Youth tobacco control: reconciling theory and empirical evidence
Introduction
An enormous body of literature documents the effect of tobacco taxes, and other tobacco control policies, on rates and levels of tobacco use among youth and adults. Overally, Chaloupka and Warner (2000) and Evans et al. (1999) suggest that in cross-sectional studies, the elasticity of smoking participation among youth is in the range of −0.5 to −0.7, and that adults are much less elastic (estimates range from about 0–0.25). The literature also suggests that taxes are more effective than most other policies in controlling youth smoking (Chaloupka and Warner, 2000).1
The price elasticity of youth smoking is an interesting question—but it is not necessarily the question that is most relevant to public policy. From a public health perspective, youth smoking per se is largely irrelevant, except to the extent that youth smoking imposes externalities through environmental tobacco exposure by others (including prenatal exposures).2 The goal of all policy aimed at reducing the personal health effects of smoking is to reduce adult smoking. Tobacco-related diseases are mainly a consequence of continued adult smoking, manifest almost entirely in late adulthood, and can be substantially (although not completely) eliminated by quitting young.3 For example, the increased heart disease and lung cancer risks of smokers are substantially reduced 10–15 years after quitting (Centers for Disease Control, 1997), well before most youth smokers would develop these diseases. The logic of policy concern over youth smoking is the belief that reducing youth smoking is the best way to reduce smoking overall. As the principal conclusion of the 1994 Surgeon General’s Report on Smoking states: “Nearly all first use of tobacco occurs before high school graduation; this finding suggests that if adolescents can be kept tobacco free, most will never start using tobacco” (Elders et al., 1994; p. 543).
The value of the existing empirical literature as support for public policy depends crucially on the assumption (implicit in the Surgeon General’s report) that policy-induced reductions in smoking behavior in adolescence are uncorrelated (or better still, positively correlated) with reductions in smoking behavior post-adolescence. If that assumption were true, then changes in smoking in adolescence would be highly correlated with changes in smoking in adulthood. Furthermore, changes in the smoking behavior of successive cohorts of adolescents, such as those monitored in the widely-publicized surveys of high school seniors, would be meaningful predictors of future smoking rates—and eventually of smoking-related disease rates.
In this paper, I test this assumption. I first examine cross-cohort correlations in smoking rates in aggregate data. I then turn to a longitudinal dataset, the National Longitudinal Survey of Youth (NLSY), that includes information on where respondents lived as teenagers and on their smoking behavior as adults. Using these data, I assess whether taxation-induced reductions in teen smoking persist into adulthood. I find evidence that there is substantial attenuation of such tax-induced reductions. Indeed, my results suggest that by the age of 40, differences in taxes faced in youth have essentially no effect on smoking rates. The first section of the paper summarizes the theoretical economic literature on teen smoking and suggest implications of this literature for adult smoking. I then turn to the empirical implementation of my test and present results. The final section concludes.
Section snippets
The economics of teen smoking
The economics literature justifies a focus on youth smoking using arguments about youth rationality, bounded decision-making, and time inconsistent preferences. Some researchers suggest that while adults who decide to smoke may be rationally accepting the harm to their health, it is harder to make this case for smoking initiation among youth. This concern over the rationality of youth decision making is echoed in the work of several health economists, who recently concluded that “protecting
Empirical tests
I consider two sets of empirical tests concerning the relationship of youth smoking to adult smoking. First, I use published data to examine the lifecycle correlation of smoking behavior within cohorts of young people and adults. Second, I conduct direct tests using the NLSY.
These analyses are in the spirit of some earlier work on smoking initiation. Douglas and Hariharan (1994) use retrospective data from the National Health Interview Survey (NHIS) to assess the effect of taxes on smoking
Conclusion
These results suggest that focusing on the effect of taxes and other policies on smoking among youth is likely to overstate the potential public health effect of these policies. They suggest that further analysis about the long term effects of tobacco policy are in order. In particular, it would be valuable for researchers to investigate the determinants of smoking patterns within and across cohorts.
The results reported here are based on the experience of one, relatively small, sample of young
Acknowledgements
The author is grateful for comments from participants in a seminar at APPAM. David Cutler, Jonathan Gruber, Donald Kenkel, Mark Kleiman, and two anonymous referees provided additional very helpful comments.
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