Carrot Health Insights | Healthy Behavior #1: No Smoking

Published on December 5, 2017

In the last issue of Carrot Health Insights, we discussed the “Big Four” consumer lifestyle behaviors that affect population health and cost outcomes. A person cuts his or her risk of cancer by 60%, and risk of most chronic illnesses by 80%, if he or she consistently does these four things:

  • Doesn’t smoke
  • Gets around 150 minutes of moderate exercise per week
  • Has a normal body fat percentage
  • Has a healthy diet

Unfortunately, 82% of the US population demonstrates zero, one, or two of these behaviors. As a result, our country is suffering from an epidemic of chronic illness.

While much work remains to be done, smoking cessation has been a major public health bright spot over the past 50 years. According to the CDC, 42.4% of US adults were regular smokers in 1965, and by 2015, this figure had fallen to 15.1%. This progress, however, has been uneven. Minnesota, for example, is slightly below the national average at 14.4% — but as the map below shows, certain ZIP codes (green) are showing better rates of smoking cessation than others (red).

Carrot Health Smoking Cessation Index (ZIP Code Level)

What happens when people quit smoking? To answer this question, Carrot Health analyzed data from a cohort of 50-59 year olds in Minnesota. First, the bad news: some of the damaging effects of smoking can’t be reversed. Former smokers (people who haven’t smoked in at least 4 years) still have higher rates of anxiety disorders, depression, alcohol dependence, emphysema, and obesity than people who have never smoked. But there’s plenty of good news: for most of these measures (with obesity being a notable exception), this group is in better condition than current smokers.


The Health and Cost Effects of Quitting Smoking (MN Age 50-59 Cohort)

  Never-Smokers Current Smokers Recent Quitters Former Smokers
Medical Usage Baseline 1.1x 2.6x 1.5x
Diagnosis Count Baseline 1.5x 4.9x 2x
Total Charges Baseline 1.2x 3.3x 1.9x
Anxiety Disorders Baseline 1.4x 2.6x 1.5x
Depression Baseline 1.8x 3.2x 1.7x
Alcohol Dependence Baseline 6.9x 7.2x 2.8x
Emphysema Baseline 24x 51x 11x
Obesity Baseline 0.8x 2.0x 1.5x
Income & Net Worth Baseline 0.5x 0.5x 0.7x
% Married 62% 44% 50% 56%


This analysis also shows a phenomenon that will be familiar to anyone who has ever tried to quit smoking: it’s really stressful. Many indicators get worse before they get better. Recent quitters (people who last used tobacco 4 or fewer years ago) consume much more medical care than current smokers, and this group experiences a spike in anxiety disorders and depression. If they can make it to the 4-year mark, though, the spike diminishes. So if anyone reading this is in the “recent quitter” category, the data doesn’t lie — hang in there!

Carrot MarketView can bring this data, and much more, to your organization. To learn more about our Healthcare Business Intelligence platform, please contact us to schedule a demo.

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