Measuring the net costs of smoking to society and government has been controversial and difficult. Studies often have reached conflicting conclusions assessing the lifetime health-care costs of smokers, who die sooner but have higher annual medical expens

These new estimates Thursday were substantially higher than previous numbers cited by the CDC. Research based on 1993 data estimated smoking-related medical costs at $53 billion and data culled from the 1980s pegged productivity losses at $43 billion. Jeffrey Fellows, a CDC health-care economist and the study's principal investigator, said the increases were driven mainly by health-care inflation, higher average household earnings and more detailed data. CDC officials also said cigarette taxes are about 80 cents per pack, far short of the cost estimate of $7.18 per pack. Tobacco companies argue that tax figure doesn't reflect tobacco-settlement funds paid to state governments. About 22 billion packs of cigarettes were sold in the U.S. in 1999. Last year, Philip Morris Cos. distributed a company-funded report in the Czech Republic that concluded that cigarettes aren't a drag on that country's budget, in part because the government saves money on health care, pensions and housing when smokers die prematurely. Philip Morris, New York, later disavowed the report and called it a "mistake." CDC researchers said they didn't include this "ghoulish approach" concerning a positive benefit from premature deaths in their data. On average, the CDC study said, men lose 13.2 years of life because of smoking and women lose 14.5 years. . . The CDC "hasn't educated or enlightened us," said Mark Smith, spokesman for Brown & Williamson. "They have just provided some sensationalistic numbers to support their own partisan position." The CDC, of Atlanta, said it is developing cost estimates for other diseases and health behaviors.

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