U.S. Smoking Toll Put at $52 Billion : Health: Illness and productivity losses average about $1 billion per state annually, the government reports. The California cost is $5.8 billion.

Health care expenses and productivity losses associated with smoking-related disease cost the nation more than $52 billion every year, according to a government report released Tuesday.

The Department of Health and Human Services, in a national status report to Congress, estimated that illnesses caused by smoking impose an average economic burden of $1 billion per state, although some states run much higher tabs than others.

California, the most populous state, has the highest estimated smoking cost, $5.8 billion, the report said. Alaska was lowest, with $82 million annually. Following California, in order, were New York, Texas, Pennsylvania, Illinois, Ohio and Michigan.

The annual expenses of smoking-related disease average $221 for every man, woman and child in the nation, ranging from a low of $56 a person in Utah to $284 in Rhode Island, the report said.

Meanwhile, congressional sponsors of a law banning smoking on virtually all domestic airline flights vowed Tuesday to fight for no-smoking rules on other forms of transportation and to attack U.S. trade policies that encourage tobacco exports.

Sen. Frank R. Lautenberg (D-N. J.) and Rep. Richard J. Durbin (D-Ill.) said that they would next press their campaign to apply to Amtrak train service and other transportation.

The airline smoking ban, which begins Sunday, will apply to domestic flights of six hours or less. Longer flights, charter flights and overseas flights are exempt.

The law expands and extends a temporary smoking ban on short domestic flights that was adopted in 1987.

The HHS report said that expenses related to smoking are borne indirectly by all Americans in the form of higher private and public insurance premiums and the increased burden on publicly supported health care facilities and personnel.

“Each and every American, including those who don’t even smoke, is paying a hidden tax . . . for the consequences of smoking,” HHS Secretary Louis W. Sullivan said in testimony before a Senate committee considering anti-smoking legislation.

“My view,” Sullivan said, “is straightforward and simple: no smoking.”

The report was immediately assailed by the Tobacco Institute, which said that “to assume that smokers impose a cost on society is a misapplication of a valid economic theory.”

Brennan Dawson, a spokeswoman for the industry group, said that “smokers pay their own (insurance) premiums, so they cover their own costs. And, just because they file a claim, it doesn’t mean it’s a smoking claim.”

Further, she said, “if people are less productive, that’s not a cost to society--they bear the burden through lower pay, less frequent job promotions or getting fired.”

The report said that smoking causes more premature deaths than cocaine, heroin, alcohol, fire, automobile accidents, homicide and suicide combined.

Sullivan said that smoking kills nearly 400,000 Americans each year and is responsible for more than one of every six deaths in the United States. In addition, he said, smoking is becoming increasingly concentrated among low-income, less-educated Americans.

“I am especially concerned that we make more progress in reaching young people, women, minorities and blue-collar workers with accurate and compelling information about smoking and its devastating impact on their health,” he said in a statement.

Dr. Ronald M. Davis, director of the HHS Office on Smoking and Health, said that deaths caused by smoking have increased during the last 20 years, despite a dramatic decline in the number of smokers. In 1965, 40% of all U.S. adults were cigarette smokers, compared to 29% in 1987, he said.

Nevertheless, “it takes a good 20 to 25 years after the smoking rates go down before we begin to see a decrease in smoking-related deaths and costs,” he said in an interview.

Sullivan recently criticized plans by R. J. Reynolds Tobacco Co. to test-market in Philadelphia a new cigarette, called Uptown, targeted at black smokers. The firm quickly announced that it had canceled the marketing campaign.

Sullivan told members of the Senate Labor and Human Resources Committee that he was just as upset by the company’s plan to introduce another new cigarette, called Dakota, reportedly aimed at young blue-collar women.

“I’m outraged,” he said when questioned about Dakota. “No one believes the tobacco companies when they say they are not targeting young people.”

In 1985, the average number of deaths attributed to smoking was 6,097 per state, ranging from 271 in Alaska to 28,533 in California.