Does cigarette smoking affect body weight? causal estimates from the clean indoor air law discontinuity

Pieroni, Luca and Salmasi, Luca (2012): Does cigarette smoking affect body weight? causal estimates from the clean indoor air law discontinuity.

Abstract

This paper examines the causal effects of smoking behavior on body weight in Italy. In 2005, the Italian government introduced a smoking ban in all indoor public places. We use a regression discontinuity design, which exploits this exogenous variation across cohorts to achieve identification in our model. Our estimates indicate that the smoking ban reduced cigarette consumption and the smoking participation rate. Most interestingly, we estimate a significative, although not very large, effect of nicotine reduction on weight increases. Heterogeneous effects are also estimated, with smaller impact on men and employees and, conditionally on BMI distribution, overweight and obese people.

• Item Type: MPRA Paper
• Language: English
• Keywords: Smoking ban, overweight and obesity, Local average treatment effect
• Subjects: I - Health, Education, and Welfare > I1 - Health > I12 - Health Behavior; I - Health, Education, and Welfare > I1 - Health > I18 - Government Policy ; Regulation ; Public Health; I - Health, Education, and Welfare > I1 - Health > I10 - General

References

Abbring, J. H. & Heckman, J. J. (2007), Chapter 72 econometric evaluation of social programs, part iii: Distributional treatment effects, dynamic treatment effects, dynamic discrete choice, and general equilibrium policy evaluation, Vol. 6, Part B of Handbook of Econometrics, Elsevier, pp. 5145 – 5303.

Adda, J., Bashkar, V., Berlinski, S. & Machin, S. (2012), ‘Market regulation and firm performance: The case of smoking bans in the uk’, Journal of Law and Economics forthcoming.

Adda, J. & Cornaglia, F. (2010), ‘The effect of bans and taxes on passive smoking’, American Economic Journal: Applied Economics 2(1), 1–32.

Angrist, J. D. (1995), ‘The economic returns to schooling in the west bank and gaza strip’, American Economic Review 85(5), 1065–87.

Anonymous (2005), ‘Ireland’s smoking ban is an admirable achievement’, Lancet (365), 1282.

Aristei, D. & Pieroni, L. (2010), ‘Habits, complementarities and heterogeneity in alcohol and tobacco demand: A multivariate dynamic model’, Oxford Bulletin of Economics and Statistics 72(4), 428–457.

Baker, M., Gruber, J. & Milligan, K. (2008), ‘Universal child care, maternal labor supply, and family well-being’, Journal of Political Economy 116(4), 709–745.

Barefoot, J., Heitmann, B., Helms, M., Williams, R., Surwit, R. & Siegler, I. (1998), ‘Symptoms of depression and changes in body weight from adolescence to mid-life.’, International Journal of Obesity Related Metabolic Disorders. 22(7), 688–694.

Baum, C. L. (2009), ‘The effects of cigarette costs on bmi and obesity’, Health Economics 18(1), 3–19. Becker, G. S. & Murphy, K. M. (1988), ‘A theory of rational addiction’, Journal of Political Economy 96(4), 675–700.

Brunello, G., Fort, M., Schneeweis, N. & Winter-Ebmer, R. (2011), The causal effect of education on health: What is the role of health behaviors?, Economics working papers 2011-17, Department of Economics, Johannes Kepler University Linz, Austria.

Cawley, J., Markowitz, S. & Tauras, J. (2004), ‘Lighting up and slimming down: the effects of body weight and cigarette prices on adolescent smoking initiation’, Journal of Health Economics 23(2), 293–311.

Chaloupka, F. (1992), ‘Clean indoor air laws, addiction and cigarette smoking’, Applied Economics 24, 193–205.

Chaloupka, F. & Saffer, H. (1992), ‘Clean indoor air laws and the demand for cigarettes’, Contemporary Economic Policy 10, 72–83.

Chou, S.-Y., Grossman, M. & Saffer, H. (2004), ‘An economic analysis of adult obesity: results from the behavioral risk factor surveillance system’, Journal of Health Economics 23(3), 565–587.

Cinciripini, P., Wetter, D., Fouladi, R., Blalock, J., Carter, B., Cinciripini, L. & Baile, W. (2003), ‘The effects of depressed mood on smoking cessation: mediation by postcessation self-efficacy.’, Journal of Consulting and Clinical Psychology. 71(2), 292–301.

Colombo, P., Scarpino, V., Zuccaro, P., Apolone, G., Gallus, S. & La Vecchia, C. (2002), ‘Smoking in italian women and men, 2001’, Tumori 88, 10–12.

Courtemanche, C. (2009), ‘Rising cigarette prices and rising obesity: Coincidence or unintended consequence?’, Journal of Health Economics 28(4), 781–798.

Cutler, D. M. & Glaeser, E. L. (2009), Why do europeans smoke more than americans?, in ‘Developments in the Economics of Aging’, NBER Chapters, National Bureau of Economic Research, Inc, pp. 255–282.

Deaton, A. (1985), ‘Panel data from time series of cross-sections’, Journal of Econometrics 30(1-2), 109–126.

Dill, D., Edwards, H. & Forbes, W. (1934), ‘Tobacco smoking in relation to blood sugar, blood lactic acid and metabolism’, Am J Physiol 109, 118–22.

Drewnowski, A. & Darmon, N. (2005), ‘Food choices and diet costs: an economic analysis’, Journal of Nutrition 135, 900–904.

Eisenberg, D. & Quinn, B. (2006), ‘Estimating the causal effect of smoking cessation on weight gain: An instrumental variables approach.’, Health Services Research 41(6), 2255–2266.

Eriksen, M. & Chaloupka, F. (2007), ‘The economic impact of clean indoor air laws’, A Cancer Journal for clinicians 57(6), 367–378.

Evans, W. N., Farrelly, M. C. & Montgomery, E. (1999), ‘Do workplace smoking bans reduce smoking?’, American Economic Review 89(4), 728–747.

Fang, H., Ali, M. M. & Rizzo, J. A. (2009), ‘Does smoking affect body weight and obesity in china?’, Economics & Human Biology 7(3), 334–350.

Fichtenberg, C. & Glantz, S. (2004), ‘Effect of smoke-free workplaces on smoking behavior: Systematic review’, British Medical Journal (325), 188–194.

Flegal, K. (2007), ‘The effects of changes in smoking prevalence on obesity prevalence in the united states’, American Journal of Public Health 97, 1510–1514.

Fong, G., Hyland, A., Borland, R., Hammond, D., Hastings, G., McNeill, A., Anderson, S., Cummings, K., Allwright, S., Mulcahy, M., Howell, F., Clancy, L., Thompson, M., Connolly, G. & Driezen, P. (2006), ‘Reductions in tobacco smoke pollution and increases in support for smoke-free public places following the implementation of comprehensive smoke-free workplace legislation in the republic of ireland: findings from the itc ireland/uk survey’, Tobacco Control 15, 51–58.

French, S. & Jeffery, R. (1995), ‘Weight concerns and smoking: a literature review’, Annals of Behavioral Medicine 17, 234–244.

Gallus, S., Pacifici, R. & Colombo, P. e. a. (2006), ‘Prevalence of smoking and attitude towards smoking regulation in italy, 2004’, Eur. J. Cancer Prev. 15, 77–81.

Garcia, J. & Labeaga, J. M. (1996), ‘Alternative approaches to modelling zero expenditure: An application to spanish demand for tobacco’, Oxford Bulletin of Economics and Statistics 58(3), 489–506.

Glauser, S., Glauser, E., Reidenberg, M., Rusy, B. & Tallarida, R. (1970), ‘Metabolic changes associated with the cessation of cigarette smoking’, Arch Environ Health 20(1), 377–81.

Gruber, J. & Frakes, M. (2006), ‘Does falling smoking lead to rising obesity?’, Journal of Health Economics 25(2), 183–197.

Grunberg, N. (1985), ‘Nicotine, cigarette smoking, and body weight’, British Journal of Addiction 80, 369–377.

Hahn, J., Todd, P. & Van der Klaauw, W. (2001), ‘Identification and estimation of treatment effects with a regression-discontinuity design’, Econometrica 69(1), 201–09.

Havnes, T. & Mogstad, M. (2010), Is universal child care leveling the playing field? evidence from nonlinear difference-in-differences, IZA Discussion Papers 4978, Institute for the Study of Labor (IZA).

Heckman, J. J., Flyer, F. & Loughlin, C. (2008), ‘An assessment of causal inference in smoking initiation research and a framework for future research’, Economic Inquiry 46(1), 37–44.

Heckman, J. J. & Vytlacil, E. J. (2007), Chapter 71 econometric evaluation of social programs, part ii: Using the marginal treatment effect to organize alternative econometric estimators to evaluate social programs, and to forecast their effects in new environments, Vol. 6, Part B of Handbook of Econometrics, Elsevier, pp. 4875 – 5143.

Higgins, M.W.and Kjelsberg, M. (1967), ‘Characteristics of smokers and nonsmokers in tecumseh, michigan’, American Journal of Epidemiology 86, 60–77.

Imbens, G. W. & Angrist, J. D. (1994), ‘Identification and estimation of local average treatment effects’, Econometrica 62(2), 467–75.

Imbens, G. W. & Rubin, D. B. (1997), ‘Estimating outcome distributions for compliers in instrumental variables models’, Review of Economic Studies 64(4), 555–74.

Jacobs, D. & Gottenberg, S. (1981), ‘Smoking and weight: The minnesota lipid research clinic’, American Journal of Public Health (71), 391–396.

Jacobs, M., Knapp, P., Anderson, L., Karnsh, N., Meissner, R. & Richman, S. (1965), ‘Relationship of oral frustration factors with heavy cigarette smoking in male college students.’, J Nerv Ment Dis 141, 161–171.

Jones, A. M. & Yen, S. T. (2000), ‘A box-cox double-hurdle model’, Manchester School 68(2), 203–21.

Juster, H., Loomis, B., Hinman, T. & et al. (2007), ‘Declines in hospital admissions for acute myocardial infarction in new york state after implementation of a comprehensive smoking ban.’, Am J Public Health 97(11), 2035–2039.

Kapteyn, A., Alessie, R. & Lusardi, A. (2005), ‘Explaining the wealth holdings of different cohorts: Productivity growth and social security’, European Economic Review 49(5), 1361–1391.

Karvonen, M., Keys, A., Orma, E., Fidanzo, F. & Brozek, J. (1959), ‘Cigarette smoking, serum cholesterol, blood pressure and body fatness: observations in finland.’, Lancet 1, 492–494.

Keane, M. P., Todd, P. E. & Wolpin, K. I. (2011), Chapter 4 - the structural estimation of behavioral models: Discrete choice dynamic programming methods and applications, in O. Ashenfelter & D. Card, eds, ‘Handbooks in Economics Handbook of Labor Economics, Vol 4A’, Vol. 4, Part A of Handbook of Labor Economics, Elsevier, pp. 331 – 461.

Keys, A., Aravanis, C. & Blackburn, H. (1966), ‘Epidemiologic studies related to coronary heart disease: characteristics of men aged 40-59 in seven countries’, Acta Med Scand Suppl 460, 1–75.

Khwaja, A., Silverman, D. & Sloan, F. (2007), ‘Time preference, time discounting, and smoking decisions’, Journal of Health Economics 26(5), 927–949. URL: http://ideas.repec.org/a/eee/jhecon/v26y2007i5p92949.html

Klesges, R., Meyers, A., Klesges, L. & LaVasque, M. (1989), ‘Smoking, body weight, and their effects on smoking behavior: a comprehensive review of the literature’, Psychology Bulletin 106, 204–230.

Kriegbaum, M., Larsen, A., Christensen, U., Lund, R. & Osler, M. (2010), ‘Reduced probability of smoking cessation in men with increasing number of job losses and partnership breakdowns.’, J Epidemiol Community Health (55), 271–278.

Liu, F., Zhang, N., Cheng, K.-W. &Wang, H. (2010), ‘Reduced smoking and rising obesity: Does smoking ban in the workplace matter?’, Economics Letters 108(3), 249–252.

Luk, R., Ferrence, R. & Gmel, G. (2011), ‘The economic impact of a smoke-free bylaw on restaurant and bar sales in ottawa, canada’, Addiction (101), 738–745.

Machin, S., Marie, O. & Vujic, S. (2011), ‘The crime reducing effect of education’, Economic Journal 121(552), 463–484.

Nonnemaker, J., Finkelstein, E., Engelen, M., Hoerger, T. & Farrelly, M. (2009), ‘Have efforts to reduce smoking really contributed to the obesity epidemic?’, Economic Inquiry 47(2), 366–376.

Oreopoulos, P. (2006), ‘Estimating average and local average treatment effects of education when compulsory schooling laws really matter’, American Economic Review 96(1), 152–175.

Pieroni, L., Lanari, D. & Salmasi, L. (2011), ‘Food prices and overweight patterns in italy’, The European Journal of Health Economics pp. 1–19. 10.1007/s10198-011-0350-y.

Rees, D. I. & Sabia, J. J. (2010), ‘Body weight and smoking initiation: Evidence from add health’, Journal of Health Economics 29(5), 774–777.

Sargent, R., Shepard, R. & Glantz, S. (2004), ‘Reduced incidence of admissions for myocardial infarction associated with public smoking ban: before and after study.’, BMJ 328, 977.

Schunck, R. & Rogge, B. (2010), ‘Unemployment and its association with health-relevant actions: investigating the role of time perspective with german census data.’, International Journal of Public Health (55), 271–278.

Scollo, M., Lal, A. & Glantz, S. (2003), ‘Review of the quality of studies on the economic effects of smoke-free policies on the hospitality industry’, Tobacco Control 12, 13–20.

Tauras, J. A. (2005), ‘An empirical analysis of adult cigarette demand’, Eastern Economic Journal 31(3), 361–375. Trochim, W. (1984), ‘Research design for program evaluation.’, Beverly Hills: Sage Publications. .

Trochim, W. (2001), ‘Regression discontinuity design.’, International Encyclopedia of the Social and Behavioral Sciences 19, 12940–12945.

Trochim, W. & Campbell, D. (1960), ‘Regression-discontinuity analysis: An alternative to the ex-post facto design.’, Journal of Educational Psychology 51, 309–317.

US Department of Health and Human Services (1972), ‘The health consequences of smoking: A report of the surgeon general’, DHHS Publication CDC (72-7516).

US Department of Health and Human Services (2006), ‘2006 surgeon general’s report on the health consequences of involuntary exposure to tobacco smoke’, DHHS Publication CDC (90-8416).

Viscusi, W. K. & Hersch, J. (2001), ‘Cigarette smokers as job risk takers’, The Review of Economics and Statistics 83(2), 269–280.

Wasserman, J., Manning, W., Newhouse, J. & Winkler, J. (1991), ‘The effect of excise taxes and regulations on cigarette smoking’, Journal of Health Economics 10, 43–64.

Wurtman, J. (1993), ‘Depression and weight gain: the serotonin connection.’, International Journal of Obesity Related Metabolic Disorders. 29(2-3), 183–192.

Yen, S. (2005), ‘Zero observations and gender differences in cigarette consumption’, Applied Economics 37(16), 1839–1849.

Yurekli, A. & Zhang, P. (2000), ‘The impact of clean indoor air laws and cigarette smuggling on demand for cigarettes: an empirical model’, Health Economics 9, 159–170.