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Purchase restrictions as a tobacco control policy: An analysis of the effect on adverse birth outcomes

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  • Tennekoon, Vidhura S.B.W.

Abstract

The association between smoking during pregnancy and adverse birth outcomes is well known. Various tobacco control policies, however, may improve birth outcomes differently. We first study the effects of legal restrictions on purchasing tobacco products on adverse birth outcomes. The main outcome measure of interest is the causal effect of a purchase restriction on tobacco products on the probability of an adverse birth outcome. Our identification strategy utilizes the variation in the minimum legal sales age of tobacco products over time and across geographic regions within the US during 2013–2018 in a two-way fixed effects framework. We used restricted-use birth records of all live births in the US during that period by birthing people who were 18–21 years at delivery. We find that an age-based purchase restriction on tobacco products causes the incidence of adverse birth outcome to reduce by 9.5%. Our results suggest that purchase restrictions are highly effective in reducing adverse birth outcomes in deliveries by birthing people in the 18–21 age group and provide additional support for the campaign for further increasing the minimum legal sales age of tobacco products.

Suggested Citation

  • Tennekoon, Vidhura S.B.W., 2023. "Purchase restrictions as a tobacco control policy: An analysis of the effect on adverse birth outcomes," Economic Analysis and Policy, Elsevier, vol. 78(C), pages 967-974.
    • Handle: RePEc:eee:ecanpo:v:78:y:2023:i:c:p:967-974
    DOI: 10.1016/j.eap.2023.04.030
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    References listed on IDEAS

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    1. Calvin Bryan & Benjamin Hansen & Drew McNichols & Joseph J. Sabia, 2020. "Do State Tobacco 21 Laws Work?," NBER Working Papers 28173, National Bureau of Economic Research, Inc.
    2. Goodman-Bacon, Andrew, 2021. "Difference-in-differences with variation in treatment timing," Journal of Econometrics, Elsevier, vol. 225(2), pages 254-277.
    3. Ji Yan, 2014. "The Effects of a Minimum Cigarette Purchase Age of 21 on Prenatal Smoking and Infant Health," Eastern Economic Journal, Palgrave Macmillan;Eastern Economic Association, vol. 40(3), pages 289-308, June.
    4. Douglas Almond & Kenneth Y. Chay & David S. Lee, 2005. "The Costs of Low Birth Weight," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 120(3), pages 1031-1083.
    5. Apollonio, D.E. & Glantz, S.A., 2016. "Minimum ages of legal access for tobacco in the United States from 1863 to 2015," American Journal of Public Health, American Public Health Association, vol. 106(7), pages 1200-1207.
    6. Vidhura Tennekoon & Robert Rosenman, 2015. "The pot calling the kettle black? A comparison of measures of current tobacco use," Applied Economics, Taylor & Francis Journals, vol. 47(5), pages 431-448, January.
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    Keywords

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    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • K23 - Law and Economics - - Regulation and Business Law - - - Regulated Industries and Administrative Law

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