th» U.S. m/Mn^tntuM ft* f ^*n
ttwoooh 1090, Th» rote d !0Mod tobooco products ta ftra. NMk>Ml Fin Pntoctton Asaoctafion, Qirincy, Mass. Much 1093
[XFnvn. J.R. (1999). Tobacco Abwo: MorlAMy and
Mortafty In tfw PodMrtc PoputiBnii dw to th* Uw ot Tobwxo Product* fay ottwr poopto. Si*mM«d to JAMA
-------
IU
§
ft s
u>
M 5
u
ui
II
!
§
-------
i i
£
I
1
il'l*!
g
€U
--i
If"
•If
f 1s
i Is
a.
s3l«i« i*
HI
g - S
i. h. iHi
i
>• *
ir
15
III
-------
Exhibit 2-2: Proportional Reduction In Mortality Ratio (PRMR) By Years Since ETS Exposure
Yean Quit
1 to4
8 to9
1 to 10
10 to 14
1ft to 19
10 to 20
21+
Cancer
22.40
18.80
7.70
4.70
4.80
2.10
Cancer
16%
• 66%
79%
70%
91%
Heart Disease
66%
79%
91%
91%
100%
Overal
59%
77%
89%
89%
99%
68%
89%
100%
1. Cancer mortality ratio for mate smokers (DHHS 1989).
2. Heart Disease mortality ratio assumed to decline twice as fast as fee
cancer mortality ratio.
3. Average of cancer and heart disease weighted by the average proportion
of cancer and heart disease deaths between high and low estimates.
Exhibit 2*3: Percent Reduction Smoking Population and In Total Consumption due to Smoking Restrictions
Reductions From Quitting, Reduced Initiation, and a Reduced Consumption Rate of Smokers
Bawe=No Restrictions
Total Reduced
Quitting & Reduced Reduced Cons. Consumption
Inflation HI Rate 121 (50 yr av)
Annual Average
Reduction:
Low Estimate
High Estimate
4.24%
8.48%
9.58%
13.73%
13.81%
22.20%
1. Proportional reductions ki consumption due to quilting and reduced kiWtion Is assumed to be equivalent to the reductions In smokers due to
quitting and reduced Initiation.. Since Ihe population changes are relatively constant over time from these combined effects, the results would
not be affected greatly by alternative dtecount rales. Therefore, for convenience, an arithmetic annual average over all time periods is used for
the annual equivalent reduction over aX Discount rates.
2. This Is the proportional reduction In cigarette consumption due lo the reduced consumption rate of the smoWng population remaining after
quitting and reduced Initiation is taken kilo account.
-------
Exhibit 2-4: Premature Deaths Avoided from Reduced Exposure to Environmental Tobacco Smoke
RtttrictloM
Ani*atETS nilaha Deaths
Disease Deans (11
Cancer Deaths |2j
Total
sr VMT Total Pramature Death* Avoided Estimates
Low Estimate
H?>' v~ NonHome
3,240 8.760
800 2.200
4.040 10.960
Yearly Average tor 50 Year Pe
Hkjh Estimate
Home NonHome
6,480
800
7.280
rtod
17,520
2.200
19.720
i in..,. .
iiome
7.818
156
Low Estate
NonHome Total
450.430 458.248
9.009 9.165
Hkjh Estimate
Honie NonHome
28.176 810.445
564 . 16.209
Total
838.622
16.772
dtati Mn for ETS am mie»fva»*eV adjusted from the Herahm tact The esUmal** are atacalsd bahnen horn* and mnhoma ki the sum proportion as
1.
tang lung
2. Lena, cancer for hone and nortnonw expowiM to awn EPA (1999),
3. HonM aiBMaiM
to aswmed to take pi
dganm
nptkHi by anonn
In tobaooe me from qriWng and mduced W**on. RedKaons hi tmoUna du* to decMMted <
oaMde •» hom> and am th«wto» not Indudsd. Tha Bm» dMay In ptematura Juattii avofcted tasut* by aaeaning t»l the fedudbn In the mortaKy
to anunwd to occur Mce as
iatk> for cancer y?#t tfcne taHows ma sane tans pettem ai the mortally ratio tor a smoker who (Bits. Ttw reduction over Urns tor heart
tan as tor cancer pse csiculaltoni In EMM 2-2).
4. Impact* el smoMng mukJfain ne reXnWi J to ea 90% of nonhoms exposure* (ses tad).
Exhibit 2-5: Morbkfity Effects from Reductions In ETS Exposure
FUstricttorn
Morbkfity Effects
Tonsas and Aaenoids Operafjons
Tympanottlomy Operations
Ear Wecfan Episode
Asthma Exaoerbation
Astftme Indudion
Physicians Vtaite tor Cough
Lower Respiratory Tract Infoctfons
Baae Laval <1990| Annual Incidence Ratea
low Estimate
Home NonHome
300.000
12.000
2.176.000
135.000
30.000
160.000
2.800.000
100.000
1,000
3.400.000
15.000
Estimated Annual Reductions
Hkjh Estimate
» • HH..M.I.I . i
inme wonnome
700.000
40,000
2.176.000
270.000
30.000
160,000
2.800,000
300.000
5,000
3.400,000
30.000
Home Ml
12.714
509
92,217
5.721
Low Estimate
NonHome 121
27,000
144.000
2,520,000
90,000
900
3,060,000
13.500
Total
27,000
144.0S9
2,520,000
102,714
1.409
3,152,217
19.221
Home [11
59,331
3,390
184.434
22.885
Hkjh Estimate
NonHome 121
27.000
144,000
2,520,000
270.000
4,500
3,060.000
27.000
Total
27.000
144.000
2,820,000
329,331
7,890
3,244.434
49.885
1. Estimates based on reducion in ooarene consumption due to smokers quitting, and reduced initiation of new smokers. See Exhtrit 2-
3. Reductions due to reduced consumption of smokers are not included because these are assumed to take place out of me home.
Reductions am assumed to be immediate, without time delay.
2. 90% reduction (see text).
-------
ExhlbH 2-6: Annual Benefits from ETS Related Premature Deaths Avoided.
BM**NO RMtrtcttom
Total Vataelll
Discount Rate
3%
5%
7%
Low Estimate
Howe Nontonw
728
689
662
41 .856
39.681
38.118
Total
High Estimate
• IM..I • fcft,_. |n,M»»
nonia Ngnnomo
42.582 2.618
40.370 2,482
38.780 2.384
75.310
71,396
68.585
Tola)
77,928
73.860
70.970
1. A wIMngnees to pay estimate ot $4.8 mHHon per premature death .avohM to used. SM t«rt tor meaning of wflUngness to pay.
SM Appendix tor discussion ot how wo arrived at a valua of $4 J rnHWon par premature death avoMad.
Exhibit 2-7: Annual Benefits from Reduced Morbidity Effects ot ETS
Morbidity Etlbntta
TomHt and Adwwldt Opwattont
TyinpanMtoniy Operations
Ear mfadkm EptoodM
Atthma ExacarbatkNi
Aattima Induction
Phyildant VMs tor Cough
Lowar Raiplratoiy Trad Intocttom
Total Annual Savings
Lew Estimate
HohEstlmsU
MadkalCoM
Par Eptooda [1]
1,500
1.600
75
10
100
50
too
Total Cost
Par C«M 12)
1.500
1.500
75
32 (3)
1.500.000 14)
SO
100
Annual Reduction
27.000
144.000
2,520.000
102.714
1.409
3.152,217
19,221
Ann.Modtcd
Saving* {5]
(million)
41
216
168
1
0
158
2
608
Total Annual
ftavlngm (5J
(million)
41
216
180
3
2.113
156
2
2.721
Annual Reduction
27.000
144.000
2.520.000
329.331
3.945
3,244,434
49,865
Ammai Modteal
Savings (S)
(minion}
41
216
189
3
0
162
5
ai«
Total Annual
Savtaigat*]
(mHHon)
41
216
18»
11
5.916
162
S
6.S41
1. Quasflmatas based on professional judgement.
2. Utoly to baNghar than madlcaJcosL but data to support a Mghar astlmata was avallabla onty whara Indteatad.
3. Mtdrang* astbnatas of wMlngnass to pay to avoid a day of episodic asthma symptoms (Unsworth. 1993a)
4. MMranoa astlmata of wffllngness to pay to avoid navtoB a case ot chnxtlc bioncMls {Unsworth. 1994). Since asthma Is more We thraatanmg than chronic bronchitis, H to assumed
that this to a useful tower bound estimate tor asthma.
5. These savings are assumed to occur Immediately. There Is therefore no discounting.
6. The high range estlmata In ExhKDI 2-1 b to reduced by 50% to account tor the uncertainty to the estimate.
-------
Exhibit 3-1: Unit Costs for Housekesping and Maintanance
Annual Cost
Duration
Task by burkfing (minutes)
Empty and damp wipe ashtrays
Dusting Desktops
High Dusting
Venetian/Horizontal Blinds
Clean HVAC Vents
Empty and damp wipe ashtrays (per seat for smokers)
Sweeping/Vacuuming
General Cleaning for a Smoking Room (Lodging)
General Cleaning for a Non Smoking Room (Lodging)
Empty and damp wipe ashtray stands
Empty and damp vripe ashtrays (per hospital bed for smok
Sweeping (per hospital bed for smokers)
Malnienance/nepMirrReptoceinant:
Replace Office Furniture
Carpet Repairs
Computer Maintenance (per computer for smokers)
Computer Maintenance (per computer for nonsmokers)
Computer Keyboard Replacement (per computer for smokers)
Painting
Replace Table and/or chair (Food Service, per seat)
Replace Furniture (Lodging, per room)
HI
2.5
2.2
4.5
2
10
0.2S
10.0
30
24
4
0.25
5.0
120
90
6800
Cost Per
Hour
[21
$8.39
$8.39
$8.39
$8.39
$8.39
$8.39
$8.39
$8.39
$8.39
$8.39
$8.39
$8.39
$85.00
$85.00
$15.35
Cost Per
Task
131
W X 18]
$0.35
$0.31
$0.63
$0.28
$1.40
$0.03
$1.40
$4.20
$3.36
$0.56
$0.03
$0.70
$4,530
$100
$170
$128
$50.00
$1,739.79
$448
$2,125.00
Annual Frequency
Smoking
(41
250
250
52
6
4
2190
78
292
292
730
547.5
0.2
1
0.5
0.67
0.2
0.2
0.2
No Smoking
151
0
52
12
1
1
0
52
292
0
0
365
0.14
0
,
0.5
0.5
0.2
0.14
0.14
Per 1,000 Square Feet
Smoking
[6]
PI X W
$87.50
$77.50
$32.76
$1.68
$5.60
$65.70
$109.20
$1.226.40
$163.52
$21.90
$383.25
$906.00
$100.00
• $85.00
$33.50
$347.96
$89.50
$425.00
No Smoking
17]
131 X [5]
$0.00
$16.12
$7.56
$0.28
$1.40
$0.00
$72.80
$981.12
$0.00
$0.00
$255.50
$634.20
$0.00
$63.75
$25.00
$347.96
$62.65
$297.50
(1) Source Mams Facffin/ MaJntananca Standards, BOMA Offic* BuiMng Owning Operations in North Amarica, OOA 1981.
(21 Source Avaraga Hourly Waga Rats Phis Fringa. Bureau of Labor Statistic*, Maans Squara Foot Costs. 1991
14) and pi: Sourea: Various souroas. saa Appandbc for Ml feting. For houaakaaping, Dinagar 1994, Waist 1985. Bast Wastam 1994, Kaffihar 1987. For malntananca. Weiss 1965,
Lsdgar 1994 (computer maintonanca and rapfecamant).
-------
Exhibit 3-2: National Savings In Housekeeping and Maintenance Costs
Potential
Total Saving* Par
-
t
Offlc*
Housekeeping
Maintenance
Total Savings
Total Saving* per Sq. Ft.
•fair •ntlla A ttAMibtA
Mvicanms • asrvico
Housekeeping
Maintenance
Total Saving*
Total Saving* par Sq. Ft
FoodSsrvfcs
Housekeeping
Maintenance
Total Savings
Total Savings par Seating Capacity (smoking)
Health Cam
Housekeeping
Maintenance
Total Savings
Total Savings par Sq. Ft.
Assembly
Housekeeping
Maintenance
Total Savings
Total Savings per Sq. Ft
Education
Housekeeping
Maintenance
Total Savings
Total Savings par Sq. Ft.
Squar*
Fset
(million sq. ft.)
CU
11,802
11.602
13,157
13,157
1,167
1,167
15]
2.054
2.054
6.838
6,838
8,148
8,146
1,000 Sq. Ft
Or Par Unit
[21
$161.24
$547.03
$236.32
$204.39
$85.70
$123.84
$333.34
$502.28
$236.32
$204.39
$394.04
$502.28
"*
Annual Savings
Applicable
Sq.Pt . Low
(million* of
(31 M]
7,081 $1.283
7,061 $863
$2,146
$0.16
3,158 $746
3,158 $165
$91 1
$0.07
700 $438
700 $128
$565
$84.84
507 $228
507 $33
$261
$0.13
821 $194
821 $43
$237
$0.03
600 $160
600 $0
$160
$0.02
High
doHara)
$1,283
$3,793
$5,077
$0.43
$746
$481
$1,227
$0.09
$438
$306
$744
$111.89
$228
$222
$449
$0.22
$194
$125
$319
$0.05
$160
$301
$461
$0.06
-------
Exhibit 3-2: National Savings In Housekeeping and Maintenance Costa
continued
Lodging
HoiM*HMong
Maintananca
Total Saving*
Total Saving* par Quaat Room <*moMno) (6]
Maintenance
Total Saving*
Total Savingi par Sq. Ft
Total Saving*
HousaNBaping
UwniMianca1 *
Totat Saving*
Total
Squar*
F**t
(rrrthon *q. ft)
in
3.476
3.476
12.253
12.253
58.895
Total Saving* par Sq. Ft
1 1 ) Total SOJUM F««t por buMnfl UM to from DopMtawnl of Emm;, EHM~
|1J Proportion ol SQJUAM Footopjt to nport IMWIQB. litoy wy by •oHwtty.
computan. Swwt 1190 far wpottod BMtooL
1419^/V^o^tod^d^.fcm.^ ^^^
Potential
Saving* Par
1,000 So> Ft
Or Pw Unit
[2]
$373.03
$457.98
$305.14
$0.00
Annual Saving*
Appfcabto
Sq.Ft Low Wgh
(million* of dollara)
[3] [4]
342.6 $44 $354
342.6 $49 $391
$93 $745
$73.56 $569.64
7,351 $761 $995
7.351 $0 $0
$781 $995
$O.O6 *O.OB
20.561 $3.874 $4.398
$1,280 $5,620
$5,154 $10.017
$0.09 $0.17
. l~h... iJ.J.Bm IMA «MK IT
SM IMMT IBM for vquM tort h Meomtoty •dun»m. SWWlcrt Abrtwd tor numbw ol ptwonrt
*
(«1 IHto tor Lodgtao an tquw* toot for common mat and pw giiMt nom tor MwtojM.
-------
Exhibit 4-1: Excess Absenteeism of Smokers and Former Smokers
Smokere
Former Smokers
Never Smokers
Quitting
Failure to Initiate
Annual Days
4.50
3.90
3.00
Excess Days
1.50
0.90
Days Saved
0.60
1.50
1. Quitters go from smoking to fornier smoking status
2. Those that fail to initiate smoking go from a potential
smoker to a never smoker
Exhibit 4-2: Value of Reduced Absenteeism
Base=No Restrictions
Quitting
Fail to Initiate
Days Saved Per Unemplymnt Net Days Saved Average Annual Value
Person Per Year Factor Per Person Daily Earnings Per Person
0.60
1.50
0.04
0.04
0.576
1.44
104.00
104.00
59.90
149.76
Exhibit 4-3: National Annual Savings from Reduced Absenteeism [1]
Base=No Restrictions
3% 5%
7%
Quitting
Fail to Initiate
Total
Low Estimate
millions
53
170
223
High Estimate
millions
107
340
447
Low Estimate
minions
67
!21
187
High Estimate
millions
133
241
375
Low Estimate
millions
73
93
166
High Estimate
millions
147
186
333
1. Detailed discounting is necessary to separate out the differential effect of quitting and reduced
initiation. See Appendix B for discount calculations.
-------
Exhibit 5-1: Average Annual Fire Related Injuries and Property Damage (1988-1990)
Injuries
Fatal
Non-Fatal
Total
Prop. Loss [11
Total Co«
1.328
' 3,325
4,652
111.500
38
318
357
38.800
UTM UOM re toiai um 1*001
(mflHon) (nMHon]
4.8
0.17 0.17
flii«l*t«aji.»l
HBSMSnnai
(million)
6.373
561
6.924
318
7.23*
Non nosU.
(mfHon)
184
S3
237
115
111
Total
MMon)
6.557
603
7.180
430
7.S91
1. Prom MMsr (1W3). Rpurss ars an avaiags ol 1000-1900. RDUM tor 1991 ars sukidsd bscauw of dMortton due to tie OeMsnd Mrs atonn.
Z Number of tins.
3. Average cost par Injury horn Ray (1803). EsfenafeH Ineiuda msdfeel easts, transport costs, tost earrings. togal and hssJtti Insurance admlntoat^a oasts, and pah and
suNsrtng
4. Ths unit cost far riiapisfiarl mjurits on* • t» mMon (Rty. 1003)
6. Total Vatua at aach rsducad Ire4alalad IstaHy Is sssumsd to ba $4J m«on. Ssstad.
Exhfcft5-2: Fire Related Premature Deaths, Injuries, and Property Losses Avotded
LawEaflmass
High Estimate
Omsnt Annual Aiwaoj* Injuries
H^^^^^J^l M-^^^n—^U
nvanvnvv nurrnoBn.
1,328 36
3.325 318
4.6U 3S7
Antsri Raducttona hi Infurias
nesMsnttal Ml NonnasM. 121 Total
58 33 86
141 274 418
1*7 807 604
Annual Reductions hi Injuries
RssUsfltW Ml Non-ResM. 121 Total
113 31 144
282 261 643
364 202 667
T^^l *^--tJ^— s fc.s^_ a-fc i-i_^
I dav nmrjoft. awia non-iiavKian,
Low Htah
4.462 7.168
20.783 27.141
28.166 34.338
mfurles
Fatal
Non-FatsJ
TotsJ
1. Reductions ans asaumed to be proportional to reductions In the lotsl consumption ol dgaraHes dus to quHeng and fsduced Inflation. Skx»!he
raducslon bi oonsunpton ol smohars aVety tsfces ptao* sotoy oulsida the home, these reducttons are not Included hi fte catcutaUom.
2. Use* a 80% reduction for the Mtknatod portion of the nonresklenllal envhonmnents that ban smoking, end 50% reduction lor the estimated portion that
pnwMe smoMng lounges For costing purposes, the proportion of estsbeshments wtti Indoor lounges hi Bw low eathnete b toss than hi the high estimate.
Thereto*, the tow sslhiisliii lor ire related deaths end Injuries avoMed b hhjher then me Ngh ssHmele because ol thb oddrty.
Exhibit S-3: Annual Benefits In Fire Related Injuries and Property Damage
Low CithneH
ln|uries
Fstsl
NonrateJ
Totet
Property Loss
Total Savings
HlahEsthnets
^- -•-•- -*-* fc*^— .
•^BJUQMIVeiP nwi
mttofi
270
23
283
13
307
HM^fal^^
— ••••- —
mMaOP
158
45
204
&9
302
Tola)
iMeon
426
66
467
112
606
fl T I j| |
nosmfeW
^^•M^M
nanKlfl
540
47
587
27
614
Nufftestctenfal
mWon
151
43
194
94
266
Total
BlBJOCI
601
80
761
121
002
-------
Exhibit 6-1: Estimating the Effect of Smoking Restrictions on Quit Rates,
Consumption Rates, and Rates of Initiation
BafteeNo Restrictions
Quit
Site Conditions Reference
N-B. Baito, el al.(1991)
Hudzlnskl, el al.(l090)
Slave, et al.<199t)
Stflbnan. el af.(1990)
N-RorR-B Andrews (1983)
Borland el al. (1990)
Ooltteb et. al. (1990)
Sorensen et al. (1993)
Quit Rate
Reported
(Annual!
15%
9%
17%
15%
16%
9%
13%
12%
Assumed
Relapse
Rate
30%
30%
30%
30%'
30%
30%
30%
30%
Net Quit
Rate
10.50%
6.30%
11.90%
10.50%
11.20%
6.30%
9.10%
8.40%
Estimated Net Quit Rate due to workplace smoking policies
Estimated Net Quit Rate due to Comprehensive Legislation
(21
Net Quit
Rate w/o
Smoke Raatr.
2.50%
2.50%
7.50%
2.50%
2.50%
2.50%
2.50%
2.50%
Low
4%
3%
Net Quit Rate
due to
Smoking Restr.
6.00%
3.80%
4.40%
6.00%
8.70%
3.80%
6.60%
5.90%
High
8%
6%
Consumption
Consumptton
Reduction
N-B Slave et taf. (1991) 34%
Stfflman, et af.(1900) 20%
R8 Borland et al. (1990) 18%
Hocking el al. (1991 20%
Estimated Reduction in Consumption Rate due to Workplace Restrictions
Estimated Reduction in Consumption Rate due to Comprehensive Legislation 121
Low
15%
10%
High
20%
15%
Initiation
N-B
RB
Reduced Initiation
Woodruff et al. (1993) 36% (3}
Wasserman et al.(1991 41% [4]
Estimated Reduction in Initiation Rate due to Comprehensive Legislation
Low [5]
5%
High [5]
10%
1. N-B refers to sMes thai go from no restrictions (N) to a pan (B). R-B refers to sftes that go from partial wtrtctfans (R) to a ban
(B).
2. Because orfy abort 60% of the popuWfcm Is employed, coro^^
population man the effect of workplace policies on employees.
3. Cross sectional analysis of California worksites.
4. Not a workplace study. The 41% reduction raters to the difference between teenagers who Hve In communities wth legislation
mandating few restrictions In public places, compared wfth teenagers living In communifies with comprehensive legislation, including
legislation restrUing smoking In workplaces. Most of the reduced consumption Is attributed to reduced initiation.
S. Estimate Is bom conservative and exceptionally uncertain because of the paucity of Information.
-------
Exhibit S-2: Proportional Reduction In Mortality Ratio (PRMR) By Years Since Quitting
Ratio to B*s*Mortamv Data
*»o
0*34
35-44
45-54
55-64
65-74
75+
Smoker Mortaity
R«tto 11]
Bw««1.00
3.02
2.92
2.67
1.65
Y««r*Q
1 to 2
42%
26%
11%
19%
urn
3to5
43%
30%
26%
19%
6 to 10
59%
45%
27%
17%
1 to 10 m
51%
51%
51%
36%
23%
18%
11 to 15 16 +
64% 64%
64% 64%
64% 64%
55% 61%
39% 59%
2% 32%
11 to 20 (31
64%
64%
64%
58%
49%
17%
21 to 30 (4]
90%
90%
90%
90%
80%
70%
31 to 40 (41
95%
95%
95%
95%
90%
•5%
41 to 50 [41
•5%
95%
95%
95%
90%
85%
SO + M
100%
100%
100%
100%
100%
100%
1. Mates onhf. Awsraga ol mortatty rates tor atom and Mow 20 dflarattea par day.
2. VtotyNted *Mt*Q» of 1-2.3£. and 6-10 y*an. l^)» 30-44 as#jm«d to b« ttia sama as 4S-54.
3, Awragt ol 11-15. and 16 + yaan.
4, Assumed to faadi 00% avaraga reducfc • ^ go yaara based on cancar rate mortally fMtoa (OHMS
1989). and M radudten (100%) h 50 yaan wMi a sS^H teg fcr ages older than 65. .
Souraa: DHHS (1980). Tabte 7. paga 85.
-------
Exhibit 6-3: Premature Deathe Avoided (PDA) From Quitting by Years of AbeMnence
Be»e»He ReetrfcHene
1**» __S*«_t» MB* MM i» MI*
«t!1 U MM
2*21 to 203*
MStto MM
At*
*-14
M-44
4I-S4
M4«
M-74
7»+
T«t»l
OMtM WQuM
1.115 lH
SS.W 1*
M.B01 S%
U.BIO an
1*0,7*0 8%
1S1.0B1 1%
41 4.74*
PRMH.1] POA|2|
PvYMi
B1%
61% B07
11% 44fl
M« 1ST
23% 1121
1*% 700
1411
PRMH|11 PDAJ21
PwYMu
•4%
•4% SIS
Bl% 1022
49% 2357
17% »3
*t1«
PRMR|11 PDA12]
PwYw
W%
00% 1MO
•0% SIBfl
70% 2752
»H1
PflMR(1| POA(21
PvYtw
M%
00% 41-41
•5% 3342
7««3
PRMRIt POAJ2]
PWYM
to%
H% 1142
3141
VMri>Av«nMtorlh*B*Va«> PwM
. _
KM PWIII* HU
LavEMhirt* tMiEMhwM
QutFMi. QuitrM*-
3% t»
S.07* 1.M% 1i,14l
•.111 !.*•% 1t.«7l
»!,»•• 11.»l% M.TiO
11t.ll* 4|,M% 133.7H
1W.1M lt.71% I1t,37«
•71.43* 100.M% 144. *7I
*.«4M 1 10. Ml
Note: EPA does not beleve that Discounting physical effects such as premature deaths or Hve years extended has any meaning. Only monetary
values should be discounted. Discounting physical effects is done above only for analytic convenience and to display Discounting methodology.
Exhibit 6-4: Premature Deaths Avoided (PDA) From Reduced Initiation
BaM-tto RMMeUom
At*
0-34
35-44
4S-S<
SS-04
6S-74
7B+
Tot*
POATYMT
CumiMtw* Tata
10W 1001-2000
DflMlM
2.218
S3.201
11.901
M.S1C
1M.7M
131.0S1
414.741
H te DMMMlll
3%
•1
006
2001-2010
B%
3%
1.02*
10.172
2011-2020
fc%
B%
3%
I.S70
31.B72
2021-2030
B%
8%
B%
3%
4.M9
M.M*
2031-2040
fi%
S%
s%
B%
3%
10,567
100.539
2041-2050
S%
s%
s%
6%
5%
3%
17.7M
3*B.42«
2051 *
B%
S%
s%
s%
s%
B%
20.737
VMrt* Avm» brMM N VMT PNM
PDA
U*E»L
»%
i,OJ»
••,0*1
••.•4*
4B.34t
44,214
1*0.83*
3.*11
PWMM
3%
31%
11%
14%
23%
t«0%
PDA
HMibt
1*%
10,»7*
11»,1*1
73.***
•«.«>1
•Ml*
3*1 .*7*
7.MJ
W* Bnum*aH nMf wnohm conw from ttw youngest &«• eraup. thai a eoratant mmtw I* tdded every yaw. and tM N WOH 60 yaan tor th« imoMng popuMton lo eompWtty erungt,
Ttwrafora. R Mm 60 ynra tor th« smoking population to tw raduewl by the Mllmatod roductlon In trw Initiation raft*. wUh l/6fflh ot that reduction laktas ptac* «ach VMT.
2. Average rate over the Int 10 year Increment In vmtoh new molcer* en added each year.
Note: EPA does not beleve that Discounting physical effects su* as prernahire deaths w Ive yeais esrtended r^ Orty monetary
values should be dhcounted. Discounting physical effects is done above only for analytic convenience and to display discounting methodology.
-------
EXMbftM: Piemsfaite DeaBia Avoided Frew Dsdaeed Consumption
1M1 to MM
MM to Ml*
M11 to MM
2031 to MM
A*
•-34
30-44
41-M
M-*4
**-?4
71*
T«W
1000 M|Mtodtai
D»mm QiMHj > HMMM
PwYMf immiM |1|
(bwEMtoMta]
2.21S 2.121
83.2*1 I' SH
»,ni ii.fc77
51.510 S4.WO
1W.7M 153.000
1 St. 051 12S.407
414.741 3*7.171
•( ^^latadBAA BBB^ •*%*
• namajgaafn msai njav
PWVMl
.•W ^BB^MBBll
10% >1K 1M
10% 11% 1.110
10% I1« 1.40S
10% M% 2.0S4
10% 23% 9.000
10% 1t% 2,23$
11.002
ff*R m
P«V««
04% 13S
•4% 1.035
04% 1.76i
S*% 9.2»3
40% 7*S2S
17% 2.110
10.M4
V^^BlM Ok^MA^A 4W# OlOkA ** **' •^^•^^*
TBaanaj aaa^vBgat IBM/ mna> w vvjaaj f^noa|
WW PtM
PwY«M
00% 101
M% 2.MO
00% 2.401
OCX S.043
M% 12,317
70% O.TiS
•1.0*0
•ByB PGA
PwYMi
05% 202
OS% 3.020
05% 2.*2*
05% 5.323
00% 13,057
*5% 10.007
M.700
B*R PtM
NrVMT
*5% 2Q2
05% 8.08*
05% 2,629
•5% 5.323
00% 13.057
05% 10.097
30.70*
n* KM
P*YMI
100% 212
100% 3.101
1*0% 2.700
100% S.W3
100% 15.3*7
100% 12.550
30.717
UK»«»M< PWWfll U*M*«Md
LovErt MghEM
10% 21%
*.37* *.*4% 10.9M
120.103 *.**% 2«*.l«*
«0*.210 0.34% 213.440
•OO.OM 10.02% 410.111
011.103 M.00% 000.702
341.344 M.»0% 074.MO
1.310.140 1M.OO% SnOM.4CO
24.203 01.201
2. Tin iiirtiiMi tOTporttoMl t»d»dlBii
prti a) PfW IMW to BMMMri b to •»
g pdpiMon lo «eee«nHof •»•• tt«| gut or M » HU*» mtaUf*.
IB b» mdi>d m 50 yMM (PBM teclor - 100%). TtoOnw
Note: EPA does not boibvo tat dbcountnq physical effects such as premalure deafrs or ive yea re extended has any meaning. Only monetary values should be
discounted. Dbcounlng physical effsds h done above only for anatyfe convenience and to dteptey cfiscounUng
-------
Exhibit 6-6: Ufe Expectancies of Ever Smokers and Never Smokers by Age
Ever Smoker*
Never Smokore
Difference
«•
35
4B
SB
*S
75
• S
Probability ol
Survival 111
1.000
0,975
0.916
0.782
0.548
0.185
ProbebWyd
Deaths
0.025
0.004
0.21 a
0.452
0.815
Expected Ute Years
Remaining To Lie
EmMd.
34.06
24.31
15.15
7.33
1.85
ToAfjeeS
26.73
16.98
7.82
PrababUtyof
Survival HI
1.000
0.967
0.957
0.884
0.725
0.395 '
Probability ot
Deaths
0.013
0.043
0.116
0.275
0.605
Expected Ue Years
Remaining to Ufa
Expect.
39.48
29.61
20.04
11.20
3.95
TO AM 65
28.26
18.41
6.84
ExpJJe Years.
Ever Minus Never
5
5
5
4
2
1. Survival probabMttoa trom Hodgson (19B2)
Exhibit 6-7: Years of LHe Lost per Smoking Related Death by Age
Life Year* Loet Per Death
Ufa Year* Loet Per Death
A0e
35-44
45-54
St-64
65-74
74-66
Total
Excess PnbabMty
ot Death
(End ol Interval)
0.012
0.041
0.102
0.177
0.210
Excess PrabaM.
Ot Death
(WWiln mtorvaQp)
0.009
0.034
0.087
0.156
0.202
Ever Smokers
hi 1990
17.29
13.60
13.80
14.00
0.60
59.49
Exported
SmoMng Related
Deaths/year [2]
(thousands)
15.56
46.58
119.72
221 .55
12.10
415.51
Percent
Discount*
3.75%
11.21%
26.61%
53.32%
2.91%
100.00%
Average Life Yean Loet per Death [31
To L*e Expect.
(Within tntervalXll
A Yean at 3% 141 [51
20.50
16.05
10.75
4.58
1.34
6.15
To Age 65
(Within IrrtervalMl]
17.10
11.75
5.30
3.41
To Lite Expect.
(WRMn IntervaOdl
UiKkscountedYean
31.62
22.02
13.20
5.B6
1.39
10.67
TO Age 66]
(Within lntervat)tl]|
24.29
14.69
5.67
4.25
1. Estimated M 75% ol the deference bah»aen beglnnlna and ending value*.
2. EMCM probabMty of death timae the number ol evar amokan wKhtn the aga Mem*.
3. Average ol an emotdng related deatha of at age* wttghtod by lha percent ol death* In each aga group.
4. Tha dleoountad valua ot tutor* anpaded Me vaara toet at lime of death. Only a 3% tfTacourt rate h used thraughout (ha anetvalt.
5. EPA doaa not believe (hat dbcounUng phyefcat etfeeta auch at pretnaha* ototr* or ttw yearn externled hat no mearing. Only monetary valuaa ehouM be oHcountad. Dlaoourtlnfl phyateal attach ta dona here only
tor analytic eorwantonee and to dteptay daoountlng methodology.
Exhlbn 6-8: Life Years Extended Per Premature Death Avoided by type of Smoking Activity
Age
00*35
36-44
45-54
56-64
6S-74
74-6S
Total
Expected Lie Years Remaining:
To Die ExDectfH To Age 6511
74.68
20.50
16.05
10.75
4.58
1.34
74.68
17.10
11.75
5.30
Percent Premature Deaths Avoided, 50 Year Period
Quitting Reduced Cons. Reduced Initial.
2%
4%
• 12%
43%
40%
100%
1%
10%
8%
16%
39%
26%
100%
Av. LHe Yearn Extended per Premature Death Avoided
Average LHe Years Extended Over 50 Year Period |2]
To LH« Expectancy 4.74 7.65
To Age 65 1.36 3.95
3%
31%
19%
24%
23%
100%
15.06
10.61
1. Perinatal daatht. Expected IHa yeara remaining la from OTA (1993).
2. Average ol afl aga group* weighted by th* percent ot death* In aach ag* group.
-------
Exhibit 6-9: Excess Medical Costs per Smoking Related Premature Death
FeinalO
Beth Seme
Excess Mod. Cost
5 Year Total
(million )
113.500
73.100
186.600
Adjustment
Factor
0.95
0.95
0.95
Annual Excess
Medical Cost
(mttHon)
21.526
13.864
35.391
Annual Excess
M*d. Cost Per
Pram. Death
(doli&:<;
85.174
1. £di*ss msdfcal costs tor tw 1905 popuistton ol ever smotutft versus nev^
smokers In 1990 dotes. This figure accounts tor tie extodad He expectancy of
newer smokers and t» medfcsJ expenses Incurred during tone yearn.
2. Excess medcaf costs provided by Hodges an dbcountod by 3%. To obtain to
undJscaunted value, we multiply by 1.09. To obtain the excess cost of a
"nonsmoMng smoker', we muMpty by 0 97 (see Hodges.1992).
Source: Hodges (1992)
Exhibit 6-10: Costs Per Smoking Related Premature Death and Life Years Lost
Excess Cost per
Premature Death
Cost per Ufe Year
Lost to Age 65
Direct
Medical
(dollars)
85.174
Lost Earnings
Morbidity [1]
(dollars)
16.630
Lost Earnings
Mortality [2]
(dollars)
31.150
1. Catenated from OTA. 1993
2. Estimated daNy earnings of smokers (S
-------
Exhibit 6-11: Annual Savings Due To Changes in Smoking Behavior
Base-No Restrictions
Lew Estimate
Savings from Smoking Restrictions
3% Discount
Quitting
Reduced Consumption
Reduced Initiation
Total
5% discount
Quitting
Reduced Consumption
Reduced initiation
Total
7% Discount
Quitting
Reduced Consumption
Reduced Initiation
Total
High Estimate
Direct
Medical [1]
(million)
343
2,221
513
3.077
387
1,838
161
2,386
387
1.589
67
2,044
Lost Earnings
Morbidity [1]
(million)
67
434
100
601
75
359
31
466
78
310
13
399
Lost Earnings
Mortality (1)
(million)
248
826
983
2,056
203
1.127
448
1,778
170
1,319
230
1.716
Direct
Medical [1]
(million)
686
4.443
1.026
6,155
773
3.676
322
4,771
774
3.179
135
4,088
Lost Earnings
Morbidity [1]
(million)
134
867
200
1,202
151
718
63
932
151
621
26
79B
Lost Earnings
Mortality [1]
(million)
495
1.652
1.965
4.112
406
2.253
896
3,555
339
2.638
459
3,436
1. Estimates provided here only for those Interested. These are not Included hi evaluation of benefits. See text.
-------
Exhibll S-1: Summary of Costs and Benefits*
Smoking Lounga
NaHonat EnkNcamanl
VWua of Piamatun Oaalm Avohlad
Homa tMposufs
NDVWIOAIS Exposura
hcrwaad Occupant Comfort
Swings fei Opsfinng Sfid MaJntsnsnc* Expanses,
HouMhsspIng
M Chang* ta PiDdHcttvfty
Swings to R*onoaa Stnoksr Abssflnssini
••uhuM ^•^H^^BK O«l^«** C*_A_
omngs •tomonignsmMirww
Vato of ln|uriM and Daafts Awldad
NnnnsaMsiiHat
PtOMrtv Dantaps AwoUsd
(MMom of Dotan)
610 1,097
150 455
361 912
100 500
46.193 94.499
726 2,018
41.656 75.310
2.721 6.541
» f
8.164 19.919
3.674 4,390
1.280 5.620
0 0
228 447
009 902
293 507
204 194
112 121
"**»% DtocoutH RaW*
LflwEattMata Hkjh Cilfcaals
(MSHom of Doteni
917 1,004
1 59 465
359 930
100 500
43.991 99,421
689 2.402
39.661 71.398
2,721 6,541
f t
6,164 16,019
3.674 4,390
1.260 5.620
0 0
107 370
000 992
293 597
204 194
112 121
LoiV EvttaMM MQH EVHIIIH
(MMora d Doiwt)
024 1,901
159 455
364 647
100 SOO
41.691 77.811
662 2.36'
36.118 66.585
2.721 6.541
f •
6.104 19.918
3.974 4,390
1,280 E.tf20
0 0
166 111
699 992
293 587
204 194
112 121
D0n0nte of I
AvobMfte
Qu« Smoking
RsduDBd Oonwmp0on
nsouccd InKWIon
Tow
MMHILOMM
UvCtftaMto H
5.449
26.203
3.011
10,462
*M
10.090
SI ,200
7.622 [31
60.720
AMW| M»
0
30.717
20,737
00.460
MtwM Y*M*
0
77.620 Ml
41.475 [3|
110.99S
Tout* may appMr to bs gnaur than ths wm of MMdual Mams dus to rounding.
0 Nol quantMad. Saa tart to dUcusHon.
1. Moat otftfc) iiSjiiali Is dua to tha oaMmatrt vahia of faduoad aathma rnducUon In chMran.
2.' Conatdars |uat tha abow coils and banlla,
3. Annual premium dsaths a»oldad att* 60 yaars. Annual radueMoo In ^*^*un daatht gradually h
owr tha IM 60 yaars baton I raachas a constant mlua.
-------
Exhibit 7-1: Percent of Worksites with 50 or More Employees that Prohibit Smoking or
Restrict Smoking to Separately Ventilated Areas
Sl» of Worksite
50-99
100 - 249
250- 749
750 +
AH Sites
Percent
55%
61%
66%
74%
59%
Exhibit 7-2: Number of States and Territories with Legislated Smoking Restrictions -1993
Public Places
Government Workplace
Private Workplace
Restaurants
Ban
Designated
Designated w/Separate 100% Smoke
None Areas Only Ventilation
13
18
35
22
53
40
34
18
31
0
0
1
0
0
0
Free
0
0
0
0
0
-------
: Proportion of AH Employees Under BestrtcBve SmoWng Policies
Aaaumad % ol Flrma nffih RaaMettva Polkiaa
Percent al Employee
% Employ •« Covered by
BanorLoung*
% Employ«tts Covarad by
% EmptoyMs Covarad by
Assume 20%
ma«tHR34C4
Standards
Exhibit?^.: Proportion of Employees with SmoHng Bans and Lounges
Smoking Bans
Complying Smoking tounga
Totd CompHajnea
-------
ExhlbR S-2: Summary ol Cost* and B«n*flU*
CMt of HI i ptMiiOTlh IQ tiw LvQltlitton
8mcMngB«w
SmoUng Loung*
Wfoiul Entoreonwrt
VftJu* of Pranwhra OM«W AwMcd
Honw Expotur*
NoifMonw Expoowt
ImprewdHMlth1
InoMMd OoeujMnt Comfort
Swing* to Operating and MIMMIMC* ExponMs
HoHwtooptng1
hUbitaiuiw*
NM dung* In PmtotMty
Swhig* In Ftoduwd Smotor AbMrtMtom
Saving* hi SmoMng Ftatatod Fins
VihM o( InjurM «nd Doattw Avohtod
RMMOfttill
NoflRMldMttal
ProMrtv DwtMM AvoMwl
BwwfRc WRboM ttagvd to tmotara pi
*"•»% Dteetfwrt «•!««••
Urn Mlnuft* Hlo^i Ettlmat*
(MMtoru of DeH*ra)
479 1,437
123 360
270 703
77 385
14.M4 •8,041
SS» 2,016
«.22« 67,988
2,008 5.037
i •
I.M* T.714
2.B8S 3,386
086 4.327
• •
171 944
486 *94
226 452
1ST 149
86 03
39.02S 72,369
«"»% Dtvcounl Brt«»^
Low CMImat* tH0h e«Hmrt»
tMDHom ol DoHwt)
476 1,461
123 350
27« 71«
77 366
99,160 91,924
$30 1,911
ao.SSfi M.976
2.09S 6,037
* ff
3.969 7,714
2.963 3,386
986 4.327
* •
1*4 ]M
499 894
220 452
167 149
99 93
87,287 M,t7»
-7% DtMOUnl R«t«"
L«w Kctlimt* High EillinH*
tMflllona of Ooltnt
490 1,464
123 360
280 729
77 366
31,969 86,869
609 1.836
29,351 52,810
2,096 fi.037
t *
8.999 7,714
2.983 3.386
966 4.327
• *
129 269
499 994
226 462
1S7 149
86 63
99.041 86,6*4
Piwmlur* DMlM AvoMMl <9mok«n)
QuN amoWng
Roduoid ContuRfllon
ftoduMd InKMkm
Total
or LJMMB to
iMMMl fcifiai «Mr W TMT P«Mrf
LM ErthnMi HWi i«*M»i
4.196
20.170
2.934
27.300
*
8,391
39.431
6.869 [3,
93,991
9
AnHMl Mto Wlw H TMT«
Low EMIiralo High CMIiml*
0
30,682
16.V68
46.860
•
0
S9.766 [1]
31.936 [3]
91,703
0
Totals nuy >ppxr to to gmtw than tho «m of WMdual HWTM dvt to rounding.
f Not qwnWM, So* taxi tor dteeusston.
1. Mo«t of fhft •Mfmtt to dtM to tta MtfntfM mkw of ndcwwf atttim* MudfM tn cfiHdrwi. Th* Mgh MtlmU In ExhlbH ES-1 to roduood by 50% boewit* at uncwtaWy of
b rrwonHiid*.
totor* M FMehM • oonitonl whw.
2. Comldon Jiwt tho •bov* eotte Md tonffto.
3. Annual pnnwtui* dMths wraMwl •«« 60 yctra. Annul) raducllon In pMnwtvr* dwriht gradually IneraWM owr the ftrat 60 ycara
-------
-I
;:I
I
i •
i •
| •
I
1
I
Pw CaplU Clf «MU CMMUIVU**
» o w o 8 5 9
S 8 S 3 S 3 8
i
MM!
., .
H
**!!!}
l
I
ifH5
a?« •*
•HI1
SM | :
i i I s
ff I 8 3 "
8
1 I
I i
« »
-* V* *
85 ±
So
,« ^
« V *.
* ¥ a
« K o
! l
e
v> w
S A OT
W S fl»
l.M
^ ??!!
n
-------
Exhibit S-4: Benefits Minus Costs
B*M29% Restrictions
Low Estimate
High Estimate
Lew Beneffts Minus High Costs
S HllnOH
3% Dbc. Rat* 5% Disc, rat* 7% Disc. Rale
39.023
72.356
38.056
37,287
69,170
36.311
36,041
66.684
35.057
-------
-------
APPENDIX A
Review of Selected Literature
-------
-------
Appendix A-l
Value of Avoiding the Risk of Premature Death
The Environmental Protection Agency recently undertook a review of various
approaches to evaluating the the value that persons place on an incremental risk of death
(Unsworth, 1992), sometimes referred to as the value of a statistical life. In general, the
studies attempt to determane people's willingness to pay to avoid an increase in the risk of
premture death. The following summarizes portions of that review.
Methodological Issues
There are three types of estimates that are commonly used. They are wage-risk
studies/ contingent evaluation studies, and consumer behavior studies. Wage-risk studies
estimate the additional compensation individuals demand in the labor market for taking
riskier jobs. Contingent valuation studies ask individuals to state how much they would
pay to avoid additional increments of statistical mortality risk. Finally, consumer behavior
studies examine market situations (e.g. smoke detectors) other than the labor market that
involve a risk-dollar tradeoff.
Most-studies reported in the literature apply a wage-risk framework. These studies
compare wage rates among different jobs involving different risks and estimate the amount
of additional compensation that is associated with the additional risk. Difficulties in these
studies include isolating job related risks from risks associated with lifestyle, and isolating
compensation due to job related risk from other job related factors that may account for
wage differentials. Wage-risk studies assume a perfect labor market in which workers are
free to move between jobs and where wages respond readily to forces of supply and demand
for labor. The prevalence of unions and other institutional forces which move the labor
market away from a perfectly competitive state compromise the validity of these studies.
Most wage-risk studies rely on wage data for manual labor and therefore may not be fully
representative of the population at large.
The subject population may not be representative for other important reasons.
Individuals value risk differently. Some individuals are inherently more apt to accept risk
than others. Hie base level of risk in one's life may be a factor. It has been suggested, for
example, that individuals with higher baseline risks tend to place a higher value to risk
reduction (Blomquist 1981).
Age is another important factor. It is generally assumed that if one were to
differentially value saving the life of a young person compared with saving the life of an
elderly person, that the young person's life would be valued more highly. However, the
propensity to avoid mortality risk tends to increase with age. That is, the elderly tend to
value opportunities to avoid risk more highly, and they therefore reveal a greater implicit
value of life. To avoid distortion, the age distribution of subjects in the study should
represent the population to which the value of life estimates are being used.
All value of life studies involving the market value of risk suffer from difficulties
encountered when participants in the study, or in the market being studied, perceive the
risks to be different than the true risks. If, as is sometimes the case, those accepting the risk
-------
as part of the market transaction (or as part of a contingent evaluation study) underestimate
the true risks, then the market (or the contingent evaluation study) will undervalue the
risks. In addition, since many individuals have difficulty accurately distinguishing, for
example, between the risk of death at 1 in 100,000 versus 1 in 1,000,000, value of life
estimates can easily be distorted, perhaps by an order of magnitude.
Finally, the way in which individuals value risk depends on the type of risk.
Voluntary risks are generally more acceptable than involuntary risks. Other factors of
potential importance include whether the risk is controllable or uncontrollable, ordinary or
catastrophic, old or new, necessary or unnecessary, and occasional or continuous (Utai
1980).
Review of the Literature
Unsworth (1992) reviewed three major surveys of the literature of the value of a
statistical life in which each of these methods was evaluated: Viscusi (1992), Miller (1990),
and Fisher etal. (1989). The summary of results provided by Unsworth is presented in the .
exhibit below
Viscusi (1992) examined 39 wage-risk, consumer market and contingent valuation
estimates of the value of life. He concludes that labor market studies with carefully
constructed risk variables, and contingent value studies with relatively large sample sizes
are the most suitable for policy applications. Applying his expert judgement, he finds that
the most reasonable estimates of the value of life are clustered in the $3-$7 million range
(1990 dollars).
FisheT etal. (1989) examined 21 studies of willingness to pay for reductions in risk.
They conclude the most defensible estimates lie in a range from $1.9*510 million (1990
dollars). The authors go on to express a greater confidence in the lower end of this range.
However, they also suggest that this range is an underestimate.
Miller (1990) examined 67 estimates of the value of life in which he considered 47 to
be reasonably sound. Making adjustments to the 47 studies on the basis of age, income,
accuracy of risk perception, and baseline level of risk. Miller calculates a mean value of the
adjusted 47 studies of $ 2.4 million (1990 dollars), and considers a relevant range to be plus
or minus 30% of the mean,.or $1.7-$3.1 million.
Choice of an Appropriate Range of Estimates
" Of the three surveys reviewed, Unsworth (1992) concludes that Viscusi and Fisher fit
al are a more appropriate starting point for estimating the value of life, because Miller
incorporates estimates from consumer behavior studies which are deemed less appropriate
or environmental policy purposes, and because the adjustments made by Miller a subject
to considerable debate and are less defensible. Unsworth (1992) further suggests thai Viscusi
estimates are more appropriate because they include more recent studies, and also include
more recent versions of some of the studies also considered by Fisher etal. to be sound.
l/.nsworth (1992) then adds two studies included in Fisher jetaL (1989), and which
Viscusi will include in a more recent survey soon to be published in the Tournal of
-------
Eronomic Literature. Applying criteria suggested by Viscusi(1992) for studies applicable to
policy analysis, Unsworth (1992) narrows the review to 26 studies. Simulating a lognormal
distribution and two triangular distributions, and comparing the shape of the simulated
distributions to the observed distribution of the 26 studies, Unsworth (1992) concludes that
the lognormal distribution is the most appropriate. That distribution has a mean value of
$4.8 million per life saved, and a standard deviation of $ 3.2 million.
-------
Survey Autbur ami
PuMiukl»Mi Date
VmM*(IW2)
l-hiltei. diesliitil.
and VmhrlU- Ml»Hl>)
Mdlcl (IWH)
Number ami Type of
Studies Savveyed
1*> similes published '
II.HII IVM to 1941 (2(1
wage ink. studies. 7
tiMiMimer market
uudk-x d ctiniingeni
v.iloe studies)
2\ -kindle* |Mit>1isbeil
limn 1974 lit l«MW(.IS
wage risk sludio. 4
tonstiiner market
sfudM'v. 2 umlingenl
valuation *ludic»)
*i7 *ludies puhlisheil
lumt IV7) to 19*1(37
wage mk Miidies. tS
nwsumci maikct
siMilics, and 15
umltngcnl vahialiun
sludh-'s)
SUMMARY iW KECEKr VAI.UIKM- UHiSURVUVS
Range «l Reported
Hcsl lisiimalcsuf
Value ul 1 jfe
(IVWduHan)
S7U,(KNHu $162
million (miginally
icpuctcd iit I'I'Ki
dollar* )
SSWt.tM)l)i» tMll
mittion (MI S4SH.INKI to
SH.S million as
oitginally ie|n tiled
IVKh iloltars)
S4fMNNMo$ln7
mnlion (m SM>.INN( to
itS.I millwHi a\
tuiginalfy n*|>oiteil
I98H tlullai*)
HecummciMbliiNtt (IWO uiOlan)
Most rtasonaMe estimates of ihc value
of life ate clustered in the $A l«t (?
million langc
Ihe tntvsV tWIvi^iltle eii\tmtval it skills
uiilicalc a laiige ti( estimates liom Si •*
lo (Ml 1 million
Tin* suggesteil value of a btaiistk'at life
for use in tusi hctuifil analysis atwt
legal damage tau:^ is in Ilie lunge
limn tl 7 million In )1 1 million, wild
a central tendency of $24 million
(jUOHIKHb
• t'ontlutks that market studies othct t^.Ih\
(HUJMISCS
* { 4mcludev that results tioni itmsumcr m.ukci '
iluthes lelleft |Hilenlially \ignilii >*ul ilitwiiw.iid
tuaws
* States \\VA\ iwtst estimatev ic|xutctl m ihr
liieialum urukmtale the value per •>latiMk;d lilr
a|>|iropriale for cnviionnicnt .1 jutlity atulyMs
• Adjusts studies for. use uf lw(me tan .oi\mg\.
etiuc in risk peiccpliun; erim in &(iecilK.iii.i\cil
on torn cms over slinh; i|iulily
Noli All v.dms omv* ii.-d to IVHI dollars ining Hie t Tl •tcll.ii.if
-------
APPENDIX A-2
Review of Recent Literature on the Effect of
Smoking Policies on Smoking Behavior
Studies Suggesting Limited Effect
Baile, Walter F. fit a!.. 1991. Impact of a Hospital Smoking Ban: Changes in Tobacco Use
and Employee Attitudes. Addictive Behaviors. Vol. 16. pp. 419-426.
A survey was taken approximately 4 months after a hospital wide smoking ban at
the Lee Moffit Cancer Center and Research Institute where a hospital wide ban on
smoking was instituted. Separate questionnaires were developed for smokers/ non
smokers and those who had quit smoking since the ban. Only five out of 88 smokers
quit since the policy. The authors conclude that the ban had little effect on employee
quit rates.
Beiner, Lois etal.. 1989. A Comparative Evaluation of a Restrictive Smoking Policy in a
General Hospital. American Journal of Public Health. Vol. 79. No. 2. February.
A comparative study was made of two similar hospitals One hospital instituted a
restrictive smoking policy while the other did not. Surveys were conducted one
month prior to the policy, and 6 months and 12 months after the policy. No
significant difference was found in the quit rates at the two hospitals. However,
cigarette consumption while at work was reduced at the policy hospital, without a
commensurate increase in smoking while at home.
The smoking policy in the policy hospital was only partially restrictive. Smoking
was permitted in sections of the cafeteria and coffee shop, and patients were also
allowed to smoke in their rooms if their roommate did not object. It is not clear
what impact the policy may have had if the policy were more restrictive.
Gottlieb, Nell H._fitaL, 1990. Impact of a Restrictive Work Site Smoking Policy on
Smoking Behavior, Attitudes, and Norms. Journal of Occupational Medicine. Vol.
32. No. 1. January. -
Questionnaires were mailed to employees of the Texas Department of Human
Resources. Subjects were surveyed 3 months prior to implementation of a smoking
policy (but 2 months after it was announced), and 1 month and 6 months after the
policy became effective The results showed no significant change in smoking
prevalence, quit attempts, or daily cigarette consumption. However, cigarette
consumption while at work was significantly reduced.
%
Daughton D.M. elaL 1992, Total Indoor Smoking Ban and Smoker Behavior.
-------
Preventive Medicine. Vol 21. No. 5. pp 670-76. September.
Hospital employees were surveyed 1 year after announcing, and 5 months after
-implementing a total ban on smoking. A second folio -p survey was conducted 2
years after the announcement. The results showed lit Affect on overall
institutional quit rates. However, there was a decrease in consumption during
working hours, particularly by moderate to heavy smokers.
Petersen, Lyle R. fiLaL 1988. Employee Smoking Behaoior Ch- es and Attitudes
Following a Restrictive Policy on Worksite Smoking in * large Company. Public
Health Reports. Vol, 103. No. 2. March-April.
-*udy of an Connecticut insurance company which adopted a smoking ban in all
ureas except in designated rest rr oms and lounges. The authors collected data 1 year
prior and 1 month and 3 month." after the policy. The results suggested no increase
in quit rates but a substantial reduction in cigarette consumption.
, Studies Showing a Moderate to Substantial Effect
Brenner, Hermann and Mielck, Andrew 1992. Smoking Prohibition in the Workplace
and Smoking Cessation in the Federal Republic of Germany. Preventive Medicine.
Vol 21. pp 252-261.
- A national survey was conducted in the Federal Republic of Germany, with an
overall response rate of 66%. Respondents were asked if smoking was allowed in
their workplace. Quit ratios for women and men were examined and compared
with workplace smoking policy. Smoking restrictions at the workplace showed no
affect on the quit ratio for men (0.32 smoking allowed, vs. 0.33 smoking not
allowed) but showed a substantial affect for women (0.18 smoking allowed vs 0.45
smoking not allowed). Both men and women showed a considerably higher attempt
to quit rate in places were smoking was not allowed. The mean number of cigarettes
smoked per day for men was 20.2 (smoking allowed) and (18.4 smoking not allowed),
and for women was 17.1(smoking allowed).and 15.7 (smoking not allowed). This
represents a 9% and an 8% reduction for men and women respectively.
Borland et;al. 1990. Effect of Workplace Smoking Bans on Cigarette Consumption.
American Journal of Public Health. Vol. 80. No 2. February.
A total of 2,113 employees at the Australia Public Service were surveyed to
determine the effect of a smoking ban on smoking behavior. Surveys were
completed two and four weeks before and five to six months after the ban was
instituted. The pre-ban results showed that individuals restricted from smoking at
their work stations consumed an average of 16,01 cigarettes per day compared
with 20.54 cigarettes per day (22% less) at stations where smoking was allowed. After
the ban, the consumption rates were 14.16 and 15.36 (8% less) respectively. This
shows that the effect of the workplace ban was to reduce consumption by 12% (16.01
versus 14.16) where there were prior work station restrictions, and by 25% where
-------
there were no prior work station restrictions on smoking.
Borland, Ron, et al. 1991. Predicting Attempts and Sustained Cessation of Smoking After
the Introduction of Workplace Smoking Bans. Health Psychology, Vol 10. No. 5. pp 336-
342.
Using the data from the survey of Australia Public Service employees/ the authors
examined factors that predict the initiation of cessation attempts/ and the
maintenance of cessation. The strength of the desire to quit was the best predictor of
making an attempt to quit. Having quit before the ban, as well as support from
family and friends were also good predictors of attempting to quit. As expected,
heavy smokers have the most trouble maintaining abstinence, and persons who
have quit before are less likely to maintain abstinence. Social support for quitting
was a modest predictor of maintenance. The authors postulate that the imposition
of smoking bans should provide a context where smoking cessation is more likely.
Hocking Bruce, ctal. 1991. A Total Ban on Workplace Smoking Is Acceptable and
Effective. Journal of Occupational Medicine. Vol 33. No. 2. February.
Telecom Australia is a telecommunications organization with 85,000 staff. After
several years of introducing progressively more restrictive policies, Telecom Australia
introduced a total ban on smoking in 1988. Prior to and 6 and 18 months after the
ban, a survey of employees was conducted in representative areas. The number of
smokers decreased by about 5% over the two year period, compared with 2% for the
Australian community as a whole. In addition, smokers were smoking 3-4 fewer
cigarettes/day after the ban.
Hudzinski, Leonard D. 1990: One-Year Longitudinal Study of a No-Smoking Policy
Medical institution. CHEST. Vol. 97. No. 5. May.
The Ochner Medical Institutions in New Orleans instituted a campus wide smoke
free policy. A survey (198'6-87) was conducted 6 months prior, 6 months after, and 1
year after the policy was instituted. Results suggested a 30% reduction (from 20 to
14%) in population of smokers after 1 yr. Half of those who quit said the policy had
helped them a great deal. 80% of smokers after 1 year smoked less than 8 cigarettes
per day.
Sorensen e. al. 1993. Promoting Smoking Cessation at the Workplace: Results of a
Randomized Controlled Intervention Study.
In a controlled intervention study at 8 sites in Bloomington Minnesota, smokers
were surveyed 1 month and 6 months after a three month intervention program
was completed. The intervention consisted of consultation with employees about
the adoption of a nonsmoking policy, training to nonsmokers in providing
assistance to smokers attempting to quit, and cessation classes for smokers. After 1
month, the quit rate for the intervention group was 11.5% compared to 5.2% for the
-------
control group. At the 6 month interval, the quit rate for the intervention group was
12 % compared to 8.8% of the control group. These rates are adjusted for the effects
of age, sex, and education. Quit rates were based on answers to the simple question,
"Do you now smoke cigarettes?" and also, not assessing the length of abstinence. The
long term quit rates therefore are likely to be substantially lower than those reported.
Those supported by an intervention program had a slightly higher quit success rate
than those without such a policy.
Sorensen G. et. al. 1991. Effects of a Worksite Nonsmoking Policy: Evidence of
Increased Cessation. American Journal of Public Health. Vol. 81, No. 2, February.
In 1986, the New England Telephone Company instituted a no smoking policy. A
random sample of employees was taken 20 months after the policy was
implemented. The results revealed a 21% reduction in smokers after 20 months
(reduced to 18 % for those who had quit for more than 3 months). 42% of those who
quit (9% of smokers) attributed their quitting to the no smoking policy.
Sorensen, Glorian and Pechacek, Terry F. 1989. Implementing nonsmoking policies in
the private sector and assessing their effects. New York State Journal of
Medicine. Vol. 89. January.
Data was collected in a telephone interview from 711 smokers and recent ex-smokers
at seven worksites in Bloomington, Minnesota. In a survey conducted in 1986,12-18
months after intervention, 58% felt that quitting would be easier if they could not
smoke at work. Of the 42% who tried to quit in the last 2 years, 20% succeeded.
Stave, G.M. and Jackson, G.W. 1991. Effect of a Total Work-site Smoking Ban on
Employee Smoking Attitudes. Journal of Occupational Medicine. Vol 33. No.8. pp
884-90.
In this study, the authors compared data on smoking attitudes and behaviors at
Duke University Medical Center which adopted a smoking ban, and on an adjacent
campus where no such ban was adopted. Surveys were conducted three months and
9 months after the smoking ban was in affect (9 months and 15 months after
announcement). Three months after policy implementation, mean cigarette
consumption during working hours had dropped from 8.1 to 4.3 cigarettes
(47% decline) at the medical center and from 9.3 to 8.78 (6% decline) at the
University Campus. In the fifteen months alter the announcement 1Z6% of
smokers at the Medical Center and 6.9% at the University Campus had quit.
StiUman, Frances A. etal. Ending Smoking at The Johns Hopkins Medical Institutions:
An Evaluation of Smoking Prevalence and Indoor Air Pollution. JAMA, Vol 264.
No. 12. September 26,1990.
In 1988, The Johns Hopkins University Hospital Complex decided to eliminate
-------
smoking in all areas of the building complex. Previous policy allowed smoking in
designated areas of cafeterias, waiting areas, lounges, patient areas and offices.
Surveys were conducted 6 months before and 6 month after the policy was
instituted. Smoking prevalence declined from 21.7% to 16.2% (25% decline). The
number of cigarettes smoked per day went from 16.4 to 13.1 (20% decline), and the
cigarettes smoked while at work went from 7.8 to 3.8 (51% decline). The quit rate
was 20.4% between surveys, but would be reduced to 10% assuming all
nonrespondents (50%) did not quit. For those that had quit for more than 3 months
at the time of the survey, the quit rates are adjusted to 18.2% and 9% respectively.
Wasserman, Jeffrey, fiLaL 1991. The Effects of Excise Taxes and Regulations on Cigarette
Smoking. Journal of Health Economics. Vol 10. pp 43-64.
The authors used data on smoking status and behavior from 1970 to 1985 for adults
from the National Health Interview Survey, conducted annually by the National
Center for Health Statistics. Data for teenagers was taken from the National Health
and Nutrition Examination Survey II. A generalized linear model was used to
estimate the effects of excise taxes and regulations on adult and teenage smoking
behavior.
The authors used a regulation index in which a value of one was assigned to
communities with comprehensive smoking laws in most public places, including
that including restrictions in workplaces, zero for no restrictions in any places, and
values of .75, .50, .25 for combinations in between. They used a two stage model in
which the decision to smoke and the level of demand were analyzed sequentially.
The authors predict that if the regulation index was raised from 0.25 (smoking
restrictions in areas where people spend little time) to 1.00 (restrictions in almost all
places, including workplaces), then per capita cigarette consumption for adults
would decrease by 5.9%. For adults, the regulation index had a statistically
significant result only on the number of cigarettes smoked, not on the decision to
smoke. The same change in the regulation index would have a different effect on
teenage behavior. Teenage consumption would decrease by 41%. However/ this
effect results mostly from preventing teens from starting to smoke rather than
reducing the consumption of teenage smokers.
Woodruff, T. J. fiLaL 1993, Lower Levels of Cigarette Consumption Found in Smoke-free
Workplaces in California. Archives of Internal Medicine. Vol. 153. No. 12. pp 1485-
93. June 28.
Woodruff, etal. (1993) applied a logistics regression on data from the 1990 California
Tobacco Survey in which subjects were queried by telephone. Prevalence was 13.7%
in smoke-free workplaces compared with 20.6% in places with no restrictions (33%
difference). When the influence of demographic variables were accounted for, it was
estimated that persons with little restrictions on smoking were approximately 30%
more likely to be smokers than were those working in smoke-free workplaces.
The workplace smoking policies showed little effect on changing the smoking status
-------
of persons who were regular smokers 1 year prior to the survey. Approximately 85%
remained regular smokers regardless of workplace smoking policy. The authors
not: that most of California's smoking policies had been implemented before the
su: v date of July WO, and thai, smokers who were likely to change their behavior
h; ;dready done so / the time :ne survey was taken.
However, there was a substantial effect of smoking policies on the proportion
of occasional smokers who became regular smokers. Of those that had been
occasional smokers one year prior to the survey, 21% had become regular
smokers in smoke free workplaces compared to 33% in workplaces with no
restrictions. No data were shown for individuals who were previously non
smokers. ..
Cigarette consumption per smoker was 13 % less among those with no workplace
restrictions compared with those working in a smoke-free envir^-jrvent (296 versus
341 packs per year). Accounting for reduced smoking prevalence and reduced
consumption by smokers, including occasional smokers, the authors estimate that if
ail workplaces were smoke free, consumption would be 41% lower than if there
were no workplace smoking restrictions.
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APPENDIX B
Technical Appendix
-------
-------
Explanation of Housekeeping
and
Maintenance Methodology
-------
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Technical Appendix
Housekeeping and Maintenance Impacts of H.R. 3434
Offices
Offices reported reduced cleaning costs due to reduced emptying and cleaning of ashtrays,
easier dusting of desktops and high areas, reduced washing of walls, reduced cleaning of
carpets, reduced cleaning of Venetian and horizontal blinds, reduced cleaning of HVAC vents,
and reduced cleaning of indirect lighting. For the purposes of this analysis, savings associated
with ash trays, dusting desktops and high areas, cleaning Venetian/horizontal blinds, and
cleaning HVAC vents are quantified. Cleaning costs are estimated using a prototype annual
cleaning budget for items that would change in a smoke-free environment. Generally, the
estimates are Calculated by multiplying the time required for each task by the labor rate and the
frequency that each task would be performed on an annual basis to develop annual costs per
1,000 square feet Detailed calculations are discussed below:
• Ash trays: The analysis assumed that under a smoking environment, ash trays would be
emptied and cleaned each business day for a total of 250 times per year (52 weeks
multiplied by 5 days per week, minus 10 holidays). One source actually reported that ash
trays in their facility were emptied 3 times per day, however, once per day is more common.
In a smoke-free environment, emptying ash trays would be completely eliminated. The
estimate of the time required to empty and dean ash trays for 1,000 square feet of office
space (2.5 minutes) is from a BOMA report on cleaning costs in office buildings.
• Dusting: According to one documented study by BOMA, the dusting of desks was reduced
from daily to once per week in an office with a non-smoking policy. The analysis assumes
that the frequency for dusting desktops will be reduced from 250 times per year to 52 times
per year. The estimate of the. time required to dust desk tops for 1,000 square feet of office
space (22. minutes) is from a BOMA report on cleaning costs in office buildings.
• Dusting High Areas: According to the BOMA study, the dusting of high areas (top of
partitions) was reduced from once per week to once per month. The analysis assumes that
the frequency for dusting high areas will be reduced from 52 times per year to 12 times per
year. The estimate of the time required to dust high areas for 1,000 square feet of office
space (4.5 minutes) is from a BOMA report on cleaning costs in office buildings.
• Cleaning Venetian/Horizontal Blinds: According to the BOMA study, the cleaning of blinds
.was reduced from 6 times per year to once per year. The analysis assumes that the
frequency for dusting high areas will be reduced from 6 times per year to 1 time per year.
The estimate of the time required to clean blinds for 1,000 square feet of office space (2.0
minutes) is from a BOMA report on cleaning costs in office buildings.
• Dusting HVAC Vents: According to the BOMA study, the dusting of HVAC vents was
reduced from 4 times per year to once per year. The analysis assumes that the frequency for
dusting vents will be reduced from 4 times per year to 1 time per year. The estimate of the
time required to dust HVAC vents for 1,000 square feet of office space (10.0 minutes) is
from a BOMA report on cleaning costs in office buildings.
Cost savings in offices were also reported due to reduced damage to carpets, furniture, and
computer equipment. Cigarette burns to carpets would be eliminated in a smoke free
Housekeeping and Maintenance
-------
environment. Managers have the choice of either repairing burns or replacing the entire carpet
when the problem becomes too noticeable. This analysis assumes that carpets will be repaired
at an estimated cost of $100 per burn. One carpet repair is estimated to be necessary per year
per 1,000 square feet of office.
Office furniture will also be protected from bum damage in a smoke-free environment. One
article estimated that furniture would last three times as long with a smoking ban. Tax policy
estimates that the average depredation life of business furniture is 7 years. The analysis
assumes that offices will normally replace furniture once every 7 years (when it can no longer be
depredated) if there is no excess damage to the furniture (from bums, for example). Following
the estimate that furniture would need to be replace three times as often would lead to
replacing furniture once every 2 to 3 years in a smoking environment. Although this may be
accurate in extreme cases, the norm is probably less. The analysis assumes that office furniture
would be replaced once every 5 years in a smoking environment in comparison with once every
7 years in a smoke-free building. The value of office furniture was estimated by determining the
average price of a desk and upholstered desk chair from a large office furniture supplier ($525
for a desk and $230 for a chair). Six desk and chair sets were assumed to be contained in 1,000
square feet of office space (based on occupancy standards).
Computer equipment, especially personal computers, represent another category of potential
savings in a smoke-free environment. Computers will remain cleaner, requiring less time to
repair and, in extreme cases, not need to be replaced as frequently. Based on interviews, the
analysis assumes that computer keyboards used by smokers will require replacement once every
1,5 years in comparison with once every 5 years for keyboards used by non-smokers. Also,
maintenance and repairs to computers of smokers would take 30 minutes longer due to
increased cleaning required.
The need for painting would also be reduced. The analysis assumes that painting would be
required once every 5 years in a smoking environment and once every eight years in a non-
smoking area. The estimate of time required to paint 1,000 sq. ft of office space is from Means
Facilities Maintenance Standards.
Will every building or business experience the potential savings estimated? A survey of
businesses found that 43 to 60 percent of businesses instituting a smoking ban experienced
maintenance cost savings. There are many plausible explanations as to why a firm may not
experience cost savings. For example, a business may have a fixed maintenance and janitorial
stan that will not be reduced but work on other activities if the smoking-related activities are
reduced. Also, some businesses may not be able to renegotiate existing cleaning contracts.
Finally, some businesses may simply have a higher tolerance for a dirty, dingy environment with
damaged carpets and furniture.
To take into account these possibilities high and low estimate of savings is calculated. Also,
it is assumed that only a portion of potential office space will fully realize the benefits. For
Offices, the low estimate included cleaning cost savings and reduced painting. In the case of
cleaning, 60 percent of the total square feet (7,081 million sq. ft out of 11,802 million sq. ft) of
office space is estimated to report the savings. For painting, some tenant occupied office space
will in tact be painted more often than once every 5 years due to turnover of occupants. To take
this into account, the savings is only claimed for offices expected to have longer occupancy
including government owned space and single-owner occupied space (6,610 million sq. ft).
In the high estimate, carpet repairs, replacing of office furniture, replacing computer keyboards.
Housekeeping and Maintenance
-------
and computer maintenance are added to the low estimate. Carpet repairs and furniture
replacement are calculated for 60 percent of the total square feet (7,081 million so. ft out of
11,802 million sq. ft) of office space. Computer-related costs are calculated based on the
estimate of personal computers used by smokers in the workforce (estimated at 25 percent of
20,330,000 total PC's in the workplace or 6,657300 personal computers). This figure does not
take into account damage to equipment other than PC's such as printers or PC's used by non-
smokers, but in an office that permits smoking.
Mercantile and Service
Retail stores and service outlets usually restrict smoking to certain common areas in the
building. In these areas, as smoking ban will eliminate the need to empty and damp wipe
ashtray stands, reduce sweeping and vacuuming, eliminate carpet burns, reduce the need to
clean windows and display cases, and reduce painting. For the purposes of this analysis,
cleaning costs are calculated for elimination of cleaning ashtray stands and reduced need to
sweep or vacuum. With smoking allowed, ashtray stands were assumed to require cleaning and
emptying once every day for approximately 290 days per year. In actuality, ash tray stands
may require more frequent cleaning such as two or three times per day, 365 days per year. The
cleaning time per 1,000 sq. ft (4.0 minutes) is derived by assuming 10 stands in 1,000 sq. ft
requiring 0.4 minutes per stand (from Means Facility Maintenance Standards) to empty and
clean. Sweeping and vacuuming is assumed to be required twice per week with smoking allowed
and once per week in a smoke-free environment The time required to sweep/vacuum 1,000 sq.
ft is the minimum estimate from Means Facility Maintenance Standards.
Reduced maintenance costs were calculated for reduced carpet repairs and reduced painting.
Carpet repairs were estimated using the same assumptions described for Office space. Painting
was assumed to be reduced from once every 5 years to once every 7 years. This estimate may be
low since retail and service space must retain appearance to attract customers and may
therefore have lower tolerance for dingy walls.
Of the total 13,157 million square feet of building space classified as Mercantile and Services in
the Department of Energy estimates, it was assumed that for cleaning and carpet repairs, only
60 percent of this space would report savings. For painting, it was assumed that 30 percent
would report savings. Of this space, 40 percent was assumed to be in common areas subject to
smoking resulting in an applicable area of 3,158 square feet for housekeeping and by 1,579
million square feet for painting.
Food Service
Restaurants and lounges face much the same situation as hotels and motels. One restaurant
owner stated that they would need 20 additional employees to empty ashtrays, sweep butts,
wash windows, and fill in absences without a no-smoking policy in the establishment The
owner also reported less clean up time and fewer burns on tables. One restaurateur was
considering installing expensive air cleaning and nitration equipment that were not necessary
when a no smoking policy was instituted.
For the purposes of this analysis, cleaning cost savings were calculated for the elimination of
emptying ash trays every day, 6 times per day, under the assumption that ash trays will be
Housekeeping and Maintenance
-------
cleaned each time a new group arrives at a smoking table (2,190 times per year). This
assumption may be low since staff at nicer restaurants will often clean ashtrays several times
during a ^alr particularly for heavy smokers. The cost time estimate to clean one ashtray is
from Dej *ment of the Army Janitorial Formulas. Reduced time due to sweeping butts and
washing mdows was not estimated.
Painting is assumed to be necessary once every 4 years with smoking instead of once every 5
years. The painting frequency may in fact be much higher in nicer establishments subject to
heavy smoking. Damages due to cigarette burns are estimated assuming once carpet repair per
year per 1,000 square feet. The need to repair and replace table linens, chairs, and tables is
estimated at once every 5 years with s; aokingand once every 7 years (as employed in tax
depredation calculations) without snu ong. The value of a table and chair set is from Means
Square Foot Costs. „
Expected savings are calculated on the basis of food service seating capacity for smokers.
According to the Department of Energy, the food service seating capacity is 27,753,000. It was
assumed that 80 percent of this capacity are expected to report savings due to a smoke-free
environment. This is a bit higher than the 60 percent expected in office spaces because food
service establishments will place a greater emphasis on appearance and cleanliness, and have a
lower tolerance for damages. Painting benefits were expected to accrue to 60 percent of the
smoking capacity. Assuming that 30 percent of the capacity is used by smokers, the smoking
seating capacity is 8,325,900.
Healthcare
Health Care facilities contain a number of different types of space that is used for a variety of
purposes. Some space is used for administrative purposes such as billing and personnel. The
savings to this space would be the similar to that for offices. Space devoted to patient care
would have different types of savings. For the purposes of this analysis, administrative space
was assumed to have savings identical to those described for offices. It was assumed that 20
percent of space in Health Care facilities will be devoted to administrative functions.
Building space devoted to patient care will contain bed-ridden patients It was assumed that
each smoking patient will require cleaning and emptying of an ashtrayi ice per day, 365 days
per year (730 days per year total). Also, space containing smoking patients will require
sweeping 1.5 times more often than rooms with non-smokers (548 vs. 365 times per year).
The total amount of space for Health Care facilities is 4,225 million square feet. Savings
identical to those calculated for offices are expected to accrue to 60 percent of this space.
Painting savings are expected to accrue to only 30 percent of the potential space.
Administrative functions is assumed to account for 20 percent or 845 million square feet.
Savings associated with patient care is calculated on the basis of the number of hospital beds
used by smokers. It was assumed that 25 percent of the total beds (25 p cent of 3,602,000, or
900,500) would be occupied by smokers. Given that smokers have a higher rate of
hospitalization than non-smokers, this figure may be low.
Housekeeping and Maintenance
-------
Assembly
Buildings that are used for assembly will accrue benefits to that portion of their space used as a
common areas with smoking permitted. The reductions in cleaning and maintenance were
calculated using the same categories and assumptions as the common areas for the Mercantile
and Services category. Savings are expected to accrue to 60 percent of this space for cleaning
and carpet repairs, and to 30 percent for painting. It was assumed that 20 percent of the area
expected to report savings would be in common areas, resulting in an applicable area of 821
million square feet for housekeeping and carpet repairs, and 410 million square feet for
painting.
Education
As with Health Care facilities, Education facilities can be used in a variety of different ways,
particularly at the higher education (college and university) level. Since it is more likely that
smoking will be limited in elementary and secondary level schools, this estimate will focus only
on institutions of higher learning (colleges, universities, junior colleges). A fair portion of space
in colleges and universities is devoted to administrative and office functions. These spaces
would accrue the same types of savings as general office space. Colleges and universities would
also have common areas similar to Assembly and Mercantile and Services space.
It is expected that benefits will be reported by 60 percent of the total space in colleges and
universities (approximately 1,200 million square feet of 2,000 million square feet). For the
purposes of this analysis, it was assumed that half of the space in colleges and universities
(600 million square feet) will be devoted to administrative and office uses. Benefits for this
space were calculated in the same manner as benefits for the office use. Another 20 percent will
be in common areas (240 million sq. ft). Benefits for these areas are calculated the same as
common areas in other types of buildings (Assembly, for example).
lodging
Hotels and motels face the unique challenge of maintaining a pleasant, clean, and attractive
building in the presence of smoking. Very often business and profits depend on how good a
room looks, its overall cleanliness, and its odor. Thus, cleaning, painting, and replacing carpets
and furnishings are done at a greater frequency than in an office environment. For the purposes
of this analysis, the only cleaning cost savings claimed is from the elimination of emptying and
cleaning ashtrays. The same basic methodology as described under offices was used. Carpet
repairs were also estimated to occur at the same frequency and cost the same amount. This will
probably underestimate actual savings since hotels and motels will have less tolerance to
unsightly carpets, thereby leading to increased replacement of carpets rather than repair.
Lodging space can also be divided into different uses. Hie bulk of the space is used for guest
rooms, but some of the space is in common areas. Cost savings for common areas are estimated
using the same assumptions as other types of common areas. It is assumed that 20 percent of
the Lodging space is devoted to common areas.
Cost savings to guest rooms used by smokers could be quite large including reduced cleaning
time for each room, reduced carpet repairs, reduced painting, and reduced replacement of
furniture and linens. The need to repair and replace furniture and linens is estimated at once
Housekeeping and Maintenance
-------
every 5 years with smoking and once every 7 years (as employed in tax depreciation
calculations) without smoking. The value of a standard set of furniture is from Means Square
Foot Costs. It is unclear whether H.R. 3434 will prohibit smoking in guest rooms designated for
smoking use/ thus, savings associated with guest rooms are included only in the high estimate of
benefits.
Benefits are expected to accrue to 60 percent of lodging establishments for cleaning, repair and
replacing, but to 30 percent for painting savings.
Industrial/Warehouse
Warehouse and industrial environments will have lower aesthetic standards than other types of
establishments for their production areas. Reported activities for production areas that would
decrease under a no smoking policy for a warehouse include emptying ash trays and sweeping
floors. The savings associated with eliminating the need to empty ash trays is calculated in the
& : \e manner as for other categories. Savings from reduced sweeping are calculated based on
t' assumption tra> the frequency of sweeping would go from 2 times per week to once per
week in a smoke tree environment/ as reported in the literature.
The portion of industrial/warehouse space expected to report savings was assumed at 60
percent. A portion of this space would be devoted to administrative and office functions that
would be expected to have the same types of savings as offices. For the purposes of this
analysis, 20 percent of the space in this category wm be used for administrative purposes and
the remaining 80 percent wul be used ir production areas.
Total Savings
Exhibit B3-1 summarizes the low and high estimates of cleaning and maintenance savings for
each building category under H.R. 3434. Total square feet for each building category and
applicable square feet are also displayed. The savings per square feet are also calculated.
Housekeeping and Maintenance
-------
Exhibit B3-1: Detailed Houeekeepmo and Maintenance Coat Savings by Typ* of Establlahment
ASSEMBLY
Cleaning:
Empty and damp trip* ashfrsy stands
Sweeplngftracuurntrig
llalirtemneWllafMlf/RepJecoinent:
Carpel Repairs
Patnting
TOTAL
PotanHal
Savings
(per 1000 sq ft)
Total
ATM
(MHHon Square Feet)
Portion
Expected to
Report Savings
Applicable
ATM
Total
Expected
Savings
(mftlons of doMsra)
Total
Expected
Savings
(mMHons of dollars)
$163.52
$72.80
$100.00
$104.39
6,838
6,638
6,838
6,838
4,103
.4,103
4.103
4.103
821
821
821
410
$134
$60
$43
$134
$60
$82
$43
$237
$319
HEALTHCARE
Cleaning:
Empty and damp wipe ashtrays
Dusting Desktops
HighDusHng
Venetian/Horizontal Bflnds
Ctean HV AC Vents
Per Hospital Beds used by smokers:
Empty and damp wipe ashtrays
Sweeping
Malntenanee/Repali/Replacement:
Replace Office Furniture
Carpel Repairs
Pairing
TOTAL
$87.50
$62.94
$25.20
$7.00
$1.05
$21.90
$127.75
4,225
4,225
4,225
4,225
4,225
3,602,000
3,602.000
2,535
2,535
2,535
2,535
2,535
2,161,200
2.161.200
507
507
507
507
507
900,500
900.500
$44
$32
$13
$4
$1
$20
$115
$44
$32
$13
$4
$1
$20
$115
$271.80
$100.00
$130.48
4,225
4.225
4.225
2,535
2.535
2.535
507
507
254
$33
$138
$51
$33
$261
$449
EDUCATION
Cleaning:
AdmlnlslratWOfflc* Space:
Empty and damp wipe ashtrays
Dusting Desktops
US* Dusting
Venetian/Horizontal Blinds
Ctean HV AC Vents
Common areas:
Empty and damp wipe ashtray stands
SweeplngAracuumbig
$87.50
. $62.94
$25.20
$1.40
$4.20
$140.00
$72.80
8,148
8.148
6.148
8.148
8,148
8,148
6.148
,200
.200
.200
,200
,200
1.200
1.200
600
600
600
600
600
' 240
240
$53
$38
$15
$1
$3
$34
$17
$53
$38
$15
$1
$3
$34
$17
-------
1
!
* I
I III
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f *
I III
ft o co
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55
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s
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CO CO
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n ri
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S
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i
t
i !
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o e
s
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d
!
i
I
10 <- e in
v tt M U>
gsss
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Eiin
8 S g 8
S « 08
n n n n
o, e. O( o
n n n n
ui 10 to 10
o. o o. ol
IA* tft" ""
t\
§
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^- w w
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a n
o o 6 p p p
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eg CM N M N Ml
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&
i!il
U
-------
Exhibit B3-1: Detailed Housekeeping and Maintenance Coal Saving* by Type of Establishment
ConthMMd
WAREHOUSE/INDUSTRIAL, eonOmMd
Production Areas:
Empty and damp wipe ashtrays
Sweeping
TOTAL
Potential
Savings
(per 1000 sqfl)
Total
Area
(MIMon Square Feet)
Portion
Expected to
Report Saving*
Applicable
Area
Total
Expected
Savings
(muttons of doRars)
Total
Expected
Savings
(minions of dolars)
$87.50
$36.40
12.253
12.253
7.352
7,352
5.881
5.881
$515
S51S
$214
$781
$995
FOODSERVICE
Cleaning!
Empty and damp wipe ashtrays
MetntonaflcoffiepaJr/Reptecement:
Replace Table and chair set
Carpet Repairs
Painting (per 1000 sq feet)
TOTAL
OFFICES
Cleaning!
Empty and damp wipe ashtrays
Ousting Desktops
Ugh Dusting
Venetian/Horizontal Blinds
dean HVAC Vents
MalntenancefRepalr/Reptaeament:
Replace Office Furniture
Carpet Repairs
Painting
$65,70
27.753.000
22,202.400
6.660.720
$438
$438
$28.85
$10.00
$86.99
27,753,000
27,753,000
1.167
22,202.400
22.202.400
700
6.660.720
6.660,720
700
$67
$0
$179
$67
$0
$504
$683
$87.50
$62.94
$25.20
$1.40
$4.20
$271.80
$100.00
$130.48
$21.25
$23.50
11,802
11,802
11,802
11,802
1 1 ,802
1 1 ,802
11,802
1 1 ,802
Computer*
26,630,000
26.630,000
7.081
7.081
7.081
7,081
7.081
7.081
7.081
6,610
Computers
6,657,500
6.657.500
7.081
7.081
7.081
7,081
7.081
7,081
7,081
6.610
Computer*
6,657,500
6.657.500
$620
$446
$176
$10
$30
$663
$620
$446
$178
$10
$30
$1.925
$708
$863
$141
$156
TOTAL
$2.146
$5,077
-------
Examples of
Discounting Methodology
-------
Exhibit B4-1: Vahw el Reduced Absenteeism
1M1-MSS 10ei-tSfS M11»202* 3*21.2030 2031-204*
20*1-10*0
MSI
OuMktB (Uw Eatiw**)
RadueadAbaMitaaOaya
Dbjcovnt Factor
Mwrbar Yaera Factor
hooiMVahM
Am. EyfralaMVohw (La Gat.)
Am. EvwatoM VahM W Eat)
Raducad Iflkwsw (Law Eawmki)
Hunttar PoraaM (n«m)
RaducadAboMtooDara
VahM
Dtocowit Factor ,
** • ** *
nylRMr TOMradOT
PiaoMNVahM
Am. Equwatonl VMM (Lo Eat)
Am. Equwahwt VahM (HI Eal)
1.35
0.78
BO. 77
O.Ba2SOS7S4
10.00
•OS. 74
4.21
O.M
«.44
O.BS2MB7B4
10.00
271.18
1.26
0.77
SO.SB
O.M1H1047
10.00
81 7.21
O.SS
O.BS
«.!9
O.B41H1B47
10.00
SW.3B
1.00
O.SS
BB.ia
0.477SOS5SS
10.00
aaa.ta
O.B7
1.4S
151.83
0-477S095M
10.00
728.13
0.73
0.44
45.51
0.35S3B330S
10.00
1*1.74
1.39
2.0}
211.37
O.SSMS33SS
10.00
791.10
0.30
0.23
23.92
0.2B443SB24
10.00
•2.1B
1.74
2.SO
270.01
0.2S44M424
10.00
710.3S
0.10
0.0*
0.2ft
0.10S707171
10.00
ia.3t
2.12
3.11
330.49
0.100707171
10.00
080.21
0.00
0.104700401
33.3*
2.20
$.44
397.24
D.10470340C
33.33
1,002.31
1.T7S
•*
107
S.OM
17*
S4S
QuMng (Low ErifeMto)
VahM
Dwcovnl Factor
Day*
Am. E^lnlMt Vww (U EM.)
(UdncMl IntMon (Low EMbmM)
Numbw PWMM (mW«n)
Vahia
DMOWM Factor
NttntMt Vaata Factor
AIM. Etirivalam Vatoa (U Eat)
Am. EouMMM Vaba *« Eat)
7%CatMMIww
Quttmf (Low
1.3S
0.7*
•0.77
0.7U9H1M
10.00
•32.87
0.21
0.30
31.44
. 0.7835281*0
10.00
240.32
1.20
0.77
00.58
0.401017000
10.00
387.80
0.90
0.0*
•2.20
0.4810170*8
10.00
443.02
1.00
0.88
M.1B
0.209302772
10.00
201.33
0.07
1.48
151.83
0.209302772
10.00
448.39
0.73
0.44
45.51
0.1*1200285
10.00
02. SI
1.39
2.03
211.37
0.1812B02IS
10.00
383.10
0.33
0.23
23,52
0.111208500
10.00
2*. 17
1.74
2.00
270.91
0.11120890*
10.00
301.51
0.10
O.OS
*.2*
0.00*32*402
10.00
4.20
1
2.18
3.18
330.45
0.088328402
10.00
229.70
0.09008*213
20.00
2.28
3.44
357.24
0.03008*213
20.00
3*4.38
1.339
•7
113
2.413
121
241
HaJueadAbaintoi Daya
VahM
Dbeami Factor
PnaaM Vaba
Am. Eautaiant Vahw {La Eal.)
Am. Eqnbatam Vatoa fr« Eal.)
Raatead InHatfm (Law EamWa)
Nwnbar Paiagm (mKwt)
Raduead AbaanMa Daya
Vahw
DtoaoM Factor
NiMbarYaan Factor
PiaaMtVataa
Am. EqulnM Vahw (Lo Ctt.)
Am. Equfcahrt Vahw (HI EtL)
1.35
0.78
•0.77
0.712*881 70
10.00
579.80
0.21
0.30
31.44
0.71200*17*
10.00
224.14
1.20
0.77
B0.3«
0.3*244*02
10.00
2*2.0*
0.50
0.80
02.20
0.30244002
10.00
334.40
1.0*
0.88
•8.18
0.184240178
10.00
125.*2
0.87
1.4*
131.33
0.18424817*
10.00
270.74
0.73
0.44
45.91
O.M3B8203*
10.00
42.03
1.35
2.03
211.37
0.0*30*2030
10.00
107.07
0.38
0.23
23.52
0.047*13480
10.00
11.20
1.74
2.M
270.81
0.047813488
10.00
12*.**
0.10
0.0*
8.2*
0.024204283
10.00
1.52
2.12
3.18
330.45
0.024204203
10.00
7*.OB
0.01*12033*
14.28
2.2*
3.44
397.24
0.01*12833*
14.28
82.31
1,040
73
147
1.32*
03
1*8
Note: EPA does not toHeve that discounting physical stfects such as premature deaths or Ms years oxtondod has
any meaning. Only monetary values should to discounted. Discounting physical effects Is done above only lor
analytic convenience and to display discounting methodology.
-------
-------
Exhibit 6*4: Premature Deaths Avoided (PDA) From Ouhttng by Yean of Abetinenee
1000
10*1 t» MM
2001 H 2010
1011 I* MM
JOW UJ040
•OVaarTalato
Af«
••34
90-44
4i-*4
M-04
•1-74
70+
Tatar
DM*M %QuH
*.*« M
*a.i*i 1%
11.001 9%
IM19 IK
1*0.700 3%
181,051 9%
414.74*
PNWflfl! PDAI21
ParYaai
•1*
11% »7
11% 440
90% 07
»% 1121
«% 700
941*
PflMR|1| PDA[2]
ParYaai
•4%
•4% 583
51% t02i
40% ISS7
17% •«
4*1*
PflMB(1J PDAJ2]
PwY«v
M%
90% IMC
•0% S858
70% 2752
«1»1
PAMf^l) PDA|2j
PwYMi
•5%
00% 4341
•S% SS42
r«tj
FWT1) PDA|2j
IWYMf
00%
•S% 3342
M«2
r«Mh Awanot tar tba M Yaw Paria*
PDA PWMHI PDA
LovE«fen«* w^.c-^«
OrtlM*. OuttRM*
*% r*
1.071 1.00% 10,14*
0.031 ».••% 10,071
»1,»0 fl.00% 04.7M
1 10,00* 4t.M% t33,TOO
1W.100 »0.71% 210.3T*
172.4*0 190.00% H4.»7«
0.44M 1 10.0*1
1. PfOpMtlafMl mtouton h mortafty.
t.
Pmmfem DM«V AvotM
OtetYEttU.E)«>
DfKowiMd to 1000
Otoe. LYE to AO* OS
OfecounMtolOOO
OaMuntad to 10*0
DtatLYEicAftOB
O.**2*007*4
10
94.120
20.440
904.215
2*2.410
172.201
140.504
0.041 Ml 047
10
40.167
20.02*
915.704
202.0*0
110.102
70. SOS
0.4770055*0
10
•1,000
30.110
999.327
1*3.070
•3.72*
30.000
0.3653*3300
10
71.020
27.304
243.474
M.527
0.2C443M24
to
39.41*
0.037
44.09T
11.012
Tot PIM. VaL Am. Eouhf.
114.32*
740,112
900.001
4,090
12,90*
r«J
TotPiM.VaL Ai
10»r**t
1.401,300
Maftrt
m.EoMlv.
0,0*0
44.7*1
1*.*0*
0.7*35201*0
10
94,12*
20.741
904.215
230.301
172.201
114.071
0.40101700*
10
40.167
22.202
• 315,704
161,002
110.102
67.994
0.205301772
10
•1.000
24.107
393.927
113.10*
03.720
24,725
0.1012*02*5
10
7*.020
13.02*
243.474
44,13*
0.11120*500
10
39,41*
9,710
44.0*7
4,071
00.77* 4,03*
009,071 10,*77
117.030 0.011
101.M*
1,1 01,142
434,0*0
0,07*
99,104
19.019
0.7120H170
10
34.120
24.334
•04,216
2U.001
172.2*1
122.020
0.3*244*02
10
40.157
10.720
916,704
114,460
110.1*2
43.201
0.1*4240170
10
•1.00*
15,001
919,327
70,020
•3,72«
1S,427
0.0030*2030
10
70.020
7.100
249.474
22.104
0.04701 9468
10
39.41*
1.501
44.007
2.127
04,041
4H.01*
101.447
4,640
1f,00«
0.449
120,0*9
*c*,*jr
902. Ml
*,OM
IMtf
1*.*OT
Note: EPA does not befeve (hat dbcounting physical effects such as premature tteaths or »ve years extended has any meantng. Orty monetary
values should be dbcounted. Discounting physteal effectt Is done above only for analyllc convenience and to dteptay discounting methodology.
-------
Exhibit B6-4: pramalura Daartha AvoUad (PDA) From Reduc*d Inlttatton
•••••Mo Raalrlcajano
0-34
W-44
45-54
5«-«4
•574
75+
ToUl
PDAffMr
1999 1991-2000
2.215
33,261
28,901
5B.510
1B0.7M
131.031
414.748
-. » - — ._ ^
3*
81
•09
2001-2010
5*
3%
t.020
10.072
2011-2020
8%
5%
9%
2.570
30.S72
2021 -2030
5%
5%
8%
3%
4.020
B4.M6
2031*2040
5%
5%
5%
5%
3%
10,5*7
190.539
2041-2050
5%
6%
*%
5%
5%
3%
17.78ft
300.428
2051 +
ft%
5%
5%
5%
$%
6%
20.737
vMrtf iwvmfBh wv HA vv YAM Vttloo
roA
8%
S.OSO
99.891
•8,040
4B,*48
44.214
199.899
3.811
9%
»1%
10%
24%
29%
189%
•DA
19%
19.870
119.181
79.099
99.801
88.428
181 .878
7.921
nalrn
n OOIIM bom the youngest age group, thai a constant number b added every yaw. and thai M takes 80 yaan for the amoUng population to oomptetely change.
therefore, ft takaa 60 yean tw the amoWng poptrteeon to bo reduced by tha estimated nducaon ki ha Initiation rate, wnh 1/BO«i o( that redudon lakfna, placa each yaw.
2. Avwago nrie ovw Mw Iral 10 yaw bcrwnonl In which new amokets era added each year.
3%Dt«c.F«*r.
• yMn factor
19W
SnbdtoetMtof
0.893000784
10
•09
S2S
0.041981947
10
10.202
0.597
187.715
120,487
150,549
100.493
0.477OO&500
10
29.701
12.275
49B.B04
223.942
378.022
1 BO. 545
0.355383398
10
40.294
17.1B3
748.241
205,202
530.700
1 01.803
0.284430824
10
105,073
27.944
1,090.251
28B.304
B00.4B2
101.170
0.1987B7171
10
177.887
35.002
1.304.094
258.803
800.482
110.020
0.140413254
33.33333333
801,247
101,208
4.478.351
855.890
2.031.808
287.454
UmUttrato
Tot. Ms. V«L Am E«*».
t99.T84
1.81)8,228
1.811.381
8.821
84,187
11.541
H^t EMIIMM LAW E
ToL Pm. V«L Ana EaJ*.
481 ,488
3,9t9,4B8
2.182.784
12.842
198.814
•3.993
Dtoountod to 1890
1990
Dbc.LYEtoAe*8S
Dneountod to 1090
TXdbelwlM
fyMt* factor
0.783528188 0.401017090 0.295302772 0.181290205 0.111290509 0.000320402 0.041048484
10 10 10 10 10 10 20
009 10282 25701 48204 10S673 177807 41474B
477 4938 7589 *755 11781 12154 17397
187.71$ 488.884 748,241 1.000.251 1.304,094 4,478,361
90294.29415 13B482.7801 135280.1995 121341.124$ 89104.02087 107951.0931
1 59.549 378,022 539,708 009,482 8O9.482 Z,O»1 ,««
75302.B9277 111030.94M 97843.9002B 87833.1B1M 41843.08943 3521B.70957
•8,971
7«5: i',9
479.471
1.99S
22.979
14.984
128.142
1, 924,879
999.348
1.794
41.748
28.788
MceunMtotaM
OK. LYE to I* £9
OtooaunMtol9n
Dbe.LVEtoAo«05
Dtooountod to 1090
0.712998179
10
808
434
0.30244802
10
10282
3720
187.715
•8.037
1S6.S49
38.741
0.184249170
10
25701
473$
400.884
•8,392
379.022
90.850
0.003882039
10
. 48294
4$23
748,241
89.895
539.7QB
50.551
0.047B 13489
10
105673
5031
1.090,251
$1,911
608.482
29.020
0.0242042B3
10
177BB7
4308
1.304,094
31,505
608,402
14.752
0.01230423
14.28571429
298240
384$
4,478.351
SS.103
2,031,908
24.997
14.315
182.961
246.719
792
16.4I7
7.371
S2.7B9
721, 891
491.421
1.584
21,774
1*.74l
Note: EPA doe* not baNwa lhat discounting phyafcal affacte such aa pramatura daaths or Hva years axtandad haa any meaning. Only monetary
values ahouk) ba dacounlad DfacounUng phyaicat eflev^ te dona above onty for analytic convenience nnd to dteptey dscounthig mathodobgy.
-------
Eahtbtt Bft-6: PremahM Deaths AvoMad From Raduead Conaumptfon
IMI t» tao*
2M1 to Ml*
2*11 !• MM
mt
2f31
9041
1MO
••94
••-44
4B-44
••••4
•••74
7t*
T*M
PwV««
2.21*
99.2*1
2M01
•Ml*
14O.7M
191.0*1
414.74*
Adjurtrt ta
(11
2.121
•1.MO
27.*77
M.030
1S9.M*
12M*7
••7.171
KM
10% »1% 10*
10% 11% 1,*1*
10% *1% 1.4M
10% 9*% 2.094
10% tt% 3.000
10% 1«% 2.23C
11^*2
PAR PDA
NrYMi
•4% 13>
04% 9,03*
•4% 1.7M
M% 1.2*3
4«% 7.MC
17% 2,tM
1«,M4
PFM PM
PvVMi
•0% 1*1
*0% 2.*M
•0% M*1
•0% *.043
*0% 12.317
70% *.7U
3t**M
RM
•K% 202
*•% 9.02S
M%
M%
M% 13.M7
*•% 10.M7
34.7M
KM
202
$.02*
KM
•*%
•i%
••% «,*23
•0% 13.*S7
•«% 10.M7
3*.7*«
100%
100%
100%
100%
100%
100%
PM
fmfmm
212
*.1M
1.744
•,M9
11.3*7
12.KM
3*,717
•,»7*
It*.***
1M.S1*
2M.IM
•11,**9
94I.944
1.9I«.1M
•.•4%
».*•%
•.34%
1*.»2%
*••••%
•*.3*%
Mfkfal
20%
1M**
t4»,M*
219,44*
41*,11*
*M,7*3
•74,*1*
IM.40% 2.IM.4IO
10.209
_ vMMwakhfl portion ioM**wil tor tow **^«r Ml MM^Mwttif.
aT* IfW InVMm p**|MfTJdnBB ivVliHiiM it HIBIr4B% • •'JMaB • VM pVBOTl IVMWlOl n CBMBMipaofX bVlv M MMflMM to *w IWCnVV VI ID yiMfS fl^fJfci UCtOf • lOOVf. !"• llfM
p*i ol PRU tatter b MMM^ to (M ft* MM m tor «M«.
OlHOinMtoIMB
O.M140M
1*
110.021
•4.MC
1.014.0C1
•74.72*
•74.20*
4M.91*
0.441 Mt*
10
1M.037
10B.40I
1.0S2.M7
•7«.*M
M7.90I
2M.B17
0.477MM
10
31MM
111 .991
1.277.7S*
•10.204
27*.OB3
139.2M
0.3C<3*34
to
H7.04S
12*,«M
•11. »M
2M.422
0.20443M
10
9B7.00i
04.422
14I.M*
3B.372
0.221 443114
•3.93933333
1.329.BO»
2B9.1M
T* KM. V4
Ml,t*7
t.4*»,441
M9.«2«
•to
Mn. Ewb.
2*.*7«
74.CI9
2«.IM
HfhEflbMto
T«L PM. VM Am. EMb.
t.7M,IM
4.«7«,»*2
1. 717.2*1
•I.1M
14B.3M
•3.*1*
0.7*3S2«
10
110.021
M.204
1.014.0S1
7*4.19*
•74.203
4M.M3
0.4*10171
10
tM.037
•1,310
1.0U.047
•M.341
3*7.90*
1*1.112
0.2BS302*
10.00
914.9S*
M.»M
1 .177.754
977.32C
279.0B3
•2.417
0.1*11001
10
3S7.04E
•4.732
•11. MO
147,132
0.1t128M
10
3S7.00S
34.740
14I.H*
14,471
0.0430ft t»
20
7B4.34*
BM71
491. •••
1,441,t04
721.491
11. 17* 4«,tt>
•*.*•• 3.M3.I**
3*.172 1.44*.M4
44.1 M
1*4.1 M
72.»49
0.712M92
10
110.021
TM49
1,014,0*1
723.004
•74,203
4M.3M
0.**244*
10
tM.037
•1,2*7
1.0U.M7
3*1 ,»•
3*7.30*
144.003
0.19424B2
10
•14.M*
M.39*
1.277.7S*
231.42*
27*.0*3
C1.429
O.OB9M2*
10
9C7.0M
99.444
•11. CM
. 7».0ti
0.04711 3*
10
J57.045
17,001
14*.***
7.0**
0.031 7t*«7l
14
M7.9M
14.001
2M.H*
1.423.M*
M4.424
1MM tn.i1*
M.414 I.*4«,1t*
42.334 1.3M.»M
*f,91»
1 ••.*••
*4.«7*
Note: EPA does not baNava that discounting physical affects such as pramatura daattis or Iva years extended has any mearrino. Orty monetaiy values should be
discounted. DisoounHng physical effects Is dona above only for analytic convenience and lo display discounting melhodotogy.
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