Does falling smoking lead to rising obesity?
Section snippets
Smoking and weight gain
An extensive medical literature has supported the popular contention that smoking facilitates weight control. In 1990, the U.S. Surgeon General reviewed 15 medical studies involving a total of roughly 20,000 test subjects (U.S. Department of Health and Human Services, 1990). Between 58 and 87% of those who had quit smoking gained weight. On average, quitters gained 4 pounds more than those who continued smoking. Individual weight gains of 20 pounds or more following smoking cessation were found
Data
Our basic data source for this analysis is the Behavioral Risk Factor Surveillance System (BRFSS). The data consists of repeated cross-sections for the years 1984 through 2002, collected via monthly telephone surveys of individuals aged 18 years and older. The BRFSS is a nationally representative survey of the United States and has been conducted by state health departments in coordination with the CDC for the purpose of collecting state-level data pertaining to risky personal health behaviors.
Empirical strategy
We begin our analysis by showing reduced form estimates of the impact of cigarette taxes on measures of body weight. In particular, we estimate regression equations of the form:where i is the indexes individuals, j the indexes states, t the indexes years, BMI the body mass index or some other measure of body weight, RTAX the real cigarette tax in state j in year t; X the set of individual-specific covariates (e.g. age), UR the unemployment rate in state
Results
Table 2 presents our initial results from estimating equations such as that shown above. We estimate our model for two different measures of body weight: the level of the BMI (results are similar if we use the logarithm of BMI instead) and an indicator for obesity (BMI > 30). We express the cigarette tax in fractions of a dollar, rather than cents (e.g. 0.4 not 40) for ease of interpretation of the coefficients.
Surprisingly, we find that there is a negative relationship between cigarette taxes
Conclusions
Smoking and obesity are the two largest (at least partially) self-imposed health risks facing Americans today. The notion that there is a tradeoff between these risks, with lower smoking causing more weight gain, is the type of “common knowledge” that has in fact found relatively little support in the literature. We provide such analysis in this paper and are unable to detect any evidence that higher cigarette taxes, which lead to lower smoking, also lead to higher weight. The existing study
Acknowledgements
We are grateful to Shin-Yi Chou, Mike Grossman and Inas Rashad for generously providing the data from their earlier study.
Michael D. Frakes gratefully acknowledges financial support from the National Science Foundation and from Harvard Law School's John M. Olin Center for Law, Economics and Business.
Reference (22)
- et al.
An economic analysis of adult obesity: results from the behavioral risk factor surveillance system
Journal of Health Economics
(2004) - et al.
Women gain weight 1 year after smoking cessation while dietary intake temporarily increases
Journal of the American Dietetic Association
(1996) - et al.
Diet, lifestyle, and the etiology of coronary artery disease: the Cornell China Study
American Journal of Cardiology
(1998) - Centers for Disease Control and Prevention, Final Data for 1999. National Vital Statistics Reports, vol. 49. September...
- et al.
The economics of smoking
- Cutler, D., Glaeser, E., Shapiro, J. Why Have Americans Become More Obese?” NBER Working Paper 9446, January...
- et al.
Using sample survey weights in multiple regression analysis of stratified samples
Journal of the American Statistical Association
(1983) - et al.
National medical spending attributable to overweight and obesity: how much, and who's paying?
Health Affairs
(2003) - et al.
Prevalence and trends in obesity among US adults, 1999–2000
Journal of the American Medical Association
(2002) - et al.
Smoking cessation and body mass index of occupationally active men: the Israeli CORDIS Study
American Journal of Public Health, American Public Health Association
(1999)