Killing by Lung Cancer or by Diabetes? The Trade-off Between Smoking and Obesity

As the prevalence of smoking has decreased to below 20%, health practitioners interest has shifted towards the prevalence of obesity, and reducing it is one of the major health challenges in decades to come. In this paper we study the impact that the final product of the anti-smoking campaign, that is, smokers quitting the habit, had on average weight in the population. To these ends, we use data from the Behavioral Risk Factors Surveillance System, a large series of independent representative cross-sectional surveys. We construct a synthetic panel that allows us to control for unobserved heterogeneity and we exploit the exogenous changes in taxes and regulations to instrument the endogenous decision to give up the habit of smoking. Our estimates, are very close to estimates issued in the'90s by the US Department of Health, and indicate that a 10% decrease in the incidence of smoking leads to an average weight increase of 2.2 to 3 pounds, depending on choice of specification. In addition, we find evidence that the effect over shoots in the short run, although a significant part remains even after two years. However, when we split the sample between men and women, we only find a significant effect for men. Finally, the implicit elasticity of quitting smoking to the probability of becoming obese is calculated at 0.58. This implies that the net benefit from reducing the incidence of smoking by 1% is positive even though the cost to society is $0.6 billions.