I wish I could find it now. Stupidly, I didn't print it out when I first ran across it back in 2003 or 2004, but it's since been deleted. I know I read it. And Charles Krauthammer mentioned it several times in passing, both in print and on the air. And my internist mentioned the study to me. So I'm sure it wasn't a figment of my imagination.
The article appeared in the New England Journal of Medicine, which is peer-reviewed and generally regarded as authoritative. The authors, whose names escape me, were all well-regarded epidemiologists.
The principal point was that, if everyone quit smoking, or tobacco had never existed, and all other epidemiological factors were held even, the national health care bill would be about 18% higher than it was at that point, with 20% of adults smoking.
The majority of our health care expenses are concentrated in end-care, the last year(s) of life. And smokers tend to die cheaply: lung cancer (few operations, and the chemotherapy regimes are relatively inexpensive), critical cardiovascular or cerebrovascular events (heart attacks and strokes, which require intensive but extremely short-term care), etc. Smokers tend not to die of Alzheimer's disease, Parkinson's disease, and other long-term degenerative conditions, which require long-term, 24/7, extremely expensive care.
The Krauthammer article seems to be gone or edited. He wrote an article on how 'preventive medicine' increases costs of healthcare - exactly opposite of what has been promoted by the healthcare system and government. I suspected he also noted that obesity and smoking reduced costs because of early But the NEJM study still exists:
"However, in the mixed population of smokers and nonsmokers, smoking-related diseases account for only 19 percent of total costs among men and 12 percent of total costs among women, and the costs of all the other diseases have precisely the opposite relation. In a population of smokers, the costs associated with all the other diseases are less than those in the mixed population: 14 percent less for men and 18 percent less for women."
MMS: Error