OBJECTIVES: Build and pilot a rapid evaluation tool to estimate smoking-attributable mortality and economic costs. This first version leveraged existing national data sources at the state level. Future versions will estimate at state-region and county levels. The final version incorporates effects of smoking cessation programs leading to estimated changes in mortality and economic costs attributable to intervention effects.

METHODS: Methodologies from Chapter 12 of The health consequences of smoking—50 years of progress: a report of the Surgeon General (2014), were used. We combined state and county-level data from thirteen publicly available data sources to create a SAS “black box”. The “black box” produced estimates of smoking attributable mortality (SAM), years of productive life lost (YPLL), present value of lifetime earnings (PVLE) lost, and smoking attributable expenditures (SAE) using smoking attributable fractions (SAFs) created from state-specific estimates of smoking prevalence. The next generation tool estimates SAFs at the state-regional and county level. The final tool estimates differences between baseline and intervention smoking prevalence to quantify the effect of an intervention on mortality and economic costs.

RESULTS: We tested the “black box” programs in two states. In 2015, nearly 38% of Oklahoma deaths in smoking related diseases were attributable to smoking and accounted for approximately 126,690 YPLL and $1.9 billion of SAE. In Minnesota, approximately 32% of deaths in smoking related diseases were attributable to smoking, accounting for more than 83,000 YPLL and $3.2 billion in SAE.

CONCLUSIONS: Producing rapid estimates of smoking-attributable mortality and economic costs may prove informative and valuable to decision-makers. Once completed, the estimated changes in mortality and economic costs may estimate societal benefit. As the method is consistent between interventions, decision makers may use YPLL and PVLE more consistently as an assessment of interventions creating demand for similar tools for other disease areas such as obesity.