Dean R. Lillard

The Roles of High School Completion and Ged Receipt in Smoking and Obesity

We analyze data from the National Longitudinal Survey of Youth 1979 on high school completion, smoking, and obesity. First, we investigate whether GED recipients differ from other high school graduates in their smoking and obesity behaviors. Second, we explore whether the relationships between schooling and these health‐related behaviors are sensitive to controlling for background and ability measures. Third, we estimate instrumental variables models. Our results suggest that the returns to high school completion may include less smoking but the health returns to GED receipt are much smaller. We find little evidence that high school completion is associated with less obesity.

Higher standards, more dropouts? Evidence within and across time

Abstract This study investigates whether state course graduation requirements (CGRs) affect high school dropout decisions. It uses aggregate data on dropout rates, individual data on dropout decisions from two time periods, and aggregate data on high school (attrition) completion rates over fifteen years. The results strongly suggest that state mandated minimum course requirements cause students to drop out of high school. The estimated effects imply that a standard deviation increase in CGRs would cause between 26,000 and 65,000 more individuals to drop out of school. These figures constitute an increase in the population of dropouts in 1990 of 3.0 to 7.4 percent.

Sample selection rules and the intergenerational correlation of earnings

Abstract This paper investigates the sensitivity of estimates of the intergenerational correlation of earnings to different sample selection rules. Recent articles report father–son correlations to be on the order of 0.4. Those estimates, however, are based on samples which exclude observations with low or zero earnings. Since events such as unemployment are common, it is not clear that such episodes should be excluded. We show that estimated correlations are quite sensitive to the selection rule used. The sensitivity of estimates to selection rules suggests one should be cautious about using recent estimates to infer the degree of intergenerational mobility.

Private Profits and Public Health: Does Advertising of Smoking Cessation Products Encourage Smokers to Quit?

We study the impact of smoking cessation product advertising. To measure potential exposure, we link survey data on magazine‐reading habits and smoking behavior with an archive of print advertisements. We find that smokers who are exposed to more advertising are more likely to attempt to quit and to successfully quit. While some increased quitting involves product purchases, we find that product advertisements also prompt cold turkey quitting. Identifying the causal impact of advertising is difficult because advertisers target consumers. Although reverse causality could bias our estimates upward, our baseline results are not sensitive to a series of checks.

An analysis of life‐course smoking behavior in China

With a total population of more than 1.3 billion people where more than 31% of adults smoke, China has become the worlds largest producer and consumer of cigarettes. We adopt a life-course perspective to study the economics of smoking behavior in China. We use data from the China Health and Nutrition Survey (CHNS) to follow individuals over their whole lives and to analyze their decisions to both start and stop smoking. We extend the small but growing body of economic research on smoking in China. Our life-course approach emphasizes that current smoking participation reflects a decision to start and a series of past decisions to not quit. We explore how the determinants of smoking initiation differ from the determinants of smoking cessation. We find results, consistent with some previous empirical evidence, that Chinese smoking is not strongly related to the price of cigarettes. Based on our results, we offer some speculative hypotheses that, we hope, might guide future research on the economics of smoking in China. It seems especially useful to compare the broad patterns we document with the experiences of other countries.

Dying for a Smoke: How Much Does Differential Mortality of Smokers Affect Estimated Life-Course Smoking Prevalence?

OBJECTIVE An extensive literature uses reconstructed historical smoking rates by birth-cohort to inform anti-smoking policies. This paper examines whether and how these rates change when one adjusts for differential mortality of smokers and non-smokers. METHODS Using retrospectively reported data from the US (Panel Study of Income Dynamics, 1986, 1999, 2001, 2003, 2005), the UK (British Household Panel Survey, 1999, 2002), and Russia (Russian Longitudinal Monitoring Study, 2000), we generate life-course smoking prevalence rates by age-cohort. With cause-specific death rates from secondary sources and an improved method, we correct for differential mortality, and we test whether adjusted and unadjusted rates statistically differ. With US data (National Health Interview Survey, 1967-2004), we also compare contemporaneously measured smoking prevalence rates with the equivalent rates from retrospective data. RESULTS We find that differential mortality matters only for men. For Russian men over age 70 and US and UK men over age 80 unadjusted smoking prevalence understates the true prevalence. The results using retrospective and contemporaneous data are similar. CONCLUSIONS Differential mortality bias affects our understanding of smoking habits of old cohorts and, therefore, of inter-generational patterns of smoking. Unless one focuses on the young, policy recommendations based on unadjusted smoking rates may be misleading.

The Contribution and Potential of Data Harmonization for Cross-National Comparative Research

Abstract The promise of empirical evidence to inform policy makers about their populations health, wealth, employment and economic well being has propelled governments to invest in the harmonization of country-specific micro-data over the last 25 years. We review the major data harmonization projects launched over this period. These projects include the Luxembourg Income Study (LIS), the Cross-National Equivalent File (CNEF), the Consortium of Household Panels for European Socio-Economic Research (CHER), the European Community Household Panel (ECHP), the European Union Survey on Income and Living Conditions (EU-SILC), and the Survey of Health, Ageing and Retirement in Europe (SHARE). We discuss their success in providing reliable data for policy analysis and how they are being used to answer policy questions. While there have been some notable failures, on the whole these harmonization efforts have proven to be of major value to the research community and to policy makers.

Health disparities and direct-to-consumer advertising of pharmaceutical products.

Health information drives crucial consumer health decisions and plays a central role in healthcare markets. Consumers who are better-informed about smoking, diet, and physical activity make healthier choices outside the healthcare sector (Kenkel, 1991; Ippolito & Mathios, 1990, 1995; Meara, 2001). Better-informed consumers also interact differently with physicians and other healthcare providers (e.g., Cutler, Landrum, & Stewart, 2006). In addition to the immediate consequences for individual consumers, health economists have long recognized that information also has broader implications for principal–agent relationships and the functioning of healthcare markets.1 More recent lines of research in health economics and medical sociology emphasize the potential role of consumer information in explaining health disparities associated with socioeconomic status (Deaton, 2002; Goldman & Lakdawalla, 2001; Glied & Lleras-Muney, 2003; Link & Phelan, 1995). Both health economists and medical sociologists stress that because of disparities in consumer information, rapid medical progress tends to be accompanied by increased disparities in medical treatment and health outcomes.

Just passing through: the effect of the Master Settlement Agreement on estimated cigarette tax price pass-through

In 1998, cigarette manufacturers and state attorneys general in the United States settled a group of lawsuits in an agreement known as the Master Settlement Agreement (MSA). Among the provisions of this agreement were a set of mandated escrow payments to the states that would be based on cigarette sales. The result of these provisions is that the apparent relationship between taxes and prices changed substantially following implementation of the MSA. This article estimates whether the MSA escrow amounts are reflected in prices and compares the pass-through rate of state and federal cigarette taxes only and the rate when one adds escrow payments. We find much different pass-through rates for the two measures. State and federal taxes are not fully passed to smokers. In years that escrow payments were made, cigarette prices increased by more than the sum of the state and federal taxes and the escrow payments.

Educational Heterogeneity in the Association between Smoking Cessation and Health Information

Abstract I investigate the well-known educational gradient in smoking. It is well established that, at least in recent decades, people with higher levels of education are less likely to smoke and, conditional on being a smoker, are more likely to quit than are people with less education. Using longitudinal data on lifetime smoking histories, I explore whether the educational gradient changes when one accounts for differences in the amount of information smokers have about the health risks associated with smoking. At the core of the analysis is a new way to measure not only the flow of information a person receives but also a person’s stock of information in any year. I construct measures of the stock and flow of information with consumer magazine articles that discuss cigarette smoking and health. To calculate exposure, I predict individuals’ reading of particular magazines and link predicted exposure to data on individual smoking status in every year of life. The analysis sample includes many individuals who started smoking in the 1930s and 1940s – well before scientific evidence had accumulated. After replicating the education gradient in terms of smoking cessation, I show that it is mostly explained by the interaction between educational attainment and the stock of knowledge individuals possess. The findings suggest that education affects whether and how a stock of health risk information induces people to quit smoking.