The number of Americans who smoke has dropped decidedly since the days before tobacco companies were forced to disclose health risks of smoking and were banned from TV advertising. But millions still smoke, and the habit continues to extract a toll from business in productivity lost to smoking related diseases.

Research released by the Institute for Health & Aging, School of Nursing, University of California, San Francisco, attempts to quantify that toll, at least for the state of California.

Read: What drives up life insurance premiums?

Researchers examined data on smoking and health from every California county through 2009, comparing the results to similar research conducted 10 and 20 years earlier. The project, supported by a grant from the California Tobacco-Related Disease Research Program, reveals that, in 2009, the economic impact of smoking in the state was more than $18 billion — with $9.8 billion attributed directly to health care costs, and another $6.8 billion to lost productivity.

The entire report runs 207 pages and goes into fine detail. Here are some of the highlights:

15 percent of deaths in California in 2009 are attributed to smoking, for a total of 34,363 deaths. This represents $6.8 billion in lost productivity and 587,000 years of potential life lost, or 17.1 years lost per death.
The number of smoking-related deaths was 17 times higher than the number of deaths related to AIDS and five times more than the number of deaths related to diabetes
While there are fewer smokers in California than there were a decade ago, 3.9 million Californians still smoke.
The cost of smoking in California was $487 per Californian and $4,603 per smoker.
Men account for about 60 percent of deaths attributed to smoking, 60 percent of years of potential life lost, and 76 percent of the value of lost productivity.
The cost of smoking for men is greater than that for women — $11.7 billion compared to $6.4 billion. Direct costs and indirect lost productivity costs due to illness are 35 percent and 46 percent greater for men respectively, while indirect costs of lost productivity from premature death are more than three times that of women.
Direct health care costs of smoking account for 54 percent of the total cost of smoking in California — $9.8 billion. Lost productivity due to illness comprises 9 percent of the total, or $1.4 billion, and lost productivity from premature death comprises the remaining 38 percent, or $6.8 billion.
Total costs of smoking increased by 15 percent compared to the costs in 1999 — from $15.8 billion to $18.1 billion. However, real costs which adjust for inflation actually decreased by 22 percent between 1999 and 2009.
The cost of smoking per resident varies among counties, from $374 in Orange County to $1,002 in Lake County.
More adult males than females smoke in California — 2.4 million or 17.2 percent of adult men compared to 1.4 million or 10 percent of adult women. Adolescent males smoke at higher rates than adolescent females 6 percent vs. 3 percent.
A majority of adult current smokers in California are light smokers; only 18 percent and 11 percent of adult current male and female smokers respectively are heavy smokers.
Expenditures for hospital care of current and former smokers amount to $4.3 billion, or 43.9 percent of total health care costs attributable to smoking. Prescription drugs amount to $1.1 billion.

Also read: Arizona county mulls hiring ban on smokers

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Smoking takes major toll on California&rsquo;s productivity

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Smoking takes major toll on California’s productivity