Three Essays on the Effects of Tobacco Control Policies on Smoking Outcomes Open Access

Abstract

Abstract
Three Essays on the Effects of Tobacco Control Policies on Smoking Outcomes
This study explores the effects of tobacco control policies on smoking outcomes and the
differences between self-reported measures of smoking outcomes and serum cotinine
levels, a biomarker of recent nicotine exposure. The first paper uses quantile regression
to estimate whether adult smokers' responses to tobacco control policies change across
the distribution of smoking levels. I find that reductions in cigarette smoking from
increases in cigarette excise taxes and cigarette prices are concentrated among the
heaviest smokers. However, using serum cotinine levels, I find little evidence that
cigarette excise taxes or prices affect smokers' intake of nicotine at any smoking level. I
directly test whether the amount of nicotine smokers ingest from each cigarette is
affected by tobacco control policies, and in fact I find evidence that the heaviest smokers
consume more nicotine from each cigarette in response to higher cigarette prices. The
second paper estimates the effects of tobacco control policies on non-smoking workers'
exposure to secondhand smoke at their jobs. I find that smoke-free air laws reduce
secondhand smoke exposure at work and these reductions translate into reduced overall
nicotine exposure. I find some evidence that this reduction in nicotine exposure comes
from reductions in secondhand exposure at work and evidence that smoke-free air laws
reduce secondhand smoke exposure through other pathways as well. The third paper
examines how adolescent smokers change their smoking behavior in response to tobacco
control policies. I find that higher cigarette excise taxes are associated with reduced
nicotine intake among adolescent smokers and these reductions are robust to controls for
antismoking sentiment and other youth tobacco laws. In fact, I find some evidence that
more stringent tobacco control policies actually lead to reductions in the amount of
nicotine that adolescent smokers ingest from each cigarette. Lastly, I check whether
misreports of smoking status are related to tobacco control policies, which could bias the
coefficients in models where the dependent variable is self-reported smoking status. I
find some evidence that measures of youth access laws are related to misreports.

Table of Contents

Table of Contents

Preface 1

Chapter 1: Heterogeneity in Adult Smokers' Responses to Tobacco Control Policies: A Quantile Regression Approach 4
1.1. Introduction 5
1.2. Background 9
1.3. Identification Strategy 16
1.4. Data 18
1.4.1. Tobacco Control Policies 18
1.4.2. NHANES Data 20
1.4.3. Demographics 20
1.4.4. Summary Statistics 22
1.5. OLS Results 23
1.6. Quantile Regression Results 28
1.6.1. Baseline Results 28
1.6.2. Demographic Characteristics 30
1.6.3. Changes in Smoking Behavior 31
1.7. Robustness Checks 35
1.7.1. Generalized Ordered Logit 35
1.7.2. Other Potential Issues 37
1.8. Conclusion 39

Chapter 2: Do Tobacco Control Policies Reduce Secondhand Smoke Exposure in the Workplace? 74
2.1. Introduction 75
2.2. Background 77
2.3. Data 82
2.4. Methods 87
2.5. Results 89
2.5.1. Self-Reported Exposure to Secondhand Smoke 89
2.5.2. Serum Cotinine Levels 92
2.5.3. Connecting Self-Reported Exposure to Serum Cotinine Levels 93
2.5.4. Policy Endogeneity 97
2.6. Conclusion 98

Chapter 3: Do Adolescent Smokers Compensate for Higher Cigarette Taxes? 127
3.1. Introduction 128
3.2. Background 132
3.3. Methodology 135
3.4. Data 136
3.4.1. Tobacco Control Policies 136
3.4.2. NHANES Data 138
3.5. Results 142
3.6. Robustness Checks 144
3.6.1. The Effect of Interview Day on Cotinine Results 144
3.6.2. The Effect of Tobacco Control Policies on Misreported Smoking Status 145
3.6.3. Overall Cotinine Levels 146
3.6.4. Other Potential Issues 147
3.7. Conclusion 148

List of Tables

Table 1.1 Summary Statistics 62
Table 1.2 The Impact of Tobacco Control Policies on Smoking Outcomes 63
Table 1.3 "Quantile Regression Results of the Impact of Tobacco Control Policies on The Average Number of Cigarettes Smoked Per Day" 64
Table 1.4 Quantile Regression Results of the Impact of Tobacco Control Policies on The Average Number of Cigarettes Smoked Per Day 65
Table 1.5 Quantile Regression Results of the Impact of Tobacco Control Policies on Serum Cotinine Concentrations 66
Table 1.6 Quantile Regression Results of the Impact of Tobacco Control Policies on Serum Cotinine Concentrations 67
Table 1.7 Semi-Elasticities for OLS and Quantile Regression Coefficients Estimating the Effects of Tobacco Control Policies on Serum Cotinine Levels and the Average Number of Cigarettes Smoked per Day 68
Table 1.8 Quantile Regression Results of the Impact of Tobacco Control Policies on Changes in Smoking Behavior 69
Table 1.9 Quantile Regression Results of the Impact of Tobacco Control Policies on Changes in Smoking Behavior 70
Table 1.10 Generalized Ordered Logit Regression Results of the Impact of Tobacco Control Policies on The Average Number of Cigarettes Smoked Per Day 71
Appendix Table 1.1 Complete Results for Linear Probability, OLS, and Quantile Regression Results of the Impact of Tobacco Control Policies on the Average Number of Cigarettes Smoked Per Day 72
Appendix Table 1.2 Complete Results for Linear Probability, OLS, and Quantile Regression Results of the Impact of Tobacco Control Policies on Serum Cotinine Concentrations 73

Table 2.1 Number of Hours per Day of Self-Reported Secondhand Smoke Exposure at Work by Occupation 107
Table 2.2 Summary Statistics 108
Table 2.3 "Ordered Logit Estimation of the Effects of Tobacco Control Policies on Non-Smokers' Self-Reported Secondhand Smoke Exposure at Work: Using ANRF Smoke-Free Air Law Variables" 109
Table 2.4 "Ordered Logit Estimation of the Effects of Tobacco Control Policies on Non-Smokers' Self-Reported Secondhand Smoke Exposure at Work: Using Project ImpacTeen Smoke-Free Air Law Variables" 110
Table 2.5 "Poisson Estimation of the Effects of Tobacco Control Policies on Non-Smokers' Self-Reported Secondhand Smoke Exposure at Work" 111
Table 2.6 "Logit Estimation of the Effects of Tobacco Control Policies on Non-Smokers' Self-Reported Secondhand Smoke Exposure at Work" 112
Table 2.7 The Effects of Tobacco Control Policies on the Probability of Non-Smokers' Secondhand Smoke Exposure: Using ANRF Smoke-Free Air Law Variables 113
Table 2.8 The Effects of Tobacco Control Policies on Non-Smokers' Logged Cotinine Concentrations: Using Project ImpacTeen Smoke-Free Air Law Variables 114
Table 2.9 The Effects of Tobacco Control Policies on Non-Smokers' Logged Cotinine Concentrations: Using ANRF Smoke-Free Air Law Variables 115
Table 2.10 The Effects of Tobacco Control Policies on Non-Smokers' Self-Reported Secondhand Smoke Exposure at Work: Using Project ImpacTeen Smoke-Free Air Law Variables 116
Table 2.11a The Effects of Tobacco Control Policies on the Probability of Non-Smokers' Secondhand Smoke Exposure: Using ANRF Smoke-Free Air Law Variables and NHANES Sample Weights 117
Table 2.11b The Effects of Tobacco Control Policies on the Probability of Non-Smokers' Secondhand Smoke Exposure: Using ANRF Smoke-Free Air Law Variables 118
Table 2.12a The Effects of Tobacco Control Policies on the Probability of Non-Smokers' Secondhand Smoke Exposure: Using Project ImpacTeen Smoke-Free Air Law Variables and NHANES Sample Weights 119
Table 2.12b The Effects of Tobacco Control Policies on the Probability of Non-Smokers' Secondhand Smoke Exposure: Using Project ImpacTeen Smoke-Free Air Law Variables 120
Table 2.13 The Effects of Tobacco Control Policies on Non-Smokers' Secondhand Smoke Exposure at Work: Using ANRF Smoke-Free Air Law Variables 121
Table 2.14 The Effects of Tobacco Control Policies on Non-Smokers' Secondhand Smoke Exposure at Work: Using Project ImpacTeen Smoke-Free Air Law Variables 122
Table 2.15 Self-Reported Workplace Secondhand Smoke Exposure: Check of Policy Lags and Leads 123
Table 2.16 Observable Cotinine Levels: Check of Policy Lags and Leads 124
Table 2.17 Log Cotinine Levels: Check of Policy Lags and Leads 125
Appendix Table 2.A Classification of Job Categories 126

Table 3.1 Summary Statistics 159
Table 3.2 The Impact of Tobacco Control Policies on Adolescent Smoking Outcomes 160
Table 3.3 The Impact of Demographic Characteristics on Adolescent Smoking Outcomes 161
Table 3.4 The Impact of Tobacco Control Policies On Adolescent Smoking Outcomes by Interview Day 162
Table 3.5 Comparison of Self-Reporting Smoking Status and Serum Cotinine Levels 163
Table 3.6 Relationship Between Tobacco Control Policies and Misreporting of Smoking Status 164
Table 3.7 Relationship Between Tobacco Control Policies and High Cotinine Levels 165

List of Figures

Figure 1.1 Time Series of Tobacco Control Policies 1988-2008 48
Figure 1.2 Kernel Density Plot of Log Cotinine Levels by Smoking Status 49
Figure 1.3 Scatter Plot of Cigarettes Smoked per Day and Log Cotinine Levels 50
Figure 1.4 Quantile Regression Results of the Impact of Cigarette Prices on The Average Number of Cigarettes Smoked per Day 51
Figure 1.5 Quantile Regression Results of the Impact of Smoke-Free Air Laws on The Average Number of Cigarettes Smoked per Day 52
Figure 1.6 Quantile Regression Results of the Impact of Cigarette Prices on Serum Cotinine Levels 53
Figure 1.7 Quantile Regression Results of the Impact of Smoke-Free Air Laws on Serum Cotinine Levels 54
Figure 1.8 Quantile Regression Results of the Impact of Demographic Variables on The Average Number of Cigarettes Smoked Per Day 55
Figure 1.9 Quantile Regression Results of the Impact of Demographic Variables on Serum Cotinine Levels 56
Figure 1.10 Smoking Intensity and Cigarettes Smoked Per Day 57
Figure 1.11 Quantile Regression Results of the Impact of Cigarette Prices on Changes in Smoking Behavior 58
Figure 1.12 Quantile Regression Results of the Impact of Smoke-Free Air Laws on Changes in Smoking Behavior 59
Figure 1.13 Quantile Regression Results of the Impact of The Average Number of Cigarettes Smoked per Day on Serum Cotinine Levels 60
Figure 1.14 Cotinine Levels for Smokers by NHANES Survey Wave 61

Figure 2.1 Tabulation of Self-Reported Secondhand Smoke Exposure at Work by Job Category 105
Figure 2.2 Distribution of Observable Logged Cotinine Concentrations 106

Figure 3.1 Timeseries of Tobacco Control Policies 1991-2006 156
Figure 3.2 Graph of Logged Serum Density by Smoking Status 157
Figure 3.3 Scatterplot of Serum Cotinine Levels and Cigarettes Smoked per Day 158

About this Dissertation

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School	Laney Graduate School
Department	Economics
Degree	PhD
Submission	Dissertation
Language	English
Research Field	Economics, General
Keyword	cigarette taxes Smoking cotinine smoking bans secondhand smoke quantile regression
Committee Chair / Thesis Advisor	Markowitz, Sara, Emory University
Committee Members	Mialon, Hugo M, Emory University Frisvold, David, Emory University

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