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The causal impact of mental health on tobacco and alcohol consumption - An instrumental variables approach

Author

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  • Mitrou, Francis
  • Nguyen, Ha Trong
  • Le, Huong Thu
  • Zubrick, Stephen

Abstract

The reciprocal relationship between psychiatric and substance use disorders is well-known, yet it remains largely unknown whether mental health morbidity causally leads to addictive behaviours. This paper utilises a fixed effects instrumental variables model, which is identified by time-varying sources of plausibly exogenous variations in mental health, and a nationally representative panel dataset from Australia to present robust evidence on the causal impact of mental distress on cigarette smoking and alcohol drinking behaviours. We find that mental distress significantly increases the prevalence and intensity of either cigarette or alcohol consumption. Further analysis reveals that mental distress also substantially increases household monetary expenditures on either tobacco or alcohol. The impact is greater for lower educated individuals or children of smokers, and is slightly higher for males. Our findings highlight the importance of mental health screening and treatment programs, especially among lower educated individuals or children of smokers, to assist in the prevention of addictive activities.

Suggested Citation

  • Mitrou, Francis & Nguyen, Ha Trong & Le, Huong Thu & Zubrick, Stephen, 2023. "The causal impact of mental health on tobacco and alcohol consumption - An instrumental variables approach," MPRA Paper 118211, University Library of Munich, Germany.
    • Handle: RePEc:pra:mprapa:118211
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    File URL: https://mpra.ub.uni-muenchen.de/118211/1/Mental%20health%20and%20addictive%20behaviours_Aug_2023.pdf
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    Cited by:

    1. Nguyen, Ha & Schurer, Stefanie & Mitrou, Francis, 2025. "The instability of locus of control: New evidence from the distributional effects of major life events," MPRA Paper 126016, University Library of Munich, Germany, revised Jul 2025.
    2. Kesavayuth, Dusanee & Zikos, Vasileios, 2025. "Entrepreneurship and mental health," Economics Letters, Elsevier, vol. 254(C).
    3. Artur Nagapetyan & Alexander Drozd & Dmitry Subbotovsky, 2023. "How to Determine the Optimal Number of Cardiologists in a Region?," Mathematics, MDPI, vol. 11(21), pages 1-23, October.
    4. Nguyen, Ha Trong & Mitrou, Francis, 2025. "Natural disasters and the demand for health insurance," Journal of Environmental Economics and Management, Elsevier, vol. 130(C).

    More about this item

    Keywords

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    JEL classification:

    • C26 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Instrumental Variables (IV) Estimation
    • I10 - Health, Education, and Welfare - - Health - - - General
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality

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