IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v375y2025ics0277953624011080.html

Intensity Matters: Heterogeneous impact of cigarette tax reform on drinking behaviors by smoking intensity

Author

Listed:
  • Park, Mingyeong
  • Son, Hyelim

Abstract

This paper investigates the relationship between smoking and drinking behaviors across different smoking intensity groups, using a unique policy shock that increased cigarette taxes in South Korea. Using the Korean Health Panel, we employ a difference-in-differences approach to estimate the causal effect of the cigarette price increase on alcohol consumption among heavy, average, and light smokers. We find that an increase in cigarette prices reduces drinking behavior only among heavy smokers, while cigarette consumption is reduced across all smokers. Subgroup analysis shows that the reduction in alcohol use among heavy smokers is more pronounced in the elderly, low-income, and moderately educated groups. These findings suggest that the public health benefits of cigarette taxes extend beyond their impact on smoking, particularly for those who are more vulnerable to the adverse health consequences of tobacco and alcohol.

Suggested Citation

  • Park, Mingyeong & Son, Hyelim, 2025. "Intensity Matters: Heterogeneous impact of cigarette tax reform on drinking behaviors by smoking intensity," Social Science & Medicine, Elsevier, vol. 375(C).
  • Handle: RePEc:eee:socmed:v:375:y:2025:i:c:s0277953624011080
    DOI: 10.1016/j.socscimed.2024.117654
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953624011080
    Download Restriction: Full text for ScienceDirect subscribers only

    File URL: https://libkey.io/10.1016/j.socscimed.2024.117654?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to

    for a different version of it.

    References listed on IDEAS

    as
    1. Diana S. Lien & William N. Evans, 2005. "Estimating the Impact of Large Cigarette Tax Hikes: The Case of Maternal Smoking and Infant Birth Weight," Journal of Human Resources, University of Wisconsin Press, vol. 40(2).
    2. Audrey Laporte & Alfia Karimova & Brian Ferguson, 2010. "Quantile regression analysis of the rational addiction model: investigating heterogeneity in forward‐looking behavior," Health Economics, John Wiley & Sons, Ltd., vol. 19(9), pages 1063-1074, September.
    3. Gehrsitz, Markus & Saffer, Henry & Grossman, Michael, 2021. "The effect of changes in alcohol tax differentials on alcohol consumption," Journal of Public Economics, Elsevier, vol. 204(C).
    4. Friedson, Andrew & Li, Moyan & Meckel, Katherine & Rees, Daniel I. & Sacks, Daniel W., 2023. "Cigarette taxes, smoking, and health in the long run," Journal of Public Economics, Elsevier, vol. 222(C).
    5. Bharadwaj, Prashant & Johnsen, Julian V. & Løken, Katrine V., 2014. "Smoking bans, maternal smoking and birth outcomes," Journal of Public Economics, Elsevier, vol. 115(C), pages 72-93.
    6. Anindya Sen & Tony Wirjanto, 2010. "Estimating the impacts of cigarette taxes on youth smoking participation, initiation, and persistence: empirical evidence from Canada," Health Economics, John Wiley & Sons, Ltd., vol. 19(11), pages 1264-1280, November.
    7. Carpenter, Christopher & Cook, Philip J., 2008. "Cigarette taxes and youth smoking: New evidence from national, state, and local Youth Risk Behavior Surveys," Journal of Health Economics, Elsevier, vol. 27(2), pages 287-299, March.
    8. repec:plo:pone00:0068132 is not listed on IDEAS
    9. Michael Kvasnicka & Thomas Siedler & Nicolas R. Ziebarth, 2018. "The health effects of smoking bans: Evidence from German hospitalization data," Health Economics, John Wiley & Sons, Ltd., vol. 27(11), pages 1738-1753, November.
    10. Matthew C. Farrelly & Jeremy W. Bray & Terry Pechacek & Trevor Woollery, 2001. "Response by Adults to Increases in Cigarette Prices by Sociodemographic Characteristics," Southern Economic Journal, Southern Economic Association, vol. 68(1), pages 156-165, July.
    11. Courtemanche, Charles & Tchernis, Rusty & Ukert, Benjamin, 2018. "The effect of smoking on obesity: Evidence from a randomized trial," Journal of Health Economics, Elsevier, vol. 57(C), pages 31-44.
    12. Harald Tauchmann & Silja Lenz & Till Requate & Christoph Schmidt, 2013. "Tobacco and alcohol: complements or substitutes?," Empirical Economics, Springer, vol. 45(1), pages 539-566, August.
    13. Lisa Cameron & Jenny Williams, 2001. "Cannabis, Alcohol and Cigarettes: Substitutes or Complements?," The Economic Record, The Economic Society of Australia, vol. 77(236), pages 19-34, March.
    14. Xueyan Zhao & Mark N. Harris, 2004. "Demand for Marijuana, Alcohol and Tobacco: Participation, Levels of Consumption and Cross‐equation Correlations," The Economic Record, The Economic Society of Australia, vol. 80(251), pages 394-410, December.
    15. Jones, Andrew M, 1989. "A Systems Approach to the Demand for Alcohol and Tobacco," Bulletin of Economic Research, Wiley Blackwell, vol. 41(2), pages 85-105, April.
    16. Fabrizio Mazzonna & Paola Salari, 2018. "Can a smoking ban save your heart?," Health Economics, John Wiley & Sons, Ltd., vol. 27(10), pages 1435-1449, October.
    17. Koch, Steven F., 2018. "Quasi-experimental evidence on tobacco tax regressivity," Social Science & Medicine, Elsevier, vol. 196(C), pages 19-28.
    18. John A. Tauras & Frank J. Chaloupka, 1999. "Price, Clean Indoor Air, and Cigarette Smoking: Evidence from the Longitudinal Data for Young Adults," NBER Working Papers 6937, National Bureau of Economic Research, Inc.
    19. Rajeev K. Goel & Michael A. Nelson, 2006. "The Effectiveness of Anti‐Smoking Legislation: A Review," Journal of Economic Surveys, Wiley Blackwell, vol. 20(3), pages 325-355, July.
    20. Vinish Shrestha, 2018. "Do young adults substitute cigarettes for alcohol? Learning from the master settlement agreement," Review of Economics of the Household, Springer, vol. 16(2), pages 297-321, June.
    21. Mikael Bask & Maria Melkersson, 2004. "Rationally addicted to drinking and smoking?," Applied Economics, Taylor & Francis Journals, vol. 36(4), pages 373-381.
    22. Gruber, Jonathan & Sen, Anindya & Stabile, Mark, 2003. "Estimating price elasticities when there is smuggling: the sensitivity of smoking to price in Canada," Journal of Health Economics, Elsevier, vol. 22(5), pages 821-842, September.
    23. Markowitz, Sara, 2008. "The effectiveness of cigarette regulations in reducing cases of Sudden Infant Death Syndrome," Journal of Health Economics, Elsevier, vol. 27(1), pages 106-133, January.
    24. Charles L. Baum, 2009. "The effects of cigarette costs on BMI and obesity," Health Economics, John Wiley & Sons, Ltd., vol. 18(1), pages 3-19, January.
    25. Dee, Thomas S., 1999. "The complementarity of teen smoking and drinking," Journal of Health Economics, Elsevier, vol. 18(6), pages 769-793, December.
    26. Gabriel A. Picone & Frank Sloan & Justin G. Trogdon, 2004. "The effect of the tobacco settlement and smoking bans on alcohol consumption," Health Economics, John Wiley & Sons, Ltd., vol. 13(10), pages 1063-1080, October.
    27. Karen Smith Conway & David P. Niles, 2017. "Cigarette Taxes, Smoking—and Exercise?," Health Economics, John Wiley & Sons, Ltd., vol. 26(8), pages 1019-1036, August.
    28. DeCicca, Philip & Kenkel, Don & Mathios, Alan, 2008. "Cigarette taxes and the transition from youth to adult smoking: Smoking initiation, cessation, and participation," Journal of Health Economics, Elsevier, vol. 27(4), pages 904-917, July.
    29. DeCicca, Philip & McLeod, Logan, 2008. "Cigarette taxes and older adult smoking: Evidence from recent large tax increases," Journal of Health Economics, Elsevier, vol. 27(4), pages 918-929, July.
    30. Gospodinov, Nikolay & Irvine, Ian, 2009. "Tobacco taxes and regressivity," Journal of Health Economics, Elsevier, vol. 28(2), pages 375-384, March.
    31. Michael T. French & Edward C. Norton & Hai Fang & Johanna Catherine Maclean, 2010. "Alcohol consumption and body weight," Health Economics, John Wiley & Sons, Ltd., vol. 19(7), pages 814-832, July.
    32. Sandra L. Decker & Amy Ellen Schwartz, 2000. "Cigarettes and Alcohol: Substitutes or Complements?," NBER Working Papers 7535, National Bureau of Economic Research, Inc.
    33. Augustson, E.M. & Wanke, K.L. & Rogers, S. & Bergen, A.W. & Chatterjee, N. & Synder, K. & Albanes, D. & Taylor, P.R. & Caporaso, N.E., 2008. "Predictors of sustained smoking cessation: A prospective analysis of chronic smokers from the Alpha-Tocopherol Beta-Carotene Cancer Prevention Study," American Journal of Public Health, American Public Health Association, vol. 98(3), pages 549-555.
    34. David Simon, 2016. "Does Early Life Exposure to Cigarette Smoke Permanently Harm Childhood Welfare? Evidence from Cigarette Tax Hikes," American Economic Journal: Applied Economics, American Economic Association, vol. 8(4), pages 128-159, October.
    35. Erik Nesson, 2017. "Heterogeneity in Smokers' Responses to Tobacco Control Policies," Health Economics, John Wiley & Sons, Ltd., vol. 26(2), pages 206-225, February.
    36. Chaloupka, Frank J. & Wechsler, Henry, 1997. "Price, tobacco control policies and smoking among young adults," Journal of Health Economics, Elsevier, vol. 16(3), pages 359-373, June.
    37. Gruber, Jonathan & Frakes, Michael, 2006. "Does falling smoking lead to rising obesity?," Journal of Health Economics, Elsevier, vol. 25(2), pages 183-197, March.
    38. Matthew C. Farrelly & Jeremy W. Bray & Terry Pechacek & Trevor Woollery, 2001. "Response by Adults to Increases in Cigarette Prices by Sociodemographic Characteristics," Southern Economic Journal, John Wiley & Sons, vol. 68(1), pages 156-165, July.
    39. Johanna Catherine MacLean & Asia Sikora Kessler & Donald S. Kenkel, 2016. "Cigarette Taxes and Older Adult Smoking: Evidence from the Health and Retirement Study," Health Economics, John Wiley & Sons, Ltd., vol. 25(4), pages 424-438, April.
    40. Pierpaolo Pierani & Silvia Tiezzi, 2009. "Addiction and interaction between alcohol and tobacco consumption," Empirical Economics, Springer, vol. 37(1), pages 1-23, September.
    41. Jonathan Gruber & Sendhil Mullainathan, 2006. "Do Cigarette Taxes Make Smokers Happier?," Palgrave Macmillan Books, in: Yew-Kwang Ng & Lok Sang Ho (ed.), Happiness and Public Policy, chapter 6, pages 109-146, Palgrave Macmillan.
    42. Remler, D.K., 2004. "Poor Smokers, Poor Quitters, and Cigarette Tax Regressivity," American Journal of Public Health, American Public Health Association, vol. 94(2), pages 225-229.
    43. Xiaohua Yu & David Abler, 2010. "Interactions between cigarette and alcohol consumption in rural China," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 11(2), pages 151-160, April.
    44. Jason M. Fletcher & Partha Deb & Jody L. Sindelar, 2009. "Tobacco Use, Taxation and Self Control in Adolescence," NBER Working Papers 15130, National Bureau of Economic Research, Inc.
    45. Dollar, K.M. & Homish, G.G. & Kozlowski, L.T. & Leonard, K.E., 2009. "Spousal and alcohol-related predictors of smoking cessation: A longitudinal study in a community sample of married couples," American Journal of Public Health, American Public Health Association, vol. 99(2), pages 231-233.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Pearl Bader & David Boisclair & Roberta Ferrence, 2011. "Effects of Tobacco Taxation and Pricing on Smoking Behavior in High Risk Populations: A Knowledge Synthesis," IJERPH, MDPI, vol. 8(11), pages 1-22, October.
    2. Göhlmann, Silja & Schmidt, Christoph M., 2008. "Smoking in Germany: Stylized Facts, Behavioral Models, and Health Policy," Ruhr Economic Papers 64, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    3. Carpenter, Christopher S. & Sansone, Dario, 2021. "Cigarette taxes and smoking among sexual minority adults," Journal of Health Economics, Elsevier, vol. 79(C).
    4. Adrian R. Fleissig, 2020. "Impact of Casino Gambling and Lotteries on Demand for Other ‘Sin’ Goods," Atlantic Economic Journal, Springer;International Atlantic Economic Society, vol. 48(3), pages 327-338, September.
    5. Sara Markowitz & John Tauras, 2009. "Substance use among adolescent students with consideration of budget constraints," Review of Economics of the Household, Springer, vol. 7(4), pages 423-446, December.
    6. Vinish Shrestha, 2025. "Revisiting the effects of cigarette taxation on smoking outcomes," Empirical Economics, Springer, vol. 68(3), pages 1429-1475, March.
    7. Benjamin Ukert, 2017. "The short- and long-run effects of smoking cessation on alcohol consumption," International Journal of Health Economics and Management, Springer, vol. 17(4), pages 495-519, December.
    8. Tauchmann, Harald & Lenz, Silja & Requate, Till & Schmidt, Christoph M., 2013. "Tobacco and alcohol: complements or substitutes?," EconStor Open Access Articles and Book Chapters, ZBW - Leibniz Information Centre for Economics, vol. 45(1), pages 539-566.
    9. Lee, Youngju & Park, Minsung, 2026. "The effect of cigarette prices on insurance premiums: Evidence from cigarette tax increase in South Korea," Economic Analysis and Policy, Elsevier, vol. 89(C), pages 1064-1076.
    10. Sunday Azagba & Mesbah Sharaf, 2011. "Cigarette Taxes and Smoking Participation: Evidence from Recent Tax Increases in Canada," IJERPH, MDPI, vol. 8(5), pages 1-18, May.
    11. Silja Göhlmann & Christoph M. Schmidt, 2008. "Smoking in Germany: Stylized Facts, Behavioral Models, and Health Policy," Ruhr Economic Papers 0064, Rheinisch-Westfälisches Institut für Wirtschaftsforschung, Ruhr-Universität Bochum, Universität Dortmund, Universität Duisburg-Essen.
    12. Tauchmann, Harald & Göhlmann, Silja & Requate, Till & Schmidt, Christoph M., 2007. "Tobacco and Alcohol: Complements or Substitutes? – A Structural Model Approach," Ruhr Economic Papers 34, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    13. Requate, Till & Göhlmann, Silja & Tauchmann, Harald & Schmidt, Christoph M., 2006. "Tobacco and alcohol: complements or substitutes? A statistical Guinea Pig approach," Economics Working Papers 2006-18, Christian-Albrechts-University of Kiel, Department of Economics.
    14. Friedson, Andrew & Li, Moyan & Meckel, Katherine & Rees, Daniel I. & Sacks, Daniel W., 2023. "Cigarette taxes, smoking, and health in the long run," Journal of Public Economics, Elsevier, vol. 222(C).
    15. Costa-Font, Joan & Salmasi, Luca & Zaccagni, Sarah, 2025. "More Than a Ban on Smoking? Behavioural Spillovers of Smoking Bans in the Workplace," Economics & Human Biology, Elsevier, vol. 58(C).
    16. Harald Tauchmann & Silja Göhlmann & Till Requate & Chistoph M. Schmidt, 2006. "Tobacco and Alcohol: Complements or Substitutes? - A Statistical Guinea Pig Approach," RWI Discussion Papers 0052, Rheinisch-Westfälisches Institut für Wirtschaftsforschung.
    17. Leah K. Lakdawala & David Simon, 2017. "The Intergenerational Consequences of Tobacco Policy: A Review of Policy's Influence on Maternal Smoking and Child Health," Southern Economic Journal, John Wiley & Sons, vol. 84(1), pages 229-274, July.
    18. Sen Anindya & Ariizumi Hideki & Driambe Daciana, 2010. "Do Changes In Cigarette Taxes Impact Youth Smoking? Evidence from Canadian Provinces," Forum for Health Economics & Policy, De Gruyter, vol. 13(2), pages 1-25, August.
    19. Friedson, Andrew I. & Rees, Daniel I., 2020. "Cigarette Taxes and Smoking in the Long Run," IZA Discussion Papers 13252, IZA Network @ LISER.
    20. Harald Tauchmann & Silja Göhlmann & Till Requate & Christoph M. Schmidt, 2007. "Tobacco and Alcohol: Complements or Substitutes? – A Structural Model Approach," Ruhr Economic Papers 0034, Rheinisch-Westfälisches Institut für Wirtschaftsforschung, Ruhr-Universität Bochum, Universität Dortmund, Universität Duisburg-Essen.

    More about this item

    Keywords

    ;
    ;
    ;
    ;

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • H2 - Public Economics - - Taxation, Subsidies, and Revenue

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:375:y:2025:i:c:s0277953624011080. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.