Catching the habit: a study of inequality of opportunity in smoking-related mortality

This paper investigates inequality in smoking-related mortality risk, focusing on the intergenerational transmission of smoking. We estimate a latent factor model for smoking initiation, cessation and mortality risk using the British Health and Lifestyle Survey (HALS). The empirical analysis includes counterfactual simulations. The Gini coffcient for inequality in overall mortality risk, Sen's welfare index and generalised Lorenz curves are computed for the baseline model and for counterfactual scenarios that compare individual types that di®er in their circumstances and effort. Results confirm a clear socioeconomic gradient in smoking initiation and cessation as well as for mortality. Furthermore, we find that parental smoking behaviour plays an important role in smoking and indirectly affects mortality: it lowers the age at starting by about 2 years, increases smoking duration by about 12 years and lowers median lifespan by about 5 years. There is a large difference between current and never smokers in their median lifespan, which is exacerbated by parental smoking. Inequality in smoking-related mortality decreases if individuals adopt the best level of effort (not smoking) or, alternatively, if circumstances are favourable (parents are non-smokers). The health gain from not smoking (not attributable to parental smoking behaviour) is about 13 per cent in terms of mean survival probability and 5 per cent in terms of median predicted lifespan, a net gain of 3.4 years.