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Evaluation of nationwide health costs of air pollution and cigarette smoking.

Total nationwide health costs due to air pollution and cigarette smoking were evaluated by determining the percentages of the total respiratory disease cost for 1970 due to the separate and the synergistic effects of smoking and air pollution. Previous studies known to the authors did not properly account for the well established synergistic effect of smoking and air pollution, and also assumed that the urban factor (ratio of urban incidence to rural incidence) was due primarily or exclusively to air pollution. Recent evidence strongly indicates that air pollution is not the primary cause of the urban factor, although it does make a contribution. Taking a minimum of 10% and a maximum of 50% of the urban factor to be due to air pollution, the total 1970 nationwide health cost due to air pollution was found to be between $62 million and $311 million, and the nationwide health cost due to cigarette smoking was found to be $4.23 billion.