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The Self-Medication Hypothesis: Evidence from Terrorism and Cigarette Accessibility

Author

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  • Michael Pesko

    (Department of Healthcare Policy and Research, Weill Cornell Medical College, Cornell University)

  • Christopher F Baum

    (Boston College
    DIW Berlin)

Abstract

We use single equation and simultaneous instrumental variable models to explore if individuals smoke during times of stress (i.e., motivation effect) and if they are successful in self-medicating short-term stress (i.e., self-medication effect). Short-term stress is a powerful motivator of smoking, and the decision to smoke could trigger biological feedback that immediately reduces short-term stress. This feedback confounds estimates of the relationship between stress and smoking. Omitted variables, such as genetic or social factors, could also suggest a spurious correlation. We use data on self- reported smoking and stress from 240,388 current and former smokers. We instrument stress with temporal distance from September 11, 2001 (using date of interview). We instrument smoking with cigarette accessibility variables of cigarette price changes and distance to state borders. In the absence of accounting for feedback and other forms of endogeneity, we find that smoking is associated with increases in short-term stress. This is opposite of our theoretical prediction for self-medication. However, when we account for endogeneity we find no evidence of smoking affecting short-term stress. We do find a consistent positive effect of stress on smoking.

Suggested Citation

  • Michael Pesko & Christopher F Baum, 2014. "The Self-Medication Hypothesis: Evidence from Terrorism and Cigarette Accessibility," Boston College Working Papers in Economics 865, Boston College Department of Economics, revised 07 Feb 2016.
  • Handle: RePEc:boc:bocoec:865
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    References listed on IDEAS

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    1. Christopher F Baum & Mark E. Schaffer & Steven Stillman, 2003. "Instrumental variables and GMM: Estimation and testing," Stata Journal, StataCorp LP, vol. 3(1), pages 1-31, March.
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    5. DeCicca, Philip & Kenkel, Donald & Liu, Feng, 2013. "Excise tax avoidance: The case of state cigarette taxes," Journal of Health Economics, Elsevier, vol. 32(6), pages 1130-1141.
    6. Irina Grafova, 2011. "Financial Strain and Smoking," Journal of Family and Economic Issues, Springer, vol. 32(2), pages 327-340, June.
    7. Barnes Michael G & Smith Trenton G., 2009. "Tobacco Use as Response to Economic Insecurity: Evidence from the National Longitudinal Survey of Youth," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 9(1), pages 1-29, November.
    8. Christopher F Baum & Mark E. Schaffer & Steven Stillman, 2007. "Enhanced routines for instrumental variables/generalized method of moments estimation and testing," Stata Journal, StataCorp LP, vol. 7(4), pages 465-506, December.
    9. Ayyagari Padmaja & Sindelar Jody L, 2010. "The Impact of Job Stress on Smoking and Quitting: Evidence from the HRS," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 10(1), pages 1-32, March.
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    11. Michael F. Pesko, 2014. "Stress And Smoking: Associations With Terrorism And Causal Impact," Contemporary Economic Policy, Western Economic Association International, vol. 32(2), pages 351-371, April.
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    Cited by:

    1. Friedman, Abigail S., 2020. "Smoking to cope: Addictive behavior as a response to mental distress," Journal of Health Economics, Elsevier, vol. 72(C).
    2. Andrew E. Clark & Orla Doyle & Elena Stancanelli, 2017. "The Impact of Terrorism on Well-being: Evidence from the Boston Marathon Bombing," Working Papers 201717, School of Economics, University College Dublin.
    3. Palali, Ali, 2017. "Early smoking, education, and labor market performance," Other publications TiSEM a3763677-b112-4fea-a9f3-5, Tilburg University, School of Economics and Management.
    4. Ali Palali, 2017. "Early Smoking, Education, and Labor Market Performance," De Economist, Springer, vol. 165(3), pages 225-270, September.
    5. Kaiser, Micha & Reutter, Mirjam & Sousa-Poza, Alfonso & Strohmaier, Kristina, 2018. "Smoking and local unemployment: Evidence from Germany," Economics & Human Biology, Elsevier, vol. 29(C), pages 138-147.
    6. Clark, Andrew & Stancanelli, Elena, 2017. "Americans’ Responses to Terrorism and Mass-Shooting: Evidence from the American Time Use Survey and Well-Being Module," GLO Discussion Paper Series 26, Global Labor Organization (GLO).
    7. Michael F. Pesko, 2018. "The Impact Of Perceived Background Risk On Behavioral Health: Evidence From Hurricane Katrina," Economic Inquiry, Western Economic Association International, vol. 56(4), pages 2099-2115, October.

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    More about this item

    Keywords

    smoking; self-medication; stress;
    All these keywords.

    JEL classification:

    • C26 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Instrumental Variables (IV) Estimation
    • C36 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables - - - Instrumental Variables (IV) Estimation
    • I19 - Health, Education, and Welfare - - Health - - - Other

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