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Economics Smoking Health

The Economics of Smoking

Economics of Smoking - p. 1

1. Introduction and overview

Historically one of the oldest and most important crops in the United

States, tobacco has become embroiled in the second half of the twentieth

century in a struggle pitting American economic against public health

interests. While the tobacco industry ranks among the most substantial and

successful economic enterprises in the U.S., tobacco products are associated

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with more deaths than any other product (U.S. Department of Health and Human

Services, 1989, 1998). Tobacco products, and particularly cigarettes, which

account for 95% of U.S. tobacco product sales, are credited with approximately

one-fifth of the nation's annual death toll. Cigarettes cause fully a third

of deaths during middle age. The leading cause of lung cancer and chronic

obstructive pulmonary disease mortality, as well as a major cause of

cardiovascular death, cigarette smoking leads all other causes of death in

virtually all industrialized nations. According to an epidemiological

analysis sponsored by the World Health Organization, tobacco will become the

leading cause of death in developing countries during the first third of the

21st century. By 2030, tobacco will be responsible for 10 million deaths

annually worldwide (Peto et al., forthcoming), a toll that will exceed by far

that associated with any other cause of disease (Murray and Lopez, 1996).

Formal economic analysis of tobacco dates back at least half a century

(Tennant, 1950). At that time, most tobacco industry economic analysis was

motivated by the factors that prompted market analysis of any other product or

service, such as a desire on the part of an industry to understand the degree

of price elasticity of demand for its product, or the interest of government

and academic economists in the causes and implications of market

concentration. Beginning in the late 1960s, however, following publication of

seminal British and American reports on smoking and health (Royal College of

Physicians, 1962; U.S. Department of Health, Education, and Welfare, 1964),

the focus of economic research shifted from a general industrial organization

orientation toward analysis self-consciously relevant to the public health

Economics of Smoking - p. 2

damage wrought by tobacco. The subsequent economic analysis has been

motivated by a desire to determine how economic forces influence tobacco

consumption, with continuing emphasis on refining the scientific rigor of the

work; but the objective of much of the research is now to determine how to

harness economic forces and logic, how to use economic tools, to decrease

smoking, with the ultimate goal being to reduce the toll of tobacco. 1

Certainly the most important example of this phenomenon has been the

rapidly expanding and increasingly sophisticated body of research on the

effects of price increases on cigarette consumption. Because excise tax

comprises an important component of price, the resultant literature has played

a prominent role in legislative debates about using taxation as a principal

tool to discourage smoking in individual states, in the U.S. as a whole, and

in numerous other countries as well. In the United States in the late 1990s,

the findings of this literature have been showcased in the intense

congressional debate over whether to adopt comprehensive tobacco control

legislation, with a major price increase lying at the heart of all proposals

(Chaloupka, 1998).

1.1 Coverage

This chapter examines in detail economic analysis of the relationships

among taxation, price, consumption, and disease outcomes, as well as

considering how analysis has enlightened other debates about the economics of

tobacco. The relationship between price and cigarette consumption has been

the focal point of economic research on smoking, and the locus of increasingly

sophisticated and interesting development of theory and methodology. For

these reasons, and because the resultant literature constitutes the most

1 Not all of the research is motivated by a desire to decrease smoking.

Some authors express the opinion that more respect should be accorded consumer

sovereignty, despite the issues of addiction and youthful initiation of

smoking that have led many economists to perceive the market for cigarettes as

suffering from important market imperfections (Warner et al., 1995). See, for

example, Viscusi (1992) and Tollison and Wagner (1992).

Economics of Smoking - p. 3

important contribution of economics to understanding tobacco policy, this

chapter's principal emphasis is on this body of research. The chapter devotes

special consideration to recent attempts to model nicotine addiction in the

context of rational economic behavior. Borne of a generic interest in the

role of addiction in economic behavior, new theoretical models have received

their best empirical testing through the use of data on cigarette smoking. 2

The chapter also considers a variety of equity and efficiency concerns

that invariably accompany debates about cigarette taxation, including the

validity of the externality or social cost argument frequently invoked by the

public health community in calls for higher taxes; whether there are other

legitimate grounds in economic theory to support increased excise taxation;

whether cigarette tax increases are regressive, and if so how much; and

whether large tax hikes produce substantial cross-border smuggling of

cigarettes. Recent economic studies have explored subtle impacts of cigarette

taxation that receive attention here as well; for example, cross-price

elasticity issues include how cigarette taxation may shift demand toward other

tobacco products, such as smokeless tobacco, or, within the cigarette family,

from lower to higher tar and nicotine cigarettes.

Coverage in this chapter also includes attention to economic analysis of

the role of advertising in the demand for cigarettes, as well as the role of

restrictions or bans on advertising. The effects of advertising and of

advertising and other marketing restrictions are of special interest due to

their prominence in debates about tobacco control at all levels of government,

from municipalities, which have restricted cigarette advertising on public

transit and on billboards, to international bodies, which have called for

2 As is discussed below, numerous variables other than price influence the

demand for cigarettes, including consumers' knowledge of the hazards of

smoking, parental and sibling smoking behavior, smoking by peers, role

modeling, income, and education (U.S. Department of Health and Human Services,

1994). The near-exclusive focus of this chapter on price and taxation

reflects the facts that tax is the most policy-tractable variable influencing

the demand for cigarettes and that the economics literature has focused on

price, taxation, and addiction.

Economics of Smoking - p. 4

complete bans (Roemer, 1993). Although its value is constrained by obvious

limitations, econometric analysis offers insights into the role of

advertising, and of advertising restrictions, on the demand for cigarettes.

The chapter also examines what is known about the influence of other

tobacco control policies on the demand for cigarettes, including the

development and dissemination of information on the health consequences of

smoking; media advocacy by means of "counter-advertising;" the adoption and

implementation of laws or policies that limit smoking in public places; and

legal restrictions on youth access to tobacco products.

Given tobacco's role in employment, tax revenues, and, in selected

countries, trade balances, governments have a legitimate interest in the

"health" of their tobacco industries. Tobacco companies tout the industry's

economic contribution in attempts to combat tobacco control policy measures.

In recent years, independent economists have countered the industry's economic

argument by carrying out macroeconomic analyses that examine the net

contributions of tobacco to economies, rather than the gross contributions

featured by the industry. This literature, and its role in the debate over

tobacco control policy, are examined toward the end of the chapter. Also

considered briefly is the influence of tobacco agriculture support policies so

prominent in the agricultural policies of the United States and the European

Union.

Despite its wide scope of coverage, this chapter does not examine all of

the economic contributions relating to smoking and health. To illustrate with

two examples, the chapter does not consider the growing literature on the

cost-effectiveness of smoking cessation interventions ( Cromwell et al., 1997;

Warner, 1997) and it omits the newly emerging and potentially quite important

analysis of the economics of the market for nicotine replacement products

(Oster et al., 1996; Hu et al., 1998). Another limitation on coverage is that

we consider almost exclusively English language publications, believed to

comprise a very sizable majority of the peer-reviewed literature. Further,

Economics of Smoking - p. 5

reflecting the authors' knowledge of this field and familiarity with data,

examples draw heavily, although not exclusively, on the U.S. experience. In

particular, there is little coverage of the economics of smoking in developing

countries, the result primarily of the dearth of studies on the subject.

Although specific empirical conclusions from a given country may not apply

precisely to other nations, the general phenomena described and findings

presented should apply qualitatively to all countries, unless otherwise

indicated.

Before turning to the economics literature, the remainder of this

introductory section presents a brief "primer" on the health consequences of

tobacco use. We deem this important background for understanding the nature

and social significance of the economic issues.

1.2 Health consequences of tobacco consumption

The health implications of tobacco have been contemplated for at least

the past millenium. During the first half of that period, the predominant

view held that tobacco afforded users a wide variety of health benefits. The

Amerindians employed tobacco as an analgesic and as a treatment for such

diverse ailments as intestinal problems, asthma, rheumatism, headaches,

toothaches, boils, worms, fevers, and the pains of childbirth (Goodman, 1993).

Serious medical and scientific attention to the health consequences of

smoking is a phenomenon of the present century, primarily of its second half. 3

This is a reflection of the development of the science of epidemiology during

3 Concern about the health consequences of smoking predates the "modern

era" by nearly four centuries. In 1604, for example, King James I of England

lambasted smoking as "a custome lothsome to the eye, hatefull to the Nose,

harmefull to the braine, dangerous to the Lungs, and in the blacke stinking

fume thereof, neerest resembling the horrible Stigian smoke of the pit that is

bottomlesse" (as quoted in Sullum, 1998, p. 18). King James subsequently

raised the tax on tobacco by 1000%, deriving significant revenues for his

coffers. This illustrates the profound dilemma that has confronted policy

decision makers ever since: whatever its health consequences, tobacco has

long been truly a "golden leaf" for farmers and politicians alike. Its role

in the very earliest commerce between England and the American colonies is

legendary, as is its role in contemporary politics (Taylor, 1984; Fritschler

and Hoefler, 1996).

Economics of Smoking - p. 6

this period and of the relatively modest number of victims claimed by tobacco

prior to the 20th century. Before this century, relatively few people reached

the ages at which tobacco takes its greatest toll (average life expectancy in

the U.S. was 47 in 1900; currently it is 75). More importantly, widespread

intensive use of the most dangerous form of tobacco consumption, cigarette

smoking, began only in the very late 1800s. Lung cancer, today the source of

30% of all cancer deaths in the U.S. (U.S. Department of Health and Human

Services, 1989), was a rarity until earlier cigarette smoking spawned the

epidemic first widely observed during the 1930s.

Although a few scientific studies associated smoking with disease prior

to mid-century (Broders, 1920; Lombard and Doering, 1928; Pearl, 1938), the

first evidence that strongly implicated smoking in disease (specifically, lung

cancer) was published in the 1950s (Wynder and Graham, 1950; Doll and Hill,

1954, 1956; Hammond and Horn, 1958a, 1958b). Since then, some 70,000

scientific articles have implicated smoking in a wide variety of ailments,

constituting the largest and best documented literature linking any behavior

to disease in humans (U.S. Department of Health and Human Services, 1994).

Today, cigarette smoking is esta blished as the leading cause of lung

cancer (responsible for approximately 90% of lung cancer deaths in the U.S.),

the leading cause of chronic bronchitis and emphysema (responsible for over

80% of chronic obstructive pulmonary disease deaths), and a major cause of

heart disease and stroke. Smoking also causes aneurysms, atherosclerotic

peripheral vascular disease, oral cavity and laryngeal cancer, intrauterine

growth retardation and neonatal death, including SIDS (Sudden Infant Death

Syndrome). It is associated with additional cancers (bladder, pancreatic,

renal, gastric, and cervical) (U.S. Department of Health and Human Services,

1989), as well as a host of other conditions affecting a wide variety of organ

systems and disease processes, including, for example, vision and hearing

problems, slowed healing from injuries, and increased susceptibility to

certain infections (Napier, 1996). Chronic inhalation of environmental

Economics of Smoking - p. 7

tobacco smoke (ETS) causes lung cancer in nonsmokers and an assortment of

diseases and functional limitations in the children of smokers (Environmental

Protection Agency, 1994). ETS may be responsible for tens of thousands of

heart disease deaths annually ( Glantz and Parmley, 1995).

All told, smoking is far and away the leading cause of premature death

and of avoidable morbidity and disability in the United States and in most

industrialized nations. As indicated above, the intensification of smoking in

the world's less affluent nations will soon bring the same distinction to

smoking in the developing countries. Barring substantial and unexpected

decreases in tobacco use worldwide, a few decades hence the global death toll

from tobacco will dwarf all other causes, with the majority of deaths

occurring in the developing nations. The World Health Organization estimates

that fully 500 million of the 5 billion people alive at the beginning of this

decade will die as a result of consumption of tobacco products ( Peto et al.,

forthcoming).

The mortality toll of tobacco reflects not only the le thality of tobacco

products but also the prevalence of their consumption. In the United States,

approximately 45 million adults, almost a quarter of the adult population,

smoke cigarettes (down from a high of 42% in 1965 (U.S. Department of Health

and Human Services, 1989)). Worldwide, tobacco products are used by

approximately one billion people. The large numbers of tobacco consumers,

combined with their frequent use of tobacco products, account not only for the

disease toll of tobacco, but also for the substantial size of the tobacco

industry. Important features of the structure and economic importance of the

industry are reviewed in section 6 below.

2. The impact of price on the demand for tobacco products

Many researchers once viewed cigarette smo king and other addictive

behaviors as irrational and therefore not suitable for conventional economic

analysis (Elster, 1979; Winston, 1980; Schelling, 1984b). They believed that

Economics of Smoking - p. 8

the demand for cigarettes (and other addictive substances) did not follow the

basic laws of economics, including perhaps the most fundamental law, that

embodied in the downward-sloping demand curve. As the now-substantial body of

economic research demonstrates, however, the demand for cigarettes clearly

responds to changes in prices and other factors, as found in applications of

both traditional models of demand and more recent studies that explicitly

account for the addictive nature of smoking.

Conceptually, economists use a relatively broad definition of price that

includes not only the monetary price of purchasing a product, but also the

time and other costs associated with using the product. Restrictions on

smoking in public places and private work sites, for example, impose

additional costs on smokers by forcing them outdoors to smoke, raising the

time and discomfort associated with smoking, or by imposing fines for smoking

in restricted areas. Similarly, limits on youth access to tobacco may raise

the time and potential legal costs associated with smoking by minors, while

new information on the health consequences of tobacco use can raise the

perceived long-term costs of smoking. This section focuses on the effects of

monetary price on demand, while section 5 below considers the effects of other

aspects of full price.

In addition to price, a variety of other factors can affect the demands

for cigarettes and other tobacco products, including income, advertising and

other promotional activities, and tastes. In the industrialized nations, the

relationship between income and cigarette consumption has reversed. Early

demand studies (for example, Ippolito, et al., 1979; Fujii, 1980) concluded

that cigarette smoking was a normal good, with cigarette consumption rising as

income rose. More recent studies, however, have found that cigarettes have

become an inferior good, in that the likelihood of smoking declines as income

rises (Wasserman, et al., 1991; Townsend et al., 1994). The effects of

advertising and promotion on the demand for cigarettes have been the subject

of numerous studies; these are reviewed in detail in section 4 below.

Economics of Smoking - p. 9

Finally, nearly all econometric studies of cigarette demand use a variety of

factors to control for tastes, including gender, race, education, marital

status, employment status, and religiosity. Given the focus of this book on

economics, the impact of these socio-demographic determinants of demand will

not be reviewed.4

This section begins with a review of conventional studies of the impact

of money price on cigarette demand. This is followed by a discussion of

economic models of addiction and their applications to cigarette demand.

Implications for the effects of price on cigarette demand from the relatively

new field of behavioral economics are then reviewed. The section closes with

a short consideration of the relatively limited research on the effects of

price on the demand for other tobacco products.

2.1 Conventional studies of cigarette demand

Numerous investigators have estimated the effects of price on cigarette

demand using conventional models of demand that do not account for the

addictive nature of cigarette smoking. Their studies have used diverse

econometric and other statistical methods on data from numerous countries.

Many used aggregate time-series data for a single geographical unit, while

others employed pooled cross-sectional time series data; still others used

individual level data taken from surveys. The price elasticity estimates for

overall cigarette demand from recent studies fall within the relatively wide

range from -0.14 to -1.23, but most fall in the narrower range from -0.3 to -

0.5.

4 The importance of these variables should not be downplayed, however. In

many instances, these and other variables, such as parental and peer smoking

behavior and societal norms, are as important or more important than the

variables which economists have studied (U.S. Department of Health and Human

Services, 1994). Variations in these and other variables help to explain why

large variations in prices across countries are often not associated with

comparably large variations in smoking prevalence. Economists' interests

focus on the marginal impact of price, advertising, and other economic

variables on the demand for cigarettes.

Economics of Smoking - p. 10

2.1.1 Analysis of aggregate data

Many recent studies use aggregate data and appropriate econometric

methods to examine the effects of price on cigarette demand, controlling for

income, tobacco control policies, and a variety of socioeconomic and

demographic factors. The exceptions ( Baltagi and Goel, 1987; Peterson et al.,

1992) compared changes in cigarette consumption in states that had raised

cigarette taxes to consumption in states where taxes had not changed. The

estimated price elasticities from these quasi-experimental studies, in the

range from -0.17 to -0.56, are consistent with those obtained from the

econometric studies.

Although there are numerous studies of the price-de mand relationship in

industrialized nations, until recently there were almost no estimates for

developing countries. Warner (1990) argued that price responsiveness in less

developed countries is likely to be greater than in more affluent countries,

given the relatively low incomes and relatively low levels of cigarette

consumption by smokers in the poorer countries. Findings from studies using

data from Papua New Guinea (Chapman and Richardson, 1990), China (Mao, 1996;

Xu, Hu and Keeler, 1998) South Africa (van der Merwe, 1998a), Zimbabwe

(Maranvanyika, 1998), and Taiwan (Hsieh and Hu, 1997) are consistent with this

argument.

Several difficulties are encountered in studies using time-series data.

Particularly troubling are the high correlations among many of the key

independent variables and price. Consequently, estimates of the impact of

price and other factors on demand can be sensitive to the inclusion and

exclusion of other variables. Including highly correlated variables can

result in multicollinearity and unstable estimates for the parameters of

interest. Excluding potentially important variables, however, can produce

biased estimates of the impact of price on demand. Recent studies using

state-of-the-art econometric methods have addressed many of these difficulties

(Seldon and Boyd, 1991; Simonich, 1991; Flewelling et al., 1992; Sung et al.,

Economics of Smoking - p. 11

1994; Barnett et al, 1995; Keeler et al., 1996). Nearly all of the estimates

from these studies have produced estimates for the price elasticity of demand

in a relatively narrow range, centered on -0.4.

Other problems are encountered when using pooled cross-sectional timeseries

data. The measure of cigarette smoking employed in these studies is

typically annual state-level tax-paid cigarette sales. Interstate differences

in cigarette prices, resulting from wide variation in state cigarette taxes

(Tobacco Institute, 1998), can lead to casual and organized smuggling of

cigarettes from low-tax to high-tax states, however (Advisory Commission on

Intergovernmental Relations (ACIR), 1977, 1985). As such, tax-paid sales data

are likely to overstate cigarette consumption in states with low cigarette

taxes and underestimate it in high tax states. 5 Failing to account for this

will produce upward-biased estimates of the impact of price on cigarette

demand. Many of the more recent studies employing pooled time-series crosssectional

state data have controlled for the potential for smuggling (ACIR,

1977, 1985; Baltagi and Levin, 1986; Chaloupka and Saffer, 1992; Keeler et

al., 1996). These studies have also produced estimates of the price

elasticity of cigarette demand generally falling in a relatively narrow range

centered on -0.4.

The fact that cigarette prices, sales, and consumption are

simultaneously determined creates an additional complication in the analysis

of cigarette demand and supply. Failing to account for this simultaneity

would lead to biased estimates of the price elasticity of demand. Again, many

of the recent studies employing aggregate time-series data for a single

country or other geographical unit, as well as many of those using pooled

cross-sectional time-series data, have avoided this problem by theoretically

and empirically modeling cigarette demand and supply (Bishop and Yoo, 1985;

5 The same problem exists in time-series studies using aggregate countrylevel

data for countries with relatively high taxes and prices compared to

neighboring countries. See Joossens (1998) for a discussion of factors other

than price that influence smuggling across country borders.

Economics of Smoking - p. 12

Porter, 1986; Showalter, 1991; Sung et al., 1994; Barnett et al., 1995;

Tremblay and Tremblay, 1995; and Keeler et al., 1996). Other studies have

taken advantage of natural experiments, most notably 25-cent increases in the

California and Massachusetts cigarette excise taxes, to look at the impact of

price on demand (Keeler et al., 1993; Hu et al., 1994, 1995b; Sung et al.,

1994; Harris et al., 1996). After accounting for the potential simultaneity

or taking advantage of natural experiments, most of these studies produce

estimates of the price elasticity of demand that fall into the same narrow

range found in other studies.

Finally, studies employing aggregate data are generally limited to

examining the impact of cigarette prices and other factors on aggregate or per

capita measures of cigarette consumption. Consequently, these studies are

typically unable to evaluate the differential impact of prices on smoking by

various population subgroups of particular interest, especially youth and

young adults. Nor can they differentiate between the impact of price on

smoking prevalence and quantity, or smoking initiation and cessation.

A few recent analyses have attempted to address these limitations. For

example, Harris (1994) used annual time-series data on U.S. smoking prevalence

taken from the National Health Interview Surveys, coupled with aggregate

measures of cigarette consumption, to estimate the effects of price on smoking

prevalence and average cigarette consumption by smokers for the period from

1964 through 1993. His estimate of the unconditional price elasticity of

demand fell into the same narrow range generally found in other studies. He

estimated that approximately half of the impact of price was on smoking

prevalence, with the price elasticity of smoking participation being -0.238,

while the unconditional price elasticity of demand was -0.47. Townsend et al.

(1994) looked at the differential effects of price on cigarette smoking for

various population subgroups defined by age, gender, and socioeconomic status,

using data aggregated from the 1972 through 1990 British General Household

Surveys. They concluded that women were more responsive to price than men,

Economics of Smoking - p. 13

that both men and women in lower socioeconomic groups were more sensitive to

price than those that were better off, and that youth (16-19 years) and young

adults (20-24 years) were less responsive to price than adults. 6

2.1.2 Analysis of individual level data

A relatively small but growing number of cigarette demand studies have

used data on individuals taken from large-scale surveys. In general, their

estimated price elasticities of demand are comparable to those estimated using

aggregate data. The use of individual-level data helps avoid some of the

problems inherent in using aggregate data. For example, because an

individual's smoking decisions are too small to affect the market price of

cigarettes, potential simultaneity biases are less likely. Similarly,

individual-level income data and measures of socio-demographic determinants of

demand are less correlated with price and policy variables than comparable

aggregate measures.

Other problems persist but can be addressed somewhat more easily using

individual-level data. For example, failing to account for interstate

differences in cigarette prices will again produce a biased estimate of the

price elasticity of demand (biased towards 0 in this case). Thus, given

information on where an individual resides, studies using individual-level

data have employed a variety of approaches to control for potential crossborder

shopping in response to interstate price differentials. Some have

limited their samples to individuals who do not live near lower-price

localities (Lewit and Coate, 1982; Wasserman et al., 1991; Chaloupka and

Grossman, 1996; Chaloupka and Wechsler, 1997). Others have included a measure

of the price differential (Lewit et al., 1981; Chaloupka and Pacula, 1998a,

1998b). Still others have used a weighted average price based on the price in

6 As we discuss below, other studies have derived the opposite conclusions

concerning the relative price responsiveness by gender (e.g., Lewit and Coate,

1982; Mullahy, 1985; Chaloupka, 1990) and different age groups (e.g. Lewit, et

al., 1981; Chaloupka and Grossman, 1996).

Economics of Smoking - p. 14

the own-locality and other nearby localities (Chaloupka, 1991).

As with the state tax-paid sales data, self-reported data on cigarette

smoking yield inaccurate measures of true consumption, given potential

reporting biases. Based on a comparison of self-reported consumption with

aggregate sales data, Warner (1978) demonstrated that survey-based selfreported

consumption significantly and substantially understated actual sales.

Studies using individual-level survey data have implicitly treated

underreporting as proportional to true consumption across groups of interest

(e.g., age, gender, or socioeconomic groups). If the assumption is true,

estimates of the price elasticity of demand will not be systematically biased.

The assumption has yet to be demonstrated, however.

Finally, as Wasserman et al. (1991) observed, studies using individuallevel

data may be subject to a substantial ecological bias in that omitted

variables affecting tobacco use may be correlated with the included

determinants of demand. Failing to account for this can produce biased

estimates for the included variables. For example, unobserved sentiment

against smoking may affect both cigarette sales and the strength of tobacco

control policies (including taxes and, consequently, prices). Ohsfeldt et al.

(1998) considered this possibility in their analysis of cigarette smoking and

other tobacco use that employed data from the 1992/93 Current Population

Survey Tobacco Use Supplements. Surprisingly, after modeling cigarette taxes

and other tobacco control policies as a function of cigarette smoking, various

other indicators of sentiment against smoking, and other factors, they found

that taxes have a larger impact on demand.

Using individual-level data allows researchers to examine issues that

generally cannot be addressed with aggregate data. For example, most studies

using individual-level data separately consider the effects of price on the

probability of smoking and on average cigarette consumption by smokers. In

addition, several consider the differential effects of price on demand for

various population subgroups (defined by age or gender, for example).

Economics of Smoking - p. 15

Finally, some have taken advantage of retrospective or longitudinal data to

examine the effects of prices and other factors on smoking initiation and

cessation decisions.

The earliest of the cigarette demand studies employing individual-level

data were conducted by Lewit and his colleagues (Lewit et al., 1981; Lewit and

Coate, 1982). Lewit and Coate used data from the 1976 National Health

Interview Survey to examine the effects of price on cigarette smoking,

estimating an overall price elasticity of demand of -0.42 and an elasticity of

smoking participation of -0.26. In addition, they found an inverse

relationship between (the absolute value of) price elasticity and age,

estimating a total price elasticity of demand for 20 through 25 year-olds more

than double that of persons 26 and older. The researchers found that most of

the effect of price for young adults was on the decision to smoke

(participation elasticity of -0.74 and conditional demand elasticity of -

0.20), but was about evenly split for those over 35 years of age

(participation and conditional demand elasticities of -0.15). Finally, they

also looked at differences in price responsiveness by gender, concluding that

men, particularly young men, were very responsive to price, while women were

generally insensitive to price.

Lewit et al. (1981) and Grossman et al. (1983) confirmed the Lewit and

Coate (1982) conclusion concerning the inverse relationship between price

elasticity of cigarette demand and age. Using data from Cycle III of the

Health Examination Survey, Lewit et al. estimated that the price elasticity of

smoking participation for 12-17 year-olds was -1.20, while the conditional

demand elasticity was -0.25. Their estimated total price elasticity of youth

cigarette demand of -1.44 was more than three times Lewit and Coate's (1982)

estimate for adults. These conclusions were generally supported by Grossman

et al.'s (1983) analysis of data from the National Household Surveys on Drug

Use conducted during the 1970s.

Lewit et al. (1981) offered two reasons why youth should be more price

Economics of Smoking - p. 16

sensitive than adults, at least in the short run. First, given the addictive

nature of smoking, long-term adult smokers are likely to adjust less quickly

to changes in price than youth who have been smoking for a relatively short

time, if at all. In addition, peer behavior is likely to be much more

influential for youth, multiplying the effects of price on youth smoking.

That is, an increase in cigarette price directly reduces youth smoking and

then again indirectly reduces it through its impact on peer smoking. Grossman

and Chaloupka (1997) offered two additional reasons. First, the fraction of

disposable income a young smoker spends on cigarettes is likely to exceed that

spent by an adult smoker. Second, compared to adults, youth are more likely

to be present-oriented. In the context of an economic model of addictive

behavior (discussed below), Becker et al. (1991) predicted that changes in

money price will have a greater impact on individuals with higher discount

rates since they give less weight to the future consequences of addictive

consumption.

The conclusion that youth cigarette demand is more price elastic than

adult demand was widely accepted until an influential 1991 Rand study by

Wasserman and colleagues (1991). These researchers evaluated adults'

cigarette demand using data from several of the National Health Interview

Surveys from the 1970s and 1980s and youth demand with data from the Second

National Health and Nutrition Examination Survey of the late-1970s. Using a

generalized linear model, the authors concluded that adult demand in the

earlier years of their data was relatively unresponsive to price, but that

demand had become more price elastic over time. Based on the trends in price

elasticity, they predicted an overall price elasticity of adult cigarette

demand of -0.283 for 1988. Estimates from a two-part model of adult cigarette

demand implied that the effects of price on the decision to smoke were almost

double the impact of price on conditional demand. However, the authors did

not find a statistically significant impact of price on youth smoking. They

attributed their relatively low estimates of price elasticity, particularly

Economics of Smoking - p. 17

those for youth, to the inclusion in their models of an index of restrictions

on smoking. These restrictions, which they note are positively correlated

with price, had not been included in most previous studies of cigarette

demand. Indeed, they obtained very similar estimates to Lewit and Coate

(1982) when leaving the restriction index out of models estimated using the

1976 survey data.

Several more recent studies of youth and young adult smoking have

supported the earlier conclusions reached by Lewit and his colleagues (Lewit

et al., 1981; Lewit and Coate, 1982; Grossman et al., 1983) that the price

sensitivity of cigarette demand is inversely related to age. Chaloupka and

Grossman (1996) examined the impact of price, numerous tobacco control

policies (including smoking restrictions and limits on youth access to

tobacco), and a variety of other socioeconomic and demographic factors on

youth smoking, using data from the 1992, 1993, and 1994 Monitoring the Future

Surveys of eighth, tenth, and twelfth grade students. They estimated a total

price elasticity of youth cigarette demand of -1.31, strikingly similar to the

estimates obtained by Lewit et al. (1981) 15 years earlier. In contrast to

Lewit and his colleagues, however, Chaloupka and Grossman found that the

effects of price on smoking participation and conditional demand were similar

(-0.68 for smoking participation and -0.64 for conditional demand). Chaloupka

and Pacula (1998b) used the same data to look at the differential response by

gender and race, concluding that young men and young blacks are more

responsive to price than young women and young whites.

Chaloupka and Wechsler (1997) reached similar conclusions using data on

young adult smoking taken from the 1993 College Alcohol Survey. Also

controlling for numerous other determinants of cigarette demand, including a

variety of restrictions on smoking, they estimated a price elasticity of

smoking participation of -0.53 and an unconditional price elasticity of demand

of -1.11 for college students. Noting that their sample was not a random

sample of all young adults, Chaloupka and Wechsler suggested that the price

Economics of Smoking - p. 18

elasticity of cigarette demand by young adults may be even higher, given the

evidence that cigarette demand is relatively less elastic for more educated or

higher-income individuals (Townsend, 1987; Chaloupka, 1991; Townsend et al.,

1994; Farrelly et al., 1998).

Farrelly and his colleagues (1998) found similar evidence for young

adults and adults, based on 13 waves of the National Health Interview Survey

conducted between 1976 and 1992. They estimated that demand was more than

twice as elastic for their sample of young adults, ages 18 to 24 years (total

elasticity of -0.58), as for their full sample (total elasticity of -0.25).

Similarly, they estimated that blacks were about twice as responsive as whites

to cigarette prices, while Hispanics were even more price sensitive. In

addition, they found that men were more price sensitive than women. Finally,

they estimated that individuals with family incomes below the sample median

were about 70 percent more responsive to price than those with higher family

incomes.

Additional support for the inverse relationship between price

sensitivity and age is provided by recent studies by Lewit and his colleagues

(1997), Evans and Huang (1998), and Tauras and Chaloupka (1998). Lewit and

his colleagues used data for ninth grade students in 1990 and 1992 collected

in the 22 North American communities involved in the National Cancer

Institute's Community Intervention Trial for Smoking Cessation (COMMIT). They

found that both youth smoking participation and intentions to smoke among

young non-smokers were inversely related to price, with estimated price

elasticities of -0.87 and -0.95, respectively. Evans and Huang used state

level aggregated data on smoking prevalence constructed from the 1977 through

1992 Monitoring the Future surveys to estimate a price elasticity of youth

smoking participation of -0.20. Unlike other studies on youth smoking that

largely rely on the cross-sectional variation in state cigarette taxes and

prices, Evans and Huang took advantage of the long time period covered by

their data and used the time series variation in state cigarette taxes to

Economics of Smoking - p. 19

identify the impact of cigarette taxes on smoking participation. While their

estimated elasticity for the 1977 through 1992 period is relatively low, Evans

and Huang concluded that youth smoking has become more price sensitive over

time, estimating an elasticity of -0.50 for youth smoking participation in the

period from 1985 through 1992. Most recently, Tauras and Chaloupka (1998)

used the longitudinal data from the Monitoring the Future surveys of high

school seniors conducted from 1976 through 1993 to estimate the price

elasticity of smoking for young adults; respondents in their sample ranged in

age from 17 to 35 years. In models controlling for unobserved state and

individual factors affecting demand, they estimated an overall price

elasticity of demand centered on -0.79.

In general, researchers examining the effects of price on smoking

participation using individual-level data from cross-sectional surveys have

assumed that much of the price effect estimated for youth reflects the impact

of price on smoking initiation, while the estimate for adults is largely

capturing the effects of price on smoking cessation. A few recent studies

have attempted to directly examine the impact of cigarette prices on smoking

initiation. With retrospective data from the smoking supplements to the 1978

and 1979 National Health Interview Surveys, Douglas and Hariharan (1994)

studied the ages at which survey respondents reported that they began smoking.

Based on current state of residence, they matched data on cigarette prices to

the survey data to estimate the impact of price on smoking initiation. They

estimated a hazard model in which "failure" was defined as a never smoker

taking up smoking and used a relatively general variation on standard duration

methods: the split population duration model developed by Schmidt and Witte

(1989). This model allows for a large part of their sample to never begin

smoking. Finally, Douglas and Hariharan's theoretical and empirical framework

was based on the Becker and Murphy (1988) rational addiction model (described

below). As anticipated, Douglas and Hariharan found that a number of

socioeconomic and demographic factors had a significant effect on smoking

Economics of Smoking - p. 20

initiation. However, their estimates for cigarette prices were insignificant.

Given the errors-in-variables problem associated with both the retrospective

data on smoking initiation and the cigarette price data, they noted that price

effects will be biased towards zero. Nevertheless, they found no evidence

that higher cigarette prices reduced smoking initiation.

Douglas (1998) extended this work by estimating a time-varying covariate

model that allows the hazard of smoking initiation to respond dynamically to

changes in prices and other factors. In addition to initiation, Douglas also

estimated the hazard of smoking cessation in a similar empirical framework, as

well as estimating the impact of smoking regulations and information on

initiation and cessation (these findings are discussed later). Using data

from the cancer risk factor supplement to the 1987 National Health Interview

Survey, Douglas again concluded that cigarette price has little impact on

smoking initiation. As with the earlier analysis, however, there are likely

to be errors-in-variables problems that could account for this finding.

DeCicca et al. (1998a) employed data from the National Education

Longitudinal Survey of 1988 to examine the impact of price on initiation of

daily smoking. This data set contains data on youth smoking at several points

in time (eighth, tenth, and twelfth grades). Treating the three waves as

independent cross-sections, they obtained estimates of the price elasticity of

youth smoking participation comparable to other recent estimates. In an

effort to examine the impact of price on smoking initiation, they attempted to

exploit the longitudinal aspect of their data by looking at the probability of

smoking in twelfth grade for a sample that excluded those who were smokers in

eighth grade. Their estimates for the effect of cigarette taxes on the

probability of starting to smoke between the eighth and twelfth grade are not

statistically significantly different from zero, supporting the findings of

Douglas and Hariharan (1994) and Douglas (1998) that raised doubts about the

hypothesis that higher cigarette prices lead to significant reductions in

youth smoking. DeCicca et al. attributed the inconsistency in their two sets

Economics of Smoking - p. 21

of results to the possibility that cigarette tax rates are a proxy for

unobserved sentiment against cigarette smoking. If true, then estimates based

on cross-sectional studies are likely to significantly overstate the impact of

price on smoking.

Dee and Evans (1998) reexamined the longitudinal data used by DeCicca et

al., arguing that their finding that price has no impact on smoking initiation

was largely the result of the way in which their sample was constructed. In

particular, rather than following DeCicca et al. in deleting the large number

of observations with missing values for key independent variables (including

income, parental education, and number of siblings), Dee and Evans included

these along with dummy variables indicating observations for which the data

are missing. In addition, they included a variety of binary indicators for

categorically collected data, rather than constructing "continuous" measures

from these data as did DeCicca et al. (e.g. parental and family attributes).

After making these changes but otherwise following the same basic approach,

Dee and Evans estimated a negative and significant impact of cigarette taxes

on smoking initiation. Their estimated price elasticity of smoking onset is -

0.63, consistent with several other recent studies of youth smoking employing

cross-sectional data.

In response to Dee and Evans (1998), DeCicca and his colleagues (1998b)

conducted a reanalysis of the NELS data that used an alternative approach for

dealing with the missing data problem. Where possible, they used information

from the longitudinal sample to fill in missing values; when this could not be

done, they used a conditional mean imputation approach. Their reanalysis

produced somewhat more significant estimates for the effect of cigarette taxes

on the onset of daily smoking, with implied price elasticities from

alternative specifications ranging from -0.025 to -0.505; somewhat smaller,

less significant estimates were obtained from models using price rather than

tax. In addition, their estimates for samples based on race/ethnicity implied

that higher cigarette taxes significantly reduced smoking onset among

Economics of Smoking - p. 22

Hispanics, but had little impact on whites and blacks.

Clearly, the use of longitudinal data to examine the impact of cigarette

tax and price changes on smoking initiation and cessation is an important

advance. The findings from studies using relatively longer panels that

control for unobserved state and/or individual factors affecting demand (i.e.

Evans and Huang, 1998; Tauras and Chaloupka, 1998) are consistent with the

findings that price sensitivity is inversely related to age, as found in

several earlier studies based on cross-sectional data. The inconsistent

findings from a few recent studies ( DeCicca et al., 1998a, 1998b; Dee and

Evans, 1998) directly addressing the effects of price on smoking initiation

with a relatively short panel should be viewed with caution.

Hu et al. (1995a) introduced an innovation in cigarette demand

estimation, using data from California's Behavioral Risk Factor Surveys for

1985 through 1991 to examine the possible effects on adult smoking of the

interdependence of cigarette smoking with other risk factors, including

alcohol use and obesity. Estimates of the smoking participation elasticity

from models that included other behavioral risk factors were significantly

lower than when these factors were ignored, while conditional demand

elasticities were generally unaffected. Using two-part methods, Hu et al.

estimated an overall price elasticity of -0.46 from the models that included

other risks, with the effects of price about equally divided between smoking

participation and conditional demand. The authors noted, however, that their

estimate of the price elasticity might be relatively high given that they did

not control for other tobacco control efforts.

Evans and Farrelly (forthcoming) recently examined a phenomenon not

previously studied by economists. Using data from the 1979 Smoking Supplement

and the 1987 Cancer Control Supplement to the National Health Interview

Surveys, the authors investigated the compensating behavior by smokers in

response to tax and price changes. The supplements contain unique information

on smokers' choices of types of cigarettes, which Evans and Farrelly combined

Economics of Smoking - p. 23

with data from the Federal Trade Commission on the tar and nicotine content of

cigarette brands to construct a variety of measures of daily smoking intensity

(including cigarette consumption, total length of cigarettes consumed, tar

intake, and nicotine intake). They also constructed comparable aggregate

measures for 1964-1993 from the data used by Harris (1994) on aggregate

smoking prevalence and cigarette consumption. They found consistent evidence

that, although smokers reduced daily cigarette consumption in response to

higher taxes, they also compensated in several ways. In particular, smokers

in high-tax states consumed longer cigarettes and those that are higher in tar

and nicotine, with young adults smokers also most likely to engage in this

compensating behavior. As a result, they argued that the perceived health

benefits associated with higher cigarette taxes are likely to be somewhat

overstated. Given this compensating behavior, Evans and Farrelly suggest that

if cigarette taxes are to be used to reduce the health consequences of

smoking, then taxes based on tar and nicotine content would be appropriate, an

idea first suggested by Harris (1980).

2.2 Addiction models and cigarette demand

The first discussion by an economist of the effects of addiction on

demand can be found in Marshall's (1920) Principles of Economics, where he

observed that

Whether a commodity conforms to the law of diminishing or increasing

return, the increase in consumption arising from a fall in price is

gradual; and, further, habits which have once grown up around the use of

a commodity while its price is low are not so quickly abandoned when its

price rises again. (Appendix H, section 3, page 807)

As Phlips (1983) noted, Marshall's statement clearly introduced the three

basic dimensions of addiction (U.S. Department of Health and Human Services,

1988) of gradual adaptation (tolerance), irreversibility (withdrawal), and

positive effects of habits (reinforcement) that are used in many of the more

recent formal models of addictive behavior. Until recently, however,

economists have either ignored the addictive nature of goods such as

Economics of Smoking - p. 24

cigarettes when estimating demand or have assumed that behaviors such as

smoking were irrational and could not be analyzed in the rational, constrained

utility maximizing framework of economics.

Many of the most recent studies of cigarette demand explicitly address

the addictive nature of cigarette smoking. Economic models of addiction can

be divided into three basic groups: imperfectly rational models of addictive

behavior, models of myopic addictive behavior, and models of rational

addictive behavior.

2.2.1 Imperfectly rational addiction models

Elster (1979), McKenzie (1979), Winston (1980), and Schelling (1978,

1980, 1984a, 1984b) best exemplify the economic models of imperfectly rational

addictive behavior. These models generally assume stable but inconsistent

short-run and long-run preferences. This is seen, for example, in Schelling's

(1978) description of a smoker trying to "kick the habit":

Everybody behaves like two people, one who wants clean lungs and long

life and another who adores tobacco.... The two are in a continual

contest for control; the "straight" one often in command most of the

time, but the wayward one needing only to get occasional control to

spoil the other's best laid plan. (p. 290)

Thus, the farsighted personality may enroll in a smoking cessation program,

only to be undone by the shortsighted personality's relapse in a weak moment.

Winston (1980) formally modeled this behavior and described how this contest

between personalities leads to the evolution of what he called "anti-markets,"

which he defined as firms or institutions that individuals will pay to help

them stop consuming.

Strotz (1956) was the first to develop a formal model of such behavior,

describing the constrained utility maximization process as one in which an

individual chooses a future consumption path that maximizes current utility,

but later in life changes this plan "even though his original expectations of

future desires and means of consumption are verified" (p. 165). This

inconsistency between current and future preferences only arises when a nonEconomics

of Smoking - p. 25

exponential discount function is used. 7 Strotz went on to suggest that

rational persons will recognize this inconsistency and plan accordingly, by

pre-committing their future behavior or by modifying consumption plans to be

consistent with future preferences when unable to pre-commit. Pollak (1968)

went one step further, arguing that an individual may behave naively even when

using an exponential discount function. Thaler and Shefrin (1981) described

the problem similarly, referring to an individual at any point in time as both

a "farsighted planner and a myopic doer" (p. 392), with the two in continual

conflict. While these models present interesting discussions of some aspects

of addictive behavior, they have not been applied empirically to cigarette

smoking or other addictions.

2.2.2 Myopic addiction models

The naive behavior described in some of the imperfectly rational models

of addiction is the basis for many of the myopic models of addictive behavior.

As Pollak (1975) observed, behavior is naive in the sense that an individual

recognizes the dependence of current addictive consumption decisions on past

consumption, but then ignores the impact of current and past choices on future

consumption decisions when making current choices. Many of these models

treat preferences as endogenous, allowing tastes to change over time in

response to past consumption (Gorman, 1967; Pollak, 1970, 1976, 1978; von

Weizsacker, 1971; Hammond, 1976a, 1976b; El- Safty, 1976a, 1976b).

These models are similar in spirit to those in which tastes change in

response to factors other than past consumption, including advertising ( Dixit

and Norman, 1978; Galbraith, 1958, 1972) and prices ( Pollak, 1977). Others

allow past consumption to affect current consumption through an accumulated

stock of past consumption (e.g., Houthakker and Taylor, 1966, 1970). These

models are comparable to those of the demand for durable consumer goods that

7 Vuchinich and Simpson (1998) provided an interesting application of this

idea to the demand for alcoholic beverages, comparing behavior under

hyperbolic versus exponential discounting.

Economics of Smoking - p. 26

use a stock adjustment process ( e.g, Chow's (1960) model of the demand for

automobiles, and Garcia dos Santos' (1972) analysis of the demands for

household durables). As Phlips (1983) noted, however, the distinction between

models with endogenous tastes and those with stable preferences within a

household production framework is purely semantic, since the underlying

mathematics of the two are the same.

The earliest theoretical models of demand in the context of myopic

addiction can be traced to the irreversible demand models ( Haavelmo, 1944;

Duesenberry, 1949; Modigliani, 1949; Farrell, 1952). Farrell, for example,

described an irreversible demand function as one in which current demand

depends on all past price and income combinations. As a result, price and

income elasticities are constant, but may differ for increases and decreases

in price and income. Farrell tested this model empirically, using U.K. data

on the demands for tobacco and beer from 1870 through 1938, in a model that

included not only current price and income, but also price, income, and

consumption in the prior year. In general, his estimates were inconclusive,

although he did find limited evidence of habit formation for tobacco use.

The notion of asymmetric responses to price and income reappeared in

Scitovsky (1976) and was applied to cigarette demand by Young (1983) and

Pekurinen (1989), using data from the U.S. and Finland, respectively. Both

found that smoking was almost twice as responsive to price reductions as it

was to price increases, which they interpreted as evidence of addiction.

Most empirical applications of myopic models of addiction are based on

the pioneering work by Houthakker and Taylor (1966, 1970) that formally

introduced the dependence of current consumption on past consumption by

modeling current demand as a function of a "stock of habits" representing the

depreciated sum of all past consumption. Houthakker and Taylor estimated

demand functions for a variety of goods, including cigarettes, using annual

aggregates for the U.S. and several Western European countries. Their

estimates provided considerable support for their hypothesis of habit

Economics of Smoking - p. 27

formation in demand for almost all of the non-durable consumer goods they

examined, including cigarettes.

Mullahy (1985) took a similar approach in his empirical examination of

cigarette demand using individual level data from the 1979 National Health

Interview Survey. In his model, the stock of past cigarette consumption has a

negative impact on the production of commodities such as health and the

satisfaction received from current smoking. Mullahy used a two-part model to

estimate cigarette demand, as well as instrumental variables methods to

account for the unobserved individual heterogeneity likely to be correlated

with the stock of past consumption. Mullahy found strong support for the

hypothesis that cigarette smoking is an addictive behavior, as shown by the

positive and significant estimates he obtained for the addictive stock in both

the smoking participation and conditional demand equations. His estimates for

price are quite similar to those obtained by Lewit and Coate (1982), with the

overall price elasticity of demand centered on -0.47. In addition, Mullahy

estimated that men were more price responsive than women (total price

elasticities of -0.56 and -0.39, respectively). Finally, using an interaction

between the addictive stock and price, Mullahy concluded that more-addicted

smokers (defined as those with a larger addictive stock) were less responsive

to price than their less-addicted counterparts. Other approaches to

estimating myopic demand models have similarly concluded that cigarette

smoking is an addictive behavior and that price has a significant impact on

cigarette demand (e.g. Jones, 1989; Baltagi and Levin, 1986).

2.2.3 Rational addiction models

Several researchers have modeled addiction as a rational behavior. In

this context, rationality simply implies that individuals incorporate the

interdependence between past, current, and future consumption into their

utility maximization process. This is in contrast to the assumption, implicit

in myopic models of addictive behavior, that future implications are ignored

Economics of Smoking - p. 28

when making current decisions. In other words, myopic behavior implies an

infinite discounting of the future, while rational behavior implies that

future implications are considered, while not ruling out a relatively high

discount rate. Several of the rational addiction models, including those of

Lluch (1974), Spinnewyn (1981), and Boyer (1983), assume that tastes are

endogenous. These models build on the significant contributions of Ryder and

Heal (1973), Boyer (1978), and others in the optimal growth literature who

have developed endogenous taste models with rational behavior. Spinnewyn

(1981) and Phlips and Spinnewyn (1982) argued that incorporating rational

decision making into models of habit formation results in models that are

"formally equivalent to models without habit formation" ( Spinnewyn, 1981, p.

92). Thus, they argue, assuming rationality only leads to unnecessary

complications.

This assertion was challenged by Pashardes (1986) who derived demand

equations for a rational consumer in which current consumption is determined

by past consumption and current preferences with full knowledge about the

impact of current decisions on the future costs of consumption. Pashardes

found considerable empirical evidence to support the hypothesis of rational

behavior in general, as well as evidence that cigarette smoking is an

addictive behavior. Finally, he noted that expectations concerning the future

price and other costs of consumption played an important role in consumer

behavior.

Becker and Murphy (1988) similarly rejected the notion that myopic

behavior is empirically indistinguishable from rational behavior in their

theory of rational addiction. They assumed that individuals consistently

maximize utility over their life cycle, taking into account the future

consequences of their choices. In their model, utility at any point in time

depends on current addictive consumption , current non-addictive consumption,

and the stock of past addictive consumption. Tolerance is incorporated by

assuming that the marginal utility of the addictive stock is negative.

Economics of Smoking - p. 29

Reinforcement is modeled by assuming that an increase in the addictive stock

raises the marginal utility of current addictive consumption. Finally

withdrawal is captured since total utility falls with the cessation of

addictive consumption.

Becker and Murphy (1988) and Becker et al. (1991) developed several

hypotheses from this basic model. First, addictive consumption displays

"adjacent complementarity"; that is, due to reinforcement, the quantities of

the addictive good consumed in different time periods are complements. As a

result, current consumption of an addictive good is inversely related to not

only the current price of the good, but also to all past and future prices.

Consequently, the long-run effect of a permanent change in price will exceed

the short-run effect.8 Moreover, in the Becker and Murphy model, the ratio of

the long-run to short-run price effect rises as the degree of addiction rises.

In addition, they predict that the effect of an anticipated price change will

be greater than the impact of a comparable unanticipated price change, while a

permanent price change will have a larger impact on demand than a temporary

price change. Finally, price responsiveness varies with time preference :

addicts with higher discount rates will be relatively more responsive to

changes in money price than those with lower discount rates. The opposite

will be true with respect to the effects of information concerning the future

consequences of addictive consumption. Thus, the model suggests that younger,

less educated, and lower income persons will be relatively more responsive to

changes in the money price of cigarettes, while older, more educated, and

higher income persons will be relatively more responsive to new information on

the health consequences of cigarette smoking. 9

Strong adjacent complementarity, reflecting strong addiction, can lead

to unstable steady states in the Becker and Murphy model. This is a key

8 Myopic addiction models also predict that the long run price elasticity

of demand will be larger than the short run elasticity.

9 See Chaloupka (1988, 1990, 1992) or Becker et al. (1994) for a more

formal discussion of these price effects.

Economics of Smoking - p. 30

feature of their rational addiction theory, helping to explain the binge

behavior and "cold turkey" quit behavior observed among addicts. Furthermore,

these unstable steady states imply that there will be a bimodal distribution

of consumption, again something that is observed for many addictive goods. In

addition, Becker and Murphy's model implies that temporary events, including

price reductions, peer pressure, or stressful events, can lead to permanent

addictions.

Chaloupka (1988, 1990, 1991, 1992) used data from the Second National

Health and Nutrition Examination Survey conducted in the late 1970s in the

first empirical application of the rational addiction model He found

consistent evidence that cigarette smoking was an addictive behavior and that

smokers did not behave myopically. Chaloupka's (1991) estimates of the longrun

price elasticity of demand fell in the range from -0.27 to -0.48, larger

than the elasticities obtained from conventional demand equations using the

same data. In addition to estimating the rational addiction demand equations

for the full sample, Chaloupka also explored the implications of the Becker

and Murphy model with respect to the rate of time preference by estimating

comparable demand equations for subsamples based on age and educational

attainment. Chaloupka's (1991) estimates were generally consistent with the

hypothesis that less educated or younger persons behave more myopically than

their more educated or older counterparts. In addition, less educated persons

were more price responsive, with long-run price elasticities ranging from -

0.57 to -0.62, than were more educated persons, who were generally

unresponsive to price. Chaloupka (1990) also estimated separate demand

equations for subsamples based on gender, concluding that men behaved more

myopically and were relatively responsive to price (long-run price elasticity

centered on -0.60) than women (statistically insignificant effect of price on

demand).

Similar findings were obtained by Becker et al. (1994) using aggregate,

state-level sales data for the U.S. over the period from 1955 through 1985.

Economics of Smoking - p. 31

They found clear evidence that smoking was addictive, as well as evidence of

non-myopic, although not fully rational, behavior. 10 Estimates from other

studies employing U.S. data (Keeler et al., 1993; Sung et al., 1994) and data

from other countries, including Finland ( Pekurinen, 1991) and Australia

(Bardsley and Olekalns, 1998), are generally consistent with the hypothesis of

rational addiction. In contrast, Duffy (1996a), Cameron (1997), and Conniffe

(1995), using annual time-series data for the U.K., Greece, and Ireland,

respectively, found little support for the rational addiction model. These

latter studies, however, are generally limited by the relatively small number

of observations available for their analyses, and by the use of several highly

correlated regressors.

As noted above, Douglas (1998) used hazard models to examine the

determinants of smoking initiation and cessation in the context of the Becker

and Murphy (1988) rational addiction model. In contrast to his finding that

price does not significantly affect the hazard of smoking initiation, Douglas

concluded that increases in price significantly increase the likelihood

(hazard) of smoking cessation. He estimated a price elasticity for the

duration of the smoking habit of -1.07 with respect to future price,

consistent with the hypothesis of rational addiction; paradoxically, past and

current prices were not found to have a statistically significant effect on

cessation. Similarly, his parametric and non-parametric results imply that

the hazard of smoking cessation has a positive duration dependence, a finding

Douglas suggested is consistent with rational addiction in that the rational

smoker will discount future health costs less as they become more imminent.

2.2.4 Critiques of the rational addiction model

While the rational addiction model has gained acceptance among some

economists, many object to several assumptions of the model. Perhaps the most

10 The authors concluded that there was insufficient information in the

data to accurately estimate the discount rate, but that their estimates were

clearly inconsistent with myopic behavior.

Economics of Smoking - p. 32

criticized aspect of the model is the assumption of perfect foresight. As

Winston (1980) explained, in the context of the Stigler and Becker (1977)

model:

[T]he addict looks strange because he sits down at period j=0, surveys

future income, production technologies, investment/addiction functions,

and consumption preferences over his lifetime to period T, maximizes the

discounted value of his expected utility, and decides to be an

alcoholic. That's the way he will get the greatest satisfaction out of

life. Alcoholics are alcoholics because they want to be alcoholics, ex

ante, with full knowledge of its consequences. ( page 302)

Similarly, Akerlof (1991) noted that individuals who become addicted in the

rational addiction model do not regret their past decisions, given that they

are assumed to have been fully aware of the consequences of their consumption

of a potentially addictive good when making those decisions.

A recent theoretical paper by Orphanides and Zervos (1995) addressed

this and other perceived inconsistencies of the rational addiction model that

arise largely from the assumption of perfect foresight. In particular, the

authors introduced uncertainty into the model by assuming that inexperienced

users are not fully aware of the potential harm associated with consuming an

addictive substance. Instead, in their model, an individual's knowledge comes

from the observed effects of the addictive good on others as well as through

his or her own experimentation with that good. More specifically, they assume

that the harmful effects (including addiction) of consuming a potentially

addictive good are not the same for all individuals, that each individual

possesses a subjective understanding of his or her potential to become

addicted, and that this subjective belief is updated via a Bayesian learning

process as the individual consumes the addictive good. Thus, an individual

who underestimates his or her potential for addiction and experiments with an

addictive substance can end up becoming addicted. Rather than the "happy

addicts" implied by the rational addiction model (Winston, 1980), these

addicts will regret becoming addicted. As Orphanides and Zervos noted, the

incorporation of subjective beliefs into the rational addiction model helps

Economics of Smoking - p. 33

explain youthful experimentation, the importance of peer influences, and other

commonly observed facets of addiction.

More recently, in a model focusing on cigarette smoking, Suranovic et

al.(forthcoming) also reconsidered the Becker and Murphy (1988) model of

rational addiction. As described above, adjacent complementarity is a key

feature of the rational addiction model. Suranovic et al. noted, however,

that one implication of adjacent complementarity is that efforts to reduce

current consumption will lead to reductions in utility. These "quitting

costs" are an important feature of their model and help explain the seeming

inconsistency between smokers' stated wishes to quit smoking and their

continued cigarette consumption. In addition, they help explain why smokers

engage in various behavior modification treatments, such as the use of the

nicotine patch, which help make quitting easier.

A second point of departure from the Becker and Murphy model concerns

the timing of the consequences of smoking, which Suranovic et al. assume are

concentrated at the end of a smoker's life. In addition, rather than assuming

that individuals choose a lifetime consumption path that maximizes the present

value of their lifetime utility, Suranovic et al. assume "boundedly rational"

behavior, implying that individuals choose current consumption only. As a

result, their model suggests that aging is enough to induce cessation among

some smokers. As in the Becker and Murphy model, their model implies that

quitting "cold-turkey" is likely in the case of a strong addiction (one where

quitting costs rise rapidly for small reductions in consumption). However, in

contrast to Becker and Murphy, Suranovic et al. predicted gradual reductions

in consumption progressing to quitting in the case of relatively weak

addictions. Interestingly, some newly emerging epidemiologic evidence

supports this prediction (Farkas, 1998).

In addition, as Becker and Mulligan (1997) describe, addic tion and time

preference may be related. As discussed above, the Becker and Murphy (1988)

model of rational addiction implied that people who discount the future more

Economics of Smoking - p. 34

heavily were more likely to become addicted. In their theoretical discussion

on the determination of time preference, Becker and Mulligan suggest that

addictive consumption, by raising current utility at the expense of future

utility, can make even rational persons behave more myopically.

Finally, Showalter (1998), in his analysis of the behavior of firms

producing an addictive good, suggests an alternative interpretation for the

finding in most empirical applications of the rational addiction model that

future consumption has a significant impact on current consumption. Rather

than resulting from rational behavior on the part of consumers, Showalter

shows that the same finding could result from myopic behavior by consumers

coupled with rational behavior by firms. In his empirical applications of

this model, Showalter finds that the rational and myopic demand models produce

similar predictions, but that neither does well in predicting actual behavior,

a finding he attributes to the difficulties of accurately forecasting prices.

2.3 Behavioral economic analyses of cigarette demand

Behavioral economics involves the application of the principles of

consumer demand theory to experimental psychology ( Hursh and Bauman, 1987).

Over the past decade, there have been numerous behavioral economic analyses of

a variety of addictive behaviors, including cigarette smoking ( Bickel and

DeGrandpre, 1996). These studies examine the impact of price and other

factors on the self-administration of a number of addictive substances by

humans as well as a variety of non-human species in a laboratory setting.

Price, in this context, is defined as the response or effort required to

receive one dose of a drug (Bickel et al., 1993). As in standard economic

analyses, an increase in price is expected to lead to a reduction in the

quantity of drug demanded. One advantage of this experimental approach for

the analysis of cigarette demand, both in general and as it relates to policy

debates specifically, is that it allows researchers to study the effects on

demand of changes in cigarette prices that are many times larger than the

Economics of Smoking - p. 35

price differences that are observed in the cross-sectional or time-series data

that have been used in the econometric studies of demand. One limitation of

the approach, however, is that these methods are generally applicable only to

dependent individuals. For example, for ethical reasons (and others), they

cannot be used to address issues related to the effect of price on smoking

initiation.

The behavioral economics of cigarette smoking is the most extensively

researched area in the behavioral economics of drug abuse ( Bickel and Madden,

1998). In a series of papers, Bickel, DeGrandpre, and their colleagues have

reported the results of research on cigarette smoking conducted in their

behavioral economics laboratory ( Bickel et al., 1991; DeGrandpre et al., 1992;

DeGranpre et al., 1994; Bickel et al., 1995; DeGrandpre and Bickel, 1995;

Bickel and DeGrandpre, 1996; Bickel and Madden, 1998). These experiments

typically involve individuals ages 18 and older who smoke a pack or more of

cigarettes per day who participate in between two and five three-hour

experimental sessions per week. 11 Price, in these experiments, is defined as

the number of complete pulls and resets of a plunger required to receive a

preset number of puffs on a cigarette. For example, 50 pulls on the plunger

may be required to obtain two puffs on a cigarette. Puffs are monitored by a

puff-volume sensor so that each subject receives essentially the same dose per

puff (Bickel and Madden, 1998).

A wide range of prices is used in the se experiments. In some of the

experiments, respondents were also presented with an opportunity to earn money

for pulls on the plunger that could then be spent on cigarettes. As in the

econometric studies described above, the behavioral economic analyses have

consistently found an inverse relationship between cigarette smoking and

price. Estimates of the price elasticity of demand obtained from these

studies are surprisingly consistent with those obtained from econometric

11 For a discussion of a number of other requirements for the

participants and more detail on the features of these experiments, see Bickel

and Madden (1998).

Economics of Smoking - p. 36

studies. For example, Bickel et al. (1995) estimated a mean price elasticity

of demand of -0.56 for five subjects in an experiment in which price ranged

from 12 to 1600 pulls per puff. A particularly interesting finding from the

behavioral economics research is that the price elasticity of demand rises as

price rises. For example, DeGrandpre and Bickel (1995) estimated a mean price

elasticity of -1.58 for prices ranging from 400 to 4500 pulls per puff. These

findings appear to be generalizable not only across drugs but also across

species (Bickel et al., 1990).

2.4 Econometric studies of the demand for other tobacco products

In contrast to the relatively large literature examining the impact of

cigarette prices on cigarette smoking, few studies look at the effects of

price on the use of other tobacco products, and fewer still consider crossprice

effects for cigarettes and other tobacco products. Much of this

research has been conducted by Ohsfeldt and his colleagues (Ohsfeldt and

Boyle, 1994; Ohsfeldt et al., 1997, 1998). Using state-level aggregates

constructed from the September 1985 tobacco use supplement to the Current

Population Survey, Ohsfeldt and Boyle (1994) examined the impact of state

smokeless tobacco taxes and cigarette excise taxes on the prevalence of

smokeless tobacco use by males ages 16 years and older. The authors concluded

that higher smokeless tobacco taxes would significantly reduce the prevalence

of smokeless tobacco use. In addition, Ohsfeldt and Boyle found evidence of

substitution among tobacco products, in that higher cigarette excise taxes

have a positive and significant effect on the prevalence of smokeless tobacco

use. Given this finding, they suggested that the increase in smokeless

tobacco use observed among young males in the 1980s was at least in part due

to the increases in state cigarette taxes which were rising more rapidly

during this time than state taxes on other tobacco products.

Similarly, Thompson and McLeod (1976) and Pekurinen (1989, 1991)

concluded that some Canadian and Finnish cigarette smokers, respectively,

Economics of Smoking - p. 37

would switch from manufactured cigarettes to less expensive hand-rolled

cigarettes in response to increases in the prices of manufactured cigarettes.

Pekurinen also found a negative and significant relationship between the

demands for pipe tobacco and cigars and their own-prices. Leu (1984),

however, found little evidence of substitution among tobacco products by Swiss

tobacco users in response to changes in their relative prices.

The findings obtained by Ohsfeldt and Boyle based on aggregate data are

confirmed by their subsequent analyses using individual-level data from the

September 1985 CPS (Ohsfeldt et al., 1997) and the September 1992, January

1993, and May 1993 CPS (Ohsfeldt et al., 1998). In the more recent analysis,

the authors estimated an own-tax elasticity for smokeless tobacco use of -0.10

for their sample of males ages 16 and older and again concluded that smokeless

tobacco products are substitutes for cigarettes. In addition, as seen for

cigarette demand, they estimated an inverse relationship between the

elasticity of demand for smokeless tobacco products and age.

This finding was confirmed by Chaloupka et al.'s (1997) recent analysis

of smokeless tobacco use among young males using data from the 1992, 1993, and

1994 Monitoring the Future surveys of eighth, tenth, and twelfth grade

students. The researchers estimated an overall price elasticity of young

males' smokeless tobacco use of -0.746, and a participation elasticity of -

0.523.

3. Cigarette and other tobacco taxation12

With retail price an important determinant of the demand for cigarettes,

and excise tax often a significant component of retail cigarette price, the

issue of whether to increase cigarette excise taxes has been highly visible in

legislative debates on both governmental revenue raising and tobacco control

12 As most of the evidence and concern pertaining to tobacco taxation

relates to cigarette excise taxation, we refer specifically to cigarette

taxation in most of the discussion in this section. However, we do present

the evidence pertaining to the taxation of other tobacco products where it

applies.

Economics of Smoking - p. 38

for decades. Cigarette excise taxation offers an unusual attraction for

legislators: given the evidence on demand elasticities, increases in cigarette

taxes of politically plausible magnitude will produce a public health benefit,

by discouraging smoking, particularly among children. At the same time, they

will generate additional revenues for the governmental unit in question,

typically at a fairly low administrative cost. Further, polls often find

support for cigarette excise increases among American voters, frequently even

including smokers.

Still, the prospect of increased taxation raises a myriad of complicated

philosophical and practical questions. Among the former are the following:

What is the "right" level of cigarette taxation, if any? What is the basis

for determining that it is "right"? Are cigarette taxes fair, given their

distributional burdens in terms of both vertical and horizontal equity? In

particular, since more low-income than high-income people smoke (in developed

countries), will increased cigarette taxes impose an unfair regressive burden

on low-income taxpayers? What are the proper trade- offs between the interests

of individuals (liberty interests, tax burden) and the societal interest in

the public's health? Practical questions include the following: Given the

oligopolistic nature of the cigarette industry, as well as estimated supply

and demand elasticities, how will taxation affect cigarette price? With

differences in tax rates by jurisdiction defining much of the difference in

prices across borders of states and nations, will a given increase in excise

tax in a relatively high-tax jurisdiction result in a significant amount of

smuggling from a neighboring low-tax jurisdiction? What are the revenue

implications of a tax increase of given magnitude? How will a given taxinduced

price increase influence smoking, and consequently, what impacts will

it have on the public's health?

Economists have made numerous impo rtant conceptual and empirical

contributions to the policy debate on cigarette taxation, primarily, although

not exclusively, through their evaluation of the relationship between

Economics of Smoking - p. 39

cigarette price and consumption, reviewed in the preceding section. In this

section, we review economists' contributions to better understanding the

rationale for (or against), and additional effects of, cigarette excise

taxation.

3.1 Comparative standards and the effects of tax on price

3.1.1 Purposes and methods of taxation

Cigarettes and other tobacco products have been taxed for centuries,

primarily because the relatively inelastic demand for these products makes

them an easy source of revenues. In the U.S., for example, tobacco has been

taxed since colonial times, rising with revenue needs and declining during

more prosperous times. Since the Civil War, tobacco taxes have remained a

part of the U.S. federal tax system, often increasing during wartime and

falling again in peacetime. Similar historical patterns are observed in many

other developed countries. However, the importance of tobacco taxes as a

share of total revenues has generally declined over time in most countries.

In the U.S. for example, tobacco taxes currently account for less than onehalf

of one percent of total federal revenues, down from 3.36 percent of

revenues in 1950.

In recent decades, the increased taxation of cigarettes and other

tobacco products has been motivated not only by the revenue generating

potential of these taxes, but also as a means to reduce cigarette consumption.

Warner (1981b) concluded that the information on the health consequences of

cigarette smoking that began appearing in the 1950s and early 1960s led a

number of states to increase cigarette taxes as a way of discouraging

cigarette demand. More recently, a number of countries have adopted or

considered large tax increases on cigarettes and other tobacco products as a

way to reduce consumption. In Canada, for example, steady federal and

provincial tobacco tax increases throughout the 1980s and early-1990s were

motivated in part by concerns over the health consequences of smoking.

Economics of Smoking - p. 40

Similar concerns were behind the recent large increases in cigarette taxes in

California, Massachusetts, Arizona, Oregon, and other U.S. states.

Large tax increases can generate both significant declines in cigarette

smoking as well as considerable increases in cigarette tax revenues. In

Canada, for example, the over 500 percent increase in taxes between 1982 and

1992 led to an increase in real cigarette prices of 170 percent, reducing

total cigarette smoking by 38 percent ( Sweanor and Martial, 1994). Total

federal and provincial cigarette tax revenues rose by 240 percent during this

period, even with the development of a significant black market in cigarettes.

Cigarettes and other tobacco products are taxed in a variety of ways.

The most commonly used methods of taxation include excise taxes, value added

and other ad-valorem taxes, and import duties. Most cigarette excise taxes

are specified as an amount per x number of cigarettes (e.g., the U.S., Canada,

and many others), while others are based on the weight of tobacco contained in

the cigarette (e.g., Australia and Malaysia). Similarly, there are a variety

of ad-valorem taxes, including the value added taxes imposed by most European

and many other countries, as well as the sales taxes applied in most U.S.

states and elsewhere. There are comparable differences in the types of import

duties applied by nearly all countries to tobacco products. Some of the

distinctive features of these taxes include: earmarking for tobacco-related

education, counter-advertising, and other health related activities (e.g.,

Finland, Denmark, Peru, Romania, Nepal, and several U.S. states); the use of

tax revenues to create the state-run Health Promotion Foundations in several

Australian states and the Health Sponsorship Council in New Zealand, to fund

sporting and artistic events previously backed by the tobacco industry; and

the differential taxes on cigarettes with high tar and nicotine content used

in previous years in the U.K. (WHO, 1997; Roemer, 1993).

3.1.2 Effects of taxes on retail price

Increases in cigarette and other tobacco taxes result in higher prices

Economics of Smoking - p. 41

for these products. When excise taxation is the primary form of tobacco

taxation, however, the real value of the tax will fall over time, unless

regularly increased to account for inflation. Given that taxes are an

important component of price, one consequence of an excise tax system for

tobacco products with relatively infrequent tax increases is that the real

price of these products will fall over time as the prices of other goods and

services increase more rapidly. In the U.S., for example, due to the relative

stability of federal and state cigarette excise taxes throughout the 1970s,

real cigarette prices fell by nearly 40 percent. Between 1981 and 1996,

however, real cigarette prices in the U.S. rose by over 65 percent, due in

part to the tripling of the federal cigarette excise tax and numerous state

tax increases.13 In contrast, the real value of an ad- valorem tax on tobacco

products is maintained when the prices of these products rise with the prices

of other goods and services.

The oligopolistic nature of the cigarette industry and the addictive

nature of cigarette demand have important implications for the effects of

cigarette tax increases on cigarette prices. In a perfectly competitive

market with constant long-run costs of production, any tax increase would be

fully passed on to consumers. At the other extreme, a monopolist would share

the burden of the tax increase with consumers, with consumers bearing

relatively more of the burden when demand is relatively inelastic. In most

developed countries, the cigarette industry, however, is clearly at neither

extreme, but is instead an oligopoly. In the U.S., for example, the five

leading cigarette producers accounted for virtually the entire cigarette

market, with the top three (Philip Morris, R.J. Reynolds, and Brown &

Williamson) controlling over 90 percent of the market (Federal Trade

Commission, 1997). In some countries, however, particularly developing

13 Increases in the non-tax component of price, however, account for most

of the rise in U.S. cigarette prices between 1981 and 1996. During this

period, cigarette taxes as a percentage of price fell from just over one-third

to under one-quarter.

Economics of Smoking - p. 42

countries, a domestic monopoly controls most of the market.

Most of the empirical analyses of the relationship between cigarette

taxes and prices are based on data from the U.S. Early studies produced

generally inconsistent findings ( Barzel, 1976; Johnson, 1978; Sumner, 1981;

Sumner and Ward, 1981; Bulow and Pfleiderer, 1983; Bishop and Yoo, 1985;

Sullivan, 1985; Sumner and Wohlgenant, 1985; Ashenfelter and Sullivan, 1987).

One general weakness of these studies is that they failed to account for the

dynamic interaction of firms in an oligopolistic industry. Instead, they

generally assumed that the rules for firm behavior were established and then

worked backwards to estimate the degree of competition in the industry

(Harris, 1987).

More recent studies have attempted to model the dynamic nature of an

oligopolistic industry when estimating the impact of cigarette taxes on

cigarette prices. Harris (1987) used data on wholesale and retail cigarette

prices as well as manufacturing costs to estimate the change in cigarette

prices that resulted from the doubling of the U.S. federal cigarette tax in

1983. He concluded that the eight-cent tax increase led to a 17-cent price

increase that was not explained by increased manufacturing costs. Instead,

Harris argued that the scheduled tax increase served as a mechanism for a

coordinated, oligopolistic price increase.

Barnett and his colleagues (1995) not ed that Harris' analysis did not

fully account for underlying trends in cigarette prices. Consequently, they

argued that Harris attributed too much of the increase in price to the

increase in the tax since the upward trend in cigarette prices predated the

debate over the federal tax increase. Instead, they argued that the

introduction of generic cigarettes in 1981 allowed cigarette producers to

engage in coordinated increases in the prices of premium cigarettes since the

generic cigarettes would keep more price-sensitive smokers in the market.

Keeler and his colleagues (Keeler et al., 1996; Barnett et al., 1995;

Sung et al., 1994) used national and state level data in empirical analyses of

Economics of Smoking - p. 43

the effects of tax increases on price. Their models account for the

interaction of supply and demand, the oligopolistic nature of the cigarette

industry, and, in some, the addictive nature of cigarette demand. Using

annual state-level data for the period from 1960 through 1990, Keeler et al.

(1996) estimated that a one-cent increase in a state's cigarette tax would

raise retail prices in that state by 1.11 cents. In addition, they estimated

that increases in federal cigarette taxes would generate larger increases in

cigarette prices than those resulting from state tax hikes (Barnett et al.,

1995). They attributed this finding to the potential of cross-border shopping

for cigarettes in response to a state tax increase. Finally, Keeler et al.

(1996) concluded that cigarette producers price discriminate by state, in that

stronger state and local anti-smoking laws are offset by lower prices.

However, they noted that the effect of price discrimination is not large

relative to retail cigarette prices.

Based on the Becker and Murphy (1988) rational addiction model, Becke r

et al. (1994) suggested an alternative explanation for the finding that

cigarette prices increase by more than cigarette taxes when taxes are raised.

They argued that when taxes are raised, cigarette companies will raise price

by more to obtain maximum profit from current, addicted smokers. These

increased current profits help offset the future losses from the reduced

smoking initiation resulting from the price increase. Becker and his

colleagues explained this apparent paradox as follows: "If smokers are

addicted and if the industry is oligopolistic, an expected rise in future

taxes and hence in future prices induces a rise in current prices even though

current demand falls when future prices are expected to increase" (page 413).

They went on to explain that because of the addictive nature of smoking,

cigarette producers set prices below their short-run profit maximizing level

in order to "hook" consumers on their addictive product, thus raising the

future demand for this product. Showalter (1998) makes a similar argument

with respect to advertising, suggesting that cigarette producers might engage

Economics of Smoking - p. 44

in apparently excessive advertising in order to attract a few new customers.

3.1.3 Variations in cigarette tax across countries and states and the issue of

smuggling

The share of cigarette taxes in cigarette prices varies widely among

countries. In Denmark, Ireland, and the U.K., for example, over 80 percent of

cigarette prices are accounted for by cigarette taxes ( Sweanor, 1997), while

taxes in most others were between 65 and 80 percent. 14 In contrast, among

developed countries, cigarette taxes are less than half of price only in the

U.S., where they account for 35 percent of price, on average (21 percent in

the lowest taxing state and 47 percent in the highest). The large difference

in cigarette taxes leads to a five-fold difference in cigarette prices among

these countries. As the WHO (1997) has observed, inter-country differences in

wages and prices can understate the difference in price when expressed in a

single currency. When expressed in terms of minutes of labor required to earn

the price of a pack of cigarettes, the differences are even larger.

One consequence of the differences in cigarette taxes and prices, both

across countries as well as among different taxing jurisdictions within

countries, is the potential for casual and organized cigarette smuggling and

other forms of tax evasion. The cigarette industry, for example, frequently

argues that cigarette tax increases will actually lead to reductions in tax

revenues due to smuggling and other tax evasion (British American Tobacco,

1994). The smuggling problem is exacerbated by the relative ease with which

tobacco products can be transported, the potential profits from this illegal

activity, the presence of an informal distribution network in many countries,

the availability of tax-free and duty-free cigarettes, and nonexistent or

relatively weak policies concerning cigarette smuggling and their lack of

enforcement (Joossens and van der Merwe, 1997; Joossens and Raw, 1995, 1998;

Advisory Commission on Intergovernmental Relations (ACIR), 1977 and 1985).

14 Based on prices and taxes as of December 31, 1996.

Economics of Smoking - p. 45

Joosens and Raw (1995, 1998) argued that many of these other factors can be as

important as price differences in spawning cigarette smuggling. For example,

they noted that there is little evidence of cigarette smuggling in some of the

highest priced European countries, including France, Norway, Sweden and the

U.K., while there is extensive evidence of smuggling in those with relatively

low prices, such as Spain and Italy. Moreover, they concluded that much of

the cigarette smuggling that does occur in Europe and elsewhere is actually

encouraged by the large, multinational tobacco companies. Thursby and Thursby

(1994) provided empirical support for this argument, based on their analysis

of data from the U.S. from which they concluded that increases in federal

cigarette excise taxes lead to increased commercial cigarette smuggling.

There have been relatively few econometric analyses of the impact o f

price differentials on organized and casual cigarette smuggling. All of these

studies are based on annual state-level cigarette sales data from the U.S. and

all have concluded that the casual and organized smuggling of cigarettes from

major tobacco producing states, as well as other states with relatively low

cigarette prices compared to neighboring states, accounts for a significant

share of sales in these states (Saba et al., 1995; Becker et al., 1994;

Chaloupka and Saffer, 1992; Baltagi and Levin, 1986; ACIR, 1977, 1985;

Manchester, 1976).

Perhaps the most widely cited example of the link between cigarette tax

increases and smuggling is the Canadian experience during the late-1980s and

early-1990s. In 1980, when Canada adopted an ad-valorem approach to cigarette

taxation, Canadian cigarette prices were somewhat higher than prices in the

U.S. By 1984, the gap had widened as Canadian cigarette taxes doubled and

real cigarette prices rose by 25 percent. In 1984, in response to industry

pressure, the ad-valorem tax was replaced by an excise tax. Over the next few

years, growth in Canadian cigarette taxes slowed, with most tax increases

taking place at the provincial level. In 1988, however, the federal

government mounted an aggressive anti-smoking campaign that included

Economics of Smoking - p. 46

significant tax increases. In 1989, the federal tax was raised by two cents

per cigarette, followed by a three cents per cigarette increase in 1991;

provincial taxes continued to increase as well. By early 1994, the average

Canadian tax per pack was $2.96 (in U.S. dollars), more than five times the

U.S. average (Sweanor and Martial, 1994).

The large tax and price disparities between the U.S. and Canada led to

substantial cigarette smuggling from the U.S. Smuggling was a relatively

minor problem prior to 1992; however, beginning in 1992, smuggling rapidly

increased after the repeal of a Canadian tax on cigarette exports. In

addition, the smuggling problem was exacerbated by the long undefended border

between the U.S. and Canada, relatively weak border controls, and the high

concentration of the Canadian population near U.S. borders (Sweanor and

Martial, 1994). Much of the black market trade was in cigarettes originally

produced in Canada, exported to the U.S. tax-free, and then smuggled back into

Canada; relatively little involved U.S. produced cigarettes given their use of

a blend of tobacco different from that preferred by Canadian smokers.

In response to an aggressive industry-sponsored campaign, the Canadian

federal cigarette tax was reduced by $5.00 per carton on February 9, 1994,

with an agreement to match provincial tax reductions of up to another $10.00

per carton. Quebec quickly lowered its provincial tax by $11.00 per carton,

for a total tax cut of $26.00 per carton, cutting cigarette prices in half.

Several other provinces followed and by the end of 1996, the average tax per

pack was less than $2.00. Canadian tax revenues fell and rates of smoking

increased, particularly among youth.

The variations in taxes across countrie s and within countries over time

reflect a myriad of practical and political considerations, with smuggling but

one of them. In contrast to the legislators who must set taxes based on such

considerations, academic economists approach the issue of the desirable level

of cigarette taxation by contemplating the application of a number of economic

principles relating to both equity and efficiency. The remainder of section 3

Economics of Smoking - p. 47

examines these principles and their relevance to the determination of a

theoretically optimal cigarette excise tax. The discussion also compares and

contrasts the perspective of the economist with that of the public health

professional, for whom different criteria define "optimality" in cigarette

taxation.

3.2 Fairness standards

The search for an optimal tax encompasses considerations of efficiency

and equity. Each of these domains has featured prominently in policy debates

on increasing cigarette taxes as well. From an efficiency point of view, the

principal economic theory argument favoring imposition of a product-specific

(excise) tax relates to the creation of negative externalities through

production or consumption of the product. The nature and extent of such

externalities with regard to smoking have been the subject of considerable

debate among economists, as is discussed later in this section. 1516

15 Less frequently debated is a pragmatic consideration: whether

cigarette taxation violates the Ramsey Rule, namely that when dealing with

consumption taxes, tax rates should vary inversely with the elasticity of

demand for products (holding supply elasticity constant). The purpose is to

ensure that revenue-raising occurs in a manner that will minimize distortions

in consumers' choices among goods and services and in their decisions of how

much to spend and how much to save. Until recently, the empirical evidence

has suggested that cigarettes are an excellent target for taxation, consistent

with the Ramsey Rule, given the consensus view on their relatively low demand

elasticities, discussed in the preceding section. Jones and Posnett (1988)

estimated that a 1% increase in the cigarette tax rate would generate about a

0.9% increase in revenue. As noted in the preceding section, however, longrun

demand elasticities may be as much as twice short-run elasticities, as

reflected in the findings associated with application of the rational

addiction model to cigarette smoking (Becker et al., 1994). Use of these

greater long-run elasticities would suggest a lower level of tax efficiency.

16 The issues raised in this discussion would apply also to many other

behaviors and consumption goods, such as consuming large quantities of fat (a

risk factor for heart disease and cancer) or driving motorcycles (a risk

factor for serious injury). Despite the logical parallels, few economists or

public health professionals have advocated a fat tax or a special injuryrelated

tax on motorcycles. Cigarettes (and alcohol; see the chapter by Cook

and Moore) have been identified as unique in terms of the magnitude of the

health damage and negative externalities they create. The "slippery slope"

argument -- once negative externalities are used to justify taxing tobacco and

alcohol, cars will be next, then fat, then salt, etc. -- is not addressed in

this chapter.

Economics of Smoking - p. 48

First, however, we examine a central issue in cigarette taxation, namely

whether it violates widely accepted standards of fairness, with an emphasis on

vertical equity. In developed countries such as the U.S., proportionately

more lower-income people smoke than do those with high incomes. As a

consequence, the burden of a tax on cigarettes is experienced

disproportionately by the poor. The tax is criticized as being highly

regressive.

3.2.1 Horizontal and vertical equity

In terms of tax policy, the principle of horizontal equity is that

equals should be treated equally. Clearly, cigarette taxation violates this

principle, if one accepts that people who are identical except for their

smoking behavior should be deemed "equals." Arguments in favor of cigarette

taxation thus ignore this principle, while opponents of taxation appeal

directly to it (although rarely in the language of economists). Violation of

the horizontal equity principle has never been the focal point of critics'

concern, however. Rather, they have focused on questions of vertical equity,

specifically the apparent regressivity of cigarette taxes. Cigarette taxes

would be regressive with respect to income if poorer and more affluent

consumers smoked at the same rate. The potential problem of regressivity is

exacerbated, in many developed countries at least, by the above-mentioned

tendency for smoking prevalence to be inversely related to income.

Recent empirical analysis has muted this concern somewhat, concluding

that the degree of regressivity is substantially less than appears at face

value. Using data from the 1984-85 Consumer Expenditure Survey, analysts at

the Congressional Budget Office (1990) found that expenditures on tobacco

products increased with income, except for those in the highest income

quintile. In part this reflects an increasing intensity of smoking (numbers

of cigarettes) among smokers as income rises, and a propensity for higherincome

smokers to buy products that are more expensive per unit. As a

Economics of Smoking - p. 49

percentage of post-tax income, however, tobacco spending varied inversely with

income level, with the lowest quintile spending 4% on tobacco.

When the CBO analysts examined tobacco spending as a per centage of

expenditures on all good and services, however, they found that the share of

tobacco expenditures fell gradually over the first four income quintiles (from

1.6 to 1.1%) and dropped sharply in the top quintile (to 0.7%). Consequently,

CBO concluded, if annual family expenditures are more reflective of lifetime

income than annual family income, then tobacco expenditures are only slightly

regressive over income classes. CBO also noted that younger families spend a

higher proportion of their income on tobacco and that their share of tobacco

spending as a percentage of total expenditures was higher as well.

To examine the distributional impact of a cigarette excise tax increase,

CBO simulated the effects of doubling the then (1990) 16-cent federal per pack

excise tax. When income tax brackets and transfer payments were indexed to

account for the price increases associated with the excise tax increase, the

apparent regressivity was reversed; the adjustments had the effect of lowering

individual income taxes and raising transfer payments. Relative to

expenditures, CBO found the burden of the increased tax to be closer to

proportional than regressive. The largest share of the simulated tax increase

was paid for by families in the third and fourth income quintiles, with the

smallest share borne by families in the two lowest quintiles (first and

second).

To control for the intertemporal nature of cigarette smoking, Lyon and

Schwab (1995) examined the distributional effects of cigarette (and other

"sin") taxes across measures of permanent or lifetime income. The authors did

not find important differences in regressivity patterns compared to studies

based on current income.

Recent research on differences in the price elasticity of demand for

cigarettes by various measures of socioeconomic status has produced findings

that suggest that the degree of regressivity normally attributed to cigarette

Economics of Smoking - p. 50

taxation is considerably overstated. Townsend and colleagues (1994) found

that (the absolute value) of price elasticity was inversely related to social

class in Great Britain, with members of the highest social class exhibiting

little price responsiveness and those in the lowest social class having an

elasticity close to unity. In the U.S., Chaloupka (1991) concluded that lesseducated

persons were more price responsive than the more-educated, while

Farrelly and his colleagues (1998) found that cigarette demand by lower income

persons was more elastic than that by higher income persons. Given the high

correlation between income and both social class in Great Britain and

education in the U.S., these studies indicate that increased cigarette taxes

would reduce observed differences in smoking among socioeconomic groups. This

mitigates conclusions about regressivity that derive from analyses that have

failed to consider the inverse relationship between elasticity and income.

The latter has characterized all studies to date.

Regardless of whether regressivity proves to be a serious concern or not

with regard to cigarette taxation per se, analysts have pointed out that the

goal of tax policy is for the overall impact of a tax and expenditure system

to be progressive or proportional, rather than regressive (Congressional

Budget Office, 1990; Warner et al., 1995). Related to this notion, various

proposals to increase cigarette taxes have earmarked a portion of revenues to

expenditures designed to aid the poorer members of society. These have ranged

from smoking-specific expenditures (e.g., provision of smoking cessation

services for the poor) to proposals to fund health care for the poor in part

with cigarette tax revenues.

3.2.2 The benefit principle

Another perspective on fairness is that smokers should bear the costs of

smoking that they impose on other members of the society. This consists of

two categories of costs: those associated with diseases experienced by

nonsmokers due to exposure to environmental tobacco smoke; and smokers' own

Economics of Smoking - p. 51

publicly-funded medical costs subsidized by nonsmoking taxpayers. Related to

the latter, excise taxation might be partially justified on the basis of the

benefit principle, the notion that people who derive benefits from government

activities should be taxed to cover their costs of production.

In the most direct application of this " user fee" concept, proponents

argue that smokers should pay, through cigarette taxes, for the publiclyfunded

health care that smoking necessitates, primarily in the U.S. through

the Medicaid program for the indigent and the Medicare program for the

elderly. Although appealing at first blush, the logic underlying this

argument can be challenged. First, the tax is a blunt instrument: many

smokers who incur smoking-related health care expenditures will pay for them

themselves, either out of pocket or through private health insurance. Why

should they subsidize the health care costs of other smokers more than do

nonsmokers? Similarly, many of today's smokers, who pay the excise taxes,

will cease smoking in time to avoid smoking-related illnesses. Further, the

costs that today's generation of smokers will experience in the future are not

easily predicted; perhaps some currently expensive smoking-related disease

conditions will be readily and inexpensively treatable in the future. Even if

these costs were knowable, they would need to be discounted to reflect the

fact that they will not occur, on average, for two or more decades. As it has

been advanced to date, the "user fee" argument has today's smokers paying for

today's smoking-related health care costs (Warner et al., 1995).

In the case of smoking, the benefit principle is inextricably linked to

the broader issue of the negative externalities associated with smoking. We

consider the evidence pertaining to externalities below. First, however, we

turn to fairness arguments in favor of increasing cigarette taxes that emanate

from the public health community. Economists' analyses of the external costs

of smoking are highly relevant to informing the public health community's

sense of the social costs of smoking.

Economics of Smoking - p. 52

3.3 Public health standards

The public health community has advocated large increases in tobacco

taxes for two reasons. One is the notion that smokers should cover the social

costs of smoking, with the public health conception of social costs including

both private costs to smokers and their families, as well as negative

externalities (Cook, 1991). The second is based on a pragmatic realization:

through its effects on prices, taxation will discourage many people from

smoking, particularly young people. As a consequence, literally hundreds of

thousands of premature deaths could be avoided by large increases in cigarette

taxes. In this context, cigarette taxation is viewed as a powerful policy

tool with which to foster improvements in the public's health.

3.3.1 The social cost of smoking

The public health community has long argued that smoking imposes large

costs on society and that smokers should bear the burden of these costs.

Cost-of-smoking analyses include three categories of costs: ( i) the direct

medical costs of preventing, diagnosing, and treating smoking-related

diseases; (ii) the indirect morbidity costs associated with lost earnings from

work attributable to smoking;17 and (iii) the indirect mortality costs related

to the loss of future earnings due to premature smoking-produced deaths.

Combined, these total well over $100 billion in the U.S. 18 Although most of

the cost-of-smoking analysis has employed American data, estimates have also

been prepared for Canada (Forbes and Thompson, 1983; Collishaw and Myers,

1984), Great Britain [ref], China ( Jin et al., 1995), and other countries. In

addition, numerous state-specific analyses have been performed in the U.S.,

17 A significant amount of work loss is associated with smoking (U.S.

Department of Health and Human Services, 1989). In addition, smoking may

decrease productivity while smokers are on the job , due primarily to the

number and length of smoking breaks they take. The latter is rarely included

in studies of the social costs of smoking, although it has been raised during

debates on indoor smoking restriction legislation.

18 Authors' calculations, updating estimates in Bartlett et al. (1994) and

Miller et al. (1998) to contemporary dollars.

Economics of Smoking - p. 53

most based on the SAMMEC model (Smoking-Attributable Morbidity, Mortality, and

Economic Costs) (Shultz et al., 1991).

The cost-of-smoking studies have employed a variety of methods of

estimating the different cost components, with attributable-risk methodology

common in estimating smoking-related disease incidence or prevalence and the

human capital approach employed in placing a value on lost years of life

(Hodgson and Meiners, 1982; Warner et al., 1998). Following a trend in costof-

illness estimation in general, more recent studies have adopted an

incidence approach (Manning et al., 1989, 1991; Hay, 1991; Hodgson, 1988,

1992; Oster et al., 1984), in contrast with the prevalence approach

predominant in the earlier studies (e.g., Rice et al., 1986). The prevalence

approach values the present costs associated with all existing cases of

smoking-produced illness (including future lost earnings attributable to

current deaths). In contrast, the incidence approach values all of the future

costs associated with new cases of smoking-produced disease during the

reference year. The former provides an estimate of the current economic

burden of smoking, while the latter is more useful for analyses of

interventions that might interrupt the development of smoking-related illness.

The cost-of-smoking studies can be faulted on numerous grounds. For

one, they have tended to omit certain categories of smoking-related health

care, such as treatment of burn victims from smoking-ignited fires 19 and

perinatal care for low-birth-weight babies of smoking mothers (U.S. Department

of Health and Human Services, 1998). Few studies have considered the costs of

treatment of diseases caused by environmental tobacco smoking. No study has

yet attempted to value intangible costs, such as the pain and suffering of

smoking-related disease victims and their families. Ironically, these

intangible costs may well dominate all of those that are more readily

quantified (Abt, 1975).

19 Cigarette smoking is the leading cause of home fires and the leading

cause of burn deaths (Napier, 1996).

Economics of Smoking - p. 54

Hodgson (1998) and his colleagues (Warner et al., 1998) have argued

that, as it is being applied in this literature, the conventional attributable

risk methodology considerably underestimates smoking's burden on the health

care system by virtue of its failure to consider how smoking complicates the

course of many illnesses not themselves directly associated with smoking. For

example, diabetics who smoke often have more complications of their diabetes

than diabetics who do not smoke . Smokers recover more slowly from surgeries

of all types than do nonsmokers, thus extending post-surgical hospital stays.

HIV-infected smokers may be more likely to develop near-term AIDS than are

HIV-infected nonsmokers (Napier, 1996). Inclusion of such costs in cost-ofsmoking

analysis might lead to an increase in estimates of 50% or more.

The cost-of-smoking studies also fail to take account of a wide variety

of direct costs in addition to medical costs, including such items as the time

and transportation costs associated with getting patients to and through

health care services, the direct costs of home modifications to accommodate

smoking-related disabilities, damage to buildings due to smoking-produced

fires, smoking-related maintenance costs in industrial settings and homes, and

the increased frequency of laundering necessitated by smoking. Omission of

these nonmedical costs is standard practice in nearly all of the broader costof-

illness literature. Occasionally, such omissions are acknowledged, with

the researchers stating that they did not view such costs as large enough to

warrant the additional research.

The indirect morbidity and mortality costs hav e been criticized

frequently as representing an inadequate means of valuing the avoidable

premature loss of life. By relying exclusively on the human capital approach,

they place no value on life per se, clearly contrary to the behavior of

virtually all civilized societies which invest in preserving the health of

senior citizens after they retire. Many analysts concur that use of

willingness-to-pay measures would be preferable, but they bemoan the lack of

suitable instruments for assessing such values.

Economics of Smoking - p. 55

The cost-of-smoking analytical community includes individuals who have

calculated some of the economic "benefits" of smoking, including the reduction

in Social Security payments for smokers who die prematurely ( Shoven et al.,

1989) and medical expenditures avoided as a result of smokers' premature

demise. The latter, in particular, has set off a "battle of the studies" to

ascertain whether the net medical expenditures associated with smoking are

positive or negative (Leu and Schaub, 1983; Manning et al., 1989; Hodgson,

1992; Barendregt et al., 1997; Warner et al., 1998). The entire question of

whether such "negative costs," or cost offsets, should be included in the

calculation of smoking's social costs has become a major front in the academic

battle over definition of the social costs of smoking. Viscusi (1995), for

example, recently concluded that consideration of medical and pension offsets

makes the net social costs of smoking small, if positive at all. Harris

countered that in no other area of social policy analysis is death treated as

an economic benefit (Coalition on Smoking or Health, 1994; Harris, 1993).

The import of this intellectual debate is potentially substantial. At

the center of the public health community's advocacy of higher cigarette taxes

is the social cost argument that smokers (or the industry that feeds their

addiction) are imposing a huge economic burden on the society and ought to pay

for it through higher excise taxes. Using the public health construction of

social cost, some analysts have concluded that in the U.S., the cigarette

excise tax needs to be on the order of $3-4 or more to cover these costs

(e.g., Hay, 1991).

Economists of many political stripes have countered that, for purposes

of estimating an optimal cigarette excise tax, the correct notion of social

cost is the traditional economist's measure of externalities, i.e., costs

imposed by smokers on others, excluding their own family members. Economists'

contributions to this debate are considered below, following a brief

discussion of the true heart of the public health case for higher taxes: the

health benefits that would result.

Economics of Smoking - p. 56

3.3.2 The health benefits of increasing cigarette taxes

Through a variety of channels, the economics literature on tax, price,

and demand has reached the public health community (Scott and Dickert, 1993;

Coalition on Smoking or Health, 1994). Given the strength of the evidence

linking price increases to demand decreases, with the consensus that price

elasticity is inversely related to age, the public health community has become

convinced that cigarette tax increases are one of the most effective policy

tools for decreasing smoking, especially among children. As a consequence,

increasing price, generally through a tax hike, is featured in nearly every

comprehensive tobacco control policy proposal.

The raison d'etre underlying the public health community's desire to see

smoking decline is to reduce the morbidity and disability and premature

mortality associated with smoking. Economists have taken the demand

elasticity evidence and combined it with data on the health consequences of

quitting smoking (primarily adults) and not starting (primarily children) to

project the health gains that would be achieved with tax increases of various

magnitudes. For example, in the mid-1980s, the U.S. Congress had to decide

whether to permit a scheduled "sun-setting" of 8 cents of the then 16-cent

cigarette excise tax (increased from 8 cents in 1983). Warner (1986b) used

the price elasticity estimates of Lewit et al. (1981) for children and Lewit

and Coate (1982) for adults to estimate the consumption implications of

permitting the sun-setting to occur or, instead, increasing the tax by 8 or 16

cents per pack. He concluded that if the tax were doubled to 32 cents, and

the real value of the tax maintained thereafter, 800,000 youths would be

deterred from starting to smoke and 2.7 million adults encouraged to quit.

Applying the conservative assumption that one of every four lifetime smokers

dies prematurely of a smoking-related illness (the proportion is now believed

to be about half), the analysis estimated that this tax increase would

eventually reduce premature deaths in persons then 12 years and older by

Economics of Smoking - p. 57

860,000.

Harris (1987) also evaluated the consumptio n and health implications of

the 1983 doubling of the federal excise tax, considering the implications of

various elasticity estimates. He concluded that the tax increase had likely

deterred 600,000 youths from smoking and that, as a consequence of their

avoidance of cigarettes and adults quitting, 54,000 of the youths and an

additional 100,000 adults would survive to at least 65 years of age.

The General Accounting Office (1989) employed the same elasticity

estimates used by Warner (1986b) and the same assumptions about premature

mortality avoided to evaluate the likely health benefits from a sustained real

21-cent federal tax increase in 1989, which they estimated would increase

retail price by 15%. They predicted a further reduction in youth smoking of

500,000, with a subsequent reduction in premature mortality among these youths

of 125,000.

Recently, Moore (1996) developed a more sophisticated econometric model

that, incorporating state-level data on death rates from smoking-related

diseases from 1954 through 1988, could be used to evaluate the impact of

higher taxes on mortality. He determined that a 10% increase in cigarette

excise taxes would save approximately 5,200 lives each year. Similarly, Evans

and Ringel (forthcoming) examined whether or not higher state cigarette taxes

can be used to improve birth outcomes. Using data on approximately 10.5

million births in the U.S. over the period from 1989 through 1992, the authors

estimated a smoking prevalence elasticity of -0.5 for pregnant women and found

that increased cigarette taxes would significantly raise birth weight.

With the help of economic consultants, the Coalition on Smoking or

Health (1994) used relatively conservative estimates of price elasticity and

of the mortality consequences of smoking to estimate the health implications

of alternative tax hikes advocated by the Coalition's member organizations.

The Coalition determined that a 75-cent tax increase in 1992 would reduce

premature deaths due to smoking by 900,000. A $2 per pack increase was

Economics of Smoking - p. 58

estimated to save 1 million more lives than the 75-cent increase.

Chaloupka (1998) did the same for the price increases included in many

of the recent proposals for national tobacco legislation in the US. Based on

Chaloupka and Grossman's (1996) estimates, Chaloupka estimated that a $1.50

increase in cigarette taxes and prices, phased in quickly and maintained in

real terms, would reduce overall cigarette consumption by about 30 percent

while cutting youth smoking prevalence almost in half. Based on the CDC's

(1996) estimates for the number of youth in the 1995 US cohort of 0 through 17

year olds who would eventually die prematurely from a smoking related illness,

Chaloupka estimated that this tax increase would prevent approximately 2.5

million deaths in this cohort.

To most members of the public health community, the health benefits of a

tax increase justify its imposition. However, public health professionals

appeal to the social cost argument to garner public and, especially,

legislative support. Given the conceptual as well as empirical problems with

the public health community's construction of the social cost of smoking,

discussed above, the question remains as to whether economists would find

theoretical justification for increasing the cigarette tax in the analyses of

external costs that have been performed to date, or for that matter in other

considerations. The next section addresses the economic efficiency issues and

evidence.

3.4 Economic efficiency and the pursuit of an optimal cigarette tax

Most economists would concur that an economically optimal tax on

cigarettes would equate the revenues generated with the net external costs

produced by smoking.20 Here we review the evidence pertinent to determining

20 Pigou (1962) suggested that, for goods with market prices less than

their social costs, taxes could be used to raise the marginal cost of

consuming the good to the social marginal cost. For some goods, taxes could

generate revenues that exceed total external costs, reflecting the fact that

the taxes are based on marginal rather than average external costs (Cook and

Moore, 1993).

Economics of Smoking - p. 59

such a tax and evaluate additional considerations that relate to the notion of

optimality when considering taxation of an addictive substance such as

cigarettes.

3.4.1 Negative externalities associated with smoking

As discussed above, the public health community's definition of s ocial

costs incorporates both negative externalities and private costs. While

economists agree that the latter should not be considered as social costs in

contemplating a corrective tax on cigarettes, there is no complete consensus

on precisely what consequences warrant inclusion, and even for those for which

there is consensus, estimates of the magnitude of the true social

externalities vary widely. Moreover, other tobacco control policies,

particularly restrictions on smoking in public places and private worksites,

may be more efficient approaches to dealing with some of these externalities.

One author found that including the costs of the long-term intellectual

and physical consequences of smoking-related low-birth-weight disabilities

implied a tax of $4.80 per pack (Hay, 1991). In contrast, other studies have

found much smaller per-pack negative externalities, often less than existing

excise tax rates. For example, evaluating data from the RAND Health Insurance

Experiment and the 1983 National Health Interview Survey in an incidence-based

cost analysis, Manning et al. (1989) concluded that, for their mid-range

estimates, the negative externalities of smoking totaled the equivalent of 43

cents per pack (in 1986 dollars). Partially offsetting these negative

externalities, however, were an estimated 27 cents in "external savings"

resulting from smoking-related premature deaths, meaning that the net negative

externalities equaled 16 cents. The researchers thus concluded that the

empirical evidence did not justify raising the cigarette tax on grounds of

covering negative externalities. 21 In a later analysis that drew on the

21 Early analysis of the offsetting savings associated with smokers'

premature deaths is found in the work of Leu and Schaub (1983). These authors

estimated the lifetime medical expenditures of a cohort of Swiss males, which

Economics of Smoking - p. 60

Manning et al. study, Viscusi (1995) came to the same conclusion.

The Manning et al. study and Viscusi’s reanalysis hasbeen cited

frequently by opponents of a cigarette tax increase. Representing the Tobacco

Institute at a Senate hearing, Tollison (1994) identified the work by Manning

and his colleagues, as well as that of other prominent health economists, as

rejecting the propriety of an economically-motivated tax increase. The

Congressional Research Service ( Gravelle and Zimmerman, 1994) cited the same

study in the CRS's evaluation of the grounds for a tax increase (which the

authors found wanting). Updating the figures to 1995 dollars, the CRS

estimated the net negative externalities at 33 cents per pack of cigarettes,

two-thirds of the average 50 cents in federal and state taxes imposed on

cigarettes in late 1993.

Although the Manning et al. study has dominated attention within t he

economics debate about the marginal social costs of smoking, the study reveals

several problems of both omission and commission, many of which the authors

have acknowledged (Manning et al., 1991). Adjustments reflecting these issues

often lead to qualitatively different conclusions about the desirability of

increasing the cigarette excise tax. In terms of omission, most notably the

study excluded a variety of costs associated with environmental tobacco smoke

(ETS) that, if included, would significantly increase the social cost

estimate. Many of the health consequences of ETS were not well appreciated

included both smokers and nonsmokers, and compared them with the simulated

expenditures of a hypothetical cohort assumed to include only nonsmokers. The

authors concluded that the lifetime expenditures would be very similar for

both cohorts, with the higher annual costs of smokers in the "real" cohort

offset by the additional years of medical expenditures in the longer-lived

hypothetical no-smoker cohort. In estimating the medical costs of nonsmokers

in the hypothetical cohort, Leu and Schaub recognized that those who would

have been smokers in the "real" cohort would differ in ways other than just

smoking from those who would be nonsmokers in both cohorts. They introduced

the notion of the "non-smoker smoker type" as the conceptually correct entity

to evaluate in the hypothetical cohort, for those members who would have been

smokers in the "real" cohort. This useful distinction has been incorporated

in the work of several economists since then, including Manning et al. (1989).

Implicitly, it is embodied in all attempts to evaluate smoking-related health

care costs in which smokers' other risk-taking behaviors are controlled (e.g.,

Bartlett et al., 1994; Miller et al., 1998).

Economics of Smoking - p. 61

when Manning et al. undertook their research in the mid-1980s (e.g., the

consequences of ETS for heart disease). However, the authors made the

decision to consider then-known ETS costs as internal, based on the

traditional economic assumption that the family is the appropriate economic

unit for consumption decisions, including the decision to smoke. Further, the

authors reasoned, the adverse health consequences of smoking were largely

confined to the nonsmoking spouses of smokers. 22

Although few economists would challenge the sanctity of the family as

the basic economic unit, the assertion about the internal nature of ETS costs

is less clear. Certainly, some ETS costs are external to the family (e.g.,

airline attendants' ETS-induced lung disease prior to the banning of smoking

on flights). Others likely represent a mix of internal and external costs.

For example, disease and developmental problems associated with low birthweight

caused by mothers' smoking during pregnancy often have support costs

that spill over into the broader society, as social institutions are required

to pick up some of the medical, institutional, and other costs related to

these conditions. Thus, regardless of one's philosophical approach to the

issue of intra-family health problems caused by ETS, determining the

appropriate distribution of costs between family and the rest of society is a

distinct challenge.

The potential role of ETS costs in reevaluating the net negative

externalities associated with smoking is seen by considering the following

figures. Manning et al. (1991) noted that inclusion of the costs of 2,400

lung cancers from ETS (a fairly conservative estimate of this toll

(Environmental Protection Agency, 1992) ) as external costs would add

approximately 19 cents per pack in external costs (updated to 1994 dollars).

In addition, inclusion of the costs of neonatal care for smoking-related low-

22 At the time this analysis was undertaken, virtually all of the medical

literature indicting ETS as a cause of disease related to the experience of

nonsmoking wives of smoking husbands (U.S. Department of Health and Human

Services, 1986; Environmental Protection Agency, 1992); there was no

significant evidence of ETS exposure or disease effects outside of the home.

Economics of Smoking - p. 62

birth-weight babies would add 3 cents to the total, while including fetal

deaths attributable to smoking would add yet another 19 cents. Deaths from

smoking-related fires would add a further 9 cents. The ETS costs would skyrocket

if one included the estimated 30,000-60,000 heart disease deaths

recently associated with ETS (Glantz and Parmley, 1995), adding perhaps 70

cents to the total social costs per pack. Similarly, inclusion of the

smoking-induced respiratory tract infections and cases of aggravated asthma in

children (Environmental Protection Agency, 1992) would boost the total

further, as would inclusion of the long-term developmental disabilities in

smoking-related low-birth-weight babies (Hay, 1991). All told, the social

costs per pack could easily mount toward several dollars if all of the health

hazards associated with ETS are real, many are treated as external to the

basic consuming unit, and if all or even a significant fraction of the

associated costs are included.

ETS cost estimation is also influenced substantially by whether one

employs the human capital approach or willingness-to-pay to value the lives of

persons who die prematurely due to ETS exposure. Manning et al. used a

conservative estimate of $1.66 million per premature death based on the range

of estimates in the literature. 23 Using willingness-to-pay, the Environmental

Protection Agency (1994) obtained a $4.8 million figure. In its analysis

(which included the adverse effects of ETS on heart disease and children's

health, but not on fetal and perinatal health), the EPA estimated that the

benefits that would result from a ban on smoking in all worksites would total

between $39 billion and $71 billion annually, the equivalent of from $2.45 to

$4.45 per pack of cigarettes. The EPA used fairly conservative assumptions

concerning the effects of a worksite smoking ban on smoking and exposure to

23 As discussed above, the authors' estimates of external costs

attributable to ETS were negligible, making the choice of the cost of a

premature death of little consequence to their calculations (Manning et al.,

1989). However, had they included the full range of health consequences now

attributed to ETS, the choice of a value-of-life measure would have been of

much greater importance.

Economics of Smoking - p. 63

ETS. They assumed a ban would reduce the number of current smokers by 3-6%,

the number of future smokers by 5-10%, and daily consumption among continuing

smokers by 10-15%, for a total long-run reduction in cigarette consumption of

14-22%. The EPA estimated that these consumption reductions would reduce outof-

home ETS exposure by 90% and in-home exposure by 6.4%. An earlier EPA

report (1992) had concluded that an estimated 73% of ETS exposure occurs

outside the home. The EPA thus predicted that a worksite ban would reduce

total ETS exposure by 66.4%.

Quite independent of the treatment of the effects of ETS, the Manning et

al. (1989) study and "spin-offs", such as Gravelle and Zimmerman's (1994)

review of the evidence and Viscusi’s (1995) reanalysis, raise the issue of

which types of costs ought to be included in calculations of external costs.

Manning and colleagues' finding that current taxes covered external costs

would have been reversed had the authors not included the value of pensions

and Social Security benefits not realized by smokers by virtue of their

premature demise. As demonstrated by Shoven et al. (1989), smokers subsidize

nonsmokers' Social Security benefits by virtue of the smokers' early average

ages of death; the same relationship should hold for defined benefit pensions

as well. Some analysts have considered this a transfer, not subject to

consideration as an externality, rather than a compensating external benefit

of smoking, as Manning et al. treated it. However, Manning et al. did not

consider it a transfer because they viewed the length of life of smokers as

endogenous. As the literature on the costs of smoking demonstrates

repeatedly, inclusion or exclusion of such costs can play a significant role

in calculating net external costs. 24

24 Other candidates for inclusion are the reduction in income taxes and

insurance premiums paid by smokers due to reduced earnings associated with

smoking-related illnesses; smoking-related health care costs paid by public

insurance plans (and conceivably private, depending on how these are treated);

and increased sick pay and disability benefits paid during smoking-related

illnesses. If such items are included, care must be taken to consider both

reduced payments by smokers into public revenues and altered patterns of

consumption of government-financed goods and services.

Economics of Smoking - p. 64

The importance and complexity of the handling of such matters is

illustrated by their differential effects in different societies and at

different times. For example, as just noted, in the U.S. analysts have

concluded that, by dying early, smokers subsidize nonsmokers' Social Security

payments (Shoven et al., 1989; Viscusi, 1995). In the United Kingdom, by

contrast, research indicated that sickness benefits paid to smokers and

pensions paid to their dependents compensated for the lower direct pension

benefits paid to smokers as a consequence of their earlier average age of

death (Atkinson and Townsend, 1977). In developing countries in which old-age

expenses are largely a private matter, the social "benefit" of smokers' dying

early would not exist, and hence would not offset any negative externalities

of smoking. Of course, this could change over time if and as such societies

developed social security plans. Similarly, the magnitude of the offsets in

the developed countries could change if and as benefit programs in those

countries were altered (Warner et al., 1995).

As this discussion has demonstrated, calculation of the "true" net

negative externalities associated with smoking is an exceedingly difficult

challenge, one that involves conceptual questions, epidemiologic and other

data considerations, and "moving targets" in terms of both knowledge and

institutional structures. The relevance of the task to understanding optimal

cigarette taxation recommends further research, despite its difficulty. 25

3.4.2 Other efficiency considerations

Several factors related to smoking complicate the task of defining an

optimal cigarette tax. Two essential realities about smoking -- namely, that

it is a behavior initiated almost exclusively during childhood (U.S.

25 An interesting example of the problems created by institutional

structures in trying to assess the relevance of ETS to determining an optimal

tax lies in the effects of workplace smoking bans on the development of ETSrelated

diseases: the more pervasive are workplace bans, the less ETS

exposure nonsmokers will experience, and hence the amount of ETS-related

disease will decline. This, in turn, would decrease the conceptually optimal

tax.

Economics of Smoking - p. 65

Department of Health and Human Services, 1994) and that it is addictive (U.S.

Department of Health and Human Services, 1988) -- give pause in treating

cigarette consumption just like any other rational economic behavior. A third

reality -- that many smokers are not truly well informed about the hazards of

smoking (U.S. Department of Health and Human Services, 1989; Schoenbaum,

1997)26 -- also challenges a basic proposition of rational behavior. For

smoking as for other consumption, rational economic behavior presumes both the

existence of adequate knowledge on which to base consumption decisions and

rational use of the knowledge. In the absence of adequate knowledge, higher

taxes might be justified (Cordes et al., 1990). One may be particularly

interested in applying this concept to teenagers, although increasing taxes is

a decidedly blunt instrument if its purpose is solely to better "inform"

youths about the risks of smoking (Warner et al., 1995).

As discussed in an earlier section, the empirical applications of the

rational addiction model suggest that addicted adult smokers do not behave

myopically in contemplating the relationship between cigarette consumption and

past, present, and expected future prices. However, as the evidence reviewed

above indicated, youth exhibit much more myopic cigarette consumption behavior

than do adults, consistent with studies that have found young smokers greatly

underestimating the probability that they would still be smoking five years

later (U.S. Department of Health and Human Services, 1994). Moreover, as

illustrated by the Orphanides and Zervos (1995) model, the role of information

(more specifically the lack of information on the potential for addiction) is

particularly important in the initiation process, and results in later regret.

A group of health economists who have studied the economics of smoking

recently concluded that protecting children from a future of nicotine

addiction, with its associated health risks, was the most compelling reason

favoring increased taxation of cigarettes (Warner et al., 1995). They

perceived high taxes as appropriate to balance an environment in which

26 For a contrary view, see Viscusi (1992).

Economics of Smoking - p. 66

children face numerous inducements to smoke, including multi-billion dollar

advertising and marketing campaigns by the cigarette companies, many designed

to attract children to smoking (US Department of Health and Human Services,

1994). To address this imbalance, these economists supported such measures as

increased public education and increased enforcement of restrictions on youth

access to tobacco products, although the limited effectiveness of such

measures is well documented. (See section 5 below.) The economists observed,

however, that these measures do not address children's tendency to discount

the future heavily, in a manner that, as rational adults, they might come to

regret. Taxation, they felt, is the best available policy instrument to

address this problem, both conceptually and empirically. As observed above,

two recent analyses (Orphanides and Zervos, 1995; Suranovic et al., in press)

examining the initiation of smoking, continuation over time, and eventual

consideration of quitting (and difficulty in doing so) lend new insight into

this issue of regret.

4. Advertising, promotion, and the demand for tobacco products

Cigarettes are one of the most heavily advertised and promoted products

in the world. In the United States, for example, the cigarette industry spent

$5.1 billion on advertising and promotion activities in 1996 (Federal Trade

Commission, 1998); as a percentage of sales, these expenditures have increased

dramatically since 1980. Cigarette advertising includes the more traditional

advertising on television, radio, and billboards, in newspapers, magazines,

and transit facilities, and, most recently, on the internet. Spending on

promotion includes a wide variety of activities, including promotional

allowances to retailers, point-of-purchase promotional materials, direct mail

advertising, the distribution of free samples, coupons, and specialty items,

multiple pack promotions, and retail value-added offers, as well as

endorsements, sponsorship of cultural, sporting, and other entertainment

events, and sponsorship of community and other organizations. Nearly 87% of

Economics of Smoking - p. 67

all cigarette advertising and promotional expenditures in the U.S. in 1974

were devoted to traditional advertising; by 1996, in striking contrast, this

had fallen to just over 10%, with the balance going to the less-traditional

promotional activities. Promotional allowances ($2.15 billion in 1996) and

coupons and retail value added ($1.31 billion in 1996) have been the largest

spending categories in recent years.

This section begins with a brief discussion of the arguments related to

cigarette advertising and demand, as well as a review of some of the economic

issues related to cigarette advertising. We then examine the econometric

literature on the impact of cigarette advertising on smoking, consider the

limitations of the econometric approach, and review the growing literature on

the impact of restrictions and bans on cigarette advertising and promotion.

The section closes with a short description of the findings on cigarette

advertising and demand from the non-economics literature.

4.1 Theoretical and conceptual issues

The impact of cigarette advertising on cigarette smoking, particularly

youth smoking, has been the subject of extensive debate over the past several

decades. The public health community takes it as given that advertising

encourages smoking and is a particularly significant influence on smoking

initiation among youth. The industry, on the other hand, contends that

cigarette advertising is a form of competition that has no impact on overall

cigarette smoking, but instead simply affects market share. In addition, the

industry argues that advertising provides useful information to smokers about

their products, including information on tar and nicotine content.

Warner (1986a) suggested several mechanisms through which cigarette

advertising and promotion could affect cigarette consumption. He identified

four direct mechanisms: (1) advertising can entice children and young adults

to experiment with smoking and to initiate regular smoking; (2) it can reduce

current smokers' willingness to quit smoking; (3) it can serve as a cue or

Economics of Smoking - p. 68

stimulus that leads to increased daily cigarette consumption by smokers; and

(4) it can induce former smokers to resume their habit by reinforcing the

attractions of smoking. Two indirect mechanisms were: (1) discouraging a

full discussion of the health consequences of cigarette smoking in media

dependent on tobacco advertising; and (2) contributing to a social environment

in which smoking is perceived to be socially acceptable. The U.S. Surgeon

General (U.S. Department of Health and Human Services, 1989) added a third

indirect mechanism, namely that institutions dependent on tobacco industry

promotional and other support may create political opposition to strong

tobacco control policies.

Warner and his colleagues (Warner, 1985; Warner and Goldenhar, 1989;

Warner et al., 1992) have examined the first indirect mechanism empirically,

concluding that there is strong evidence that magazines' coverage of the

hazards of smoking was significantly diminished as the magazines' share of

advertising revenues from cigarette advertising rises. Warner et al. (1992)

found that magazines that did not carry cigarette advertising were more than

40% more likely to cover the health consequences of smoking than those with

cigarette advertising. The difference was more pronounced for women's

magazines, with those that did not advertise cigarettes more than 230 percent

more likely to cover the hazards of smoking.

4.2 Econometric evidence

Other than this work by Warner and colleagues, research by economists

has not addressed the hypothesized individual mechanisms by which advertising

can influence cigarette consumption. However, beginning with Schmalensee's

1972 study, there have been numerous econometric studies of the impact of

cigarette advertising on cigarette demand, mostly for the U.S. and the U.K,

but also for several other countries as well. No consensus concerning the

effects of advertising on smoking has emerged from this research, however.

Several recent reviews of this literature, drawing on many of the same

Economics of Smoking - p. 69

studies, reached opposite conclusions. Based on their review of 24 studies

with estimates of the advertising elasticity of cigarette demand, Andrews and

Franke (1991) concluded "that there is a significant relationship between

advertising and cigarette consumption across studies, independent of study

design factors. However, the estimated magnitude of this relationship varies

depending on several study design factors" (page 96). Moreover, they

concluded that the positive impact of advertising on cigarette demand has

declined over time, a factor they attributed to the maturation of cigarette

markets in most of the countries studied. Duffy (1996b), on the other hand,

concluded that econometric studies of the relationship between cigarette

advertising and demand generally have found that advertising has little or no

impact on aggregate cigarette consumption.

In his now classic volume, The Economics of Advertising, Schmalensee

(1972) introduced several concepts that reemerge repeatedly in subsequent

studies of cigarette advertising and demand. In particular, he examined

cigarette demand at both the industry and firm levels, allowed for the

possibility that a firm's cigarette advertising expenditures might be based on

current sales, and modeled not only the effects of current advertising

expenditures on demand but also the impact of lagged expenditures. As

Schmalensee observed, failing to account for the potential endogeneity of

cigarette advertising expenditures would lead to biased estimates of the

impact of advertising on demand. Similarly, failing to account for the

cumulative or "stock" effects of advertising could lead to an omitted

variables problem, although the evidence is mixed concerning the durability of

cigarette advertising (Boyd and Seldon, 1990). Schneider et al. (1981)

extended the use of the "stock" of advertising to allow the marginal

productivity of advertising expenditures in the U.S. to fall after the 1971

ban on broadcast cigarette advertising.

An additional issue raised by Schmalensee relates to the measurement of

advertising expenditures. In half of his industry-level models, he used the

Economics of Smoking - p. 70

absolute level of cigarette advertising, while in the other half, he used the

ratio of cigarette advertising to total advertising, providing an intuitive

argument favoring the latter analogous to the use of relative rather than

absolute price. Subsequent theoretical models of consumer behavior have made

this argument more formally (Theil, 1980; Duffy, 1987).

The numerous econometric studies on the impact of aggregate cigarette

advertising expenditures on aggregate cigarette consumption differ with

respect to many of the issues raised by Schmalensee, as well as in several

other respects. Almost none follows Schmalensee and treats advertising

expenditures as endogenous. A few estimate firm-specific demand (e.g.,

Roberts and Samuelson, 1988), while most examine industry demand. Several

introduce measures of past advertising expenditures; some do so directly

(e.g., Goel and Morey, 1995), while others construct a cumulative "stock" of

advertising (e.g., Schneider et al., 1981). Most look at absolute or per

capita measures of cigarette advertising expenditures, while a few employ

measures of expenditures on cigarette advertising relative to overall

advertising expenditures (e.g., Duffy, 1996a). Many estimate single equation

models of cigarette demand; several, however, estimate simultaneous equations

models of supply and demand (e.g., Porter, 1986). Most estimate conventional

demand models, while some estimate myopic demand models that include a measure

of past cigarette consumption (e.g., Baltagi and Levin, 1986) or an

alternative approach (Fujii, 1980); one estimates demand in the context of the

rational addiction model (Duffy, 1996a).

Schmalensee (1972) and many subsequent econometric studies based on

aggregate data from the U.S., U.K., and a few other countries found no

statistically significant effect of aggregate cigarette advertising

expenditures on cigarette consumption (Hamilton, 1972; Lambin, 1976;

Grabowski, 1976, 1978; Metra Consulting Group, 1979; Schneider et al., 1981;

Johnson, 1986; Baltagi and Levin, 1986; Stavrinos, 1987; Tegene, 1991; Duffy,

1991, 1996a; Wilcox and Vacker, 1992; U.K. Department of Health, 1992; Wilcox

Economics of Smoking - p. 71

et al., 1994; Franke, 1994; Goel and Morey, 1995). A few of these studies,

however, did find some evidence that lagged cigarette advertising had a

significant positive impact on current cigarette consumption, providing some

support for the durability of advertising ( Schmalensee, 1972; U.K. Department

of Health, 1992; Goel and Morey, 1995). Several other studies have found that

cigarette advertising has a positive and significant impact on aggregate

cigarette demand (McGuiness and Cowling, 1975, 1980; Fujii, 1980; Witt and

Pass, 1981; Reuijl, 1982; Radfar, 1985; Bishop and Yoo, 1985; Leeflang and

Reuijl, 1985; Abernethy and Teel, 1986; Porter, 1986; Roberts and Samuelson,

1988; Chetwynd et al., 1988; McAuliffe, 1988; Kao and Tremblay, 1988; Seldon

and Doroodian, 1989; Seldon and Boyd, 1991; Valdes, 1993; Tremblay and

Tremblay, 1995). However, the magnitude of the estimated effect is generally

small. Differences in the design, data, and empirical methods account for the

inconsistent findings.

Based on the mixed evidence from the studies using aggregate data,

aggregate cigarette advertising appears to have a small or negligible impact

on aggregate cigarette sales. However, as a number of researchers have

observed, the nature of competition in the cigarette industry and the

limitation of econometric analysis to estimating marginal effects imply that

there should be at most a small impact of aggregate cigarette advertising

expenditures on aggregate cigarette consumption (Cox, 1984; Warner, 1986a;

Warner et al., 1986; U.S. Department of Health and Human Services, 1989;

Saffer, 1995, 1998; Pollay, 1996).

As Saffer (1995, 1998) has noted, advertising expenditures will have

diminishing marginal productivity. Drawing on the "advertising response

functions" used to characterize brand-level advertising in the empirical

marketing literature, which clearly imply diminishing returns to advertising

at the brand level (Rao and Miller, 1975; Ackoff and Ernshoff, 1975), Saffer

concluded that an "industry advertising response function" will also show

diminishing returns to increasing expenditures and marginal effects could be

Economics of Smoking - p. 72

well below average effects. Moveover, in a highly concentrated market with a

virtual absence of price competition, where the "personality" of the product

is very important to consumers, total advertising expenditures will almost

certainly exceed the "rational" level associated with joint profit

maximization that would be expected to show a significant positive impact on

overall demand. Instead, in an effort to increase or protect market share,

firms will advertise beyond the level where one would expect to find a sizable

positive marginal effect of total advertising on total demand, assuming that

the firms do not collude in deciding upon the amount of advertising. A number

of econometric studies have looked at the impact of advertising on demand at

the firm or brand level. These generally have found that increases in

advertising expenditures have a positive and significant effect on market

share (Telser, 1962; Peles, 1971; Schnabel, 1972; Grabowski, 1978; Holak and

Reddy 1986; Pollay 1996). Pollay (1996), for example, estimated that "share

of voice" (brand share of advertising expenditures) has a significant impact

on market shares, and that brand choice among teenagers is about three times

more sensitive to advertising than it is for adults (a result surprisingly

similar to the estimates for youth and adult price sensitivity).

In short, given that the econometric analyses of aggregate expenditures

and consumption are designed to assess the impact of a marginal change in

advertising expenditures on total cigarette sales, it is not surprising that

most of these analyses estimate small or insignificant effects of advertising

on demand. In addition, critics of these analyses suggest several

methodological shortcomings, including : the lack of appropriate measures of

advertising exposure and other problems with the measures of advertising

employed; the failure to distinguish between the impact of advertising and

promotional activities; problems with the simultaneity between advertising

expenditures and sales; the omission of other key variables, such as

concurrent counteradvertising; and more (Cox, 1984; Warner, 1986a; Warner et

al., 1986; U.S. Department of Health and Human Services, 1989; Chapman, 1989;

Economics of Smoking - p. 73

U.K. Department of Health, 1992; Luik, 1994; Saffer, 1995, 1998; Duffy, 1996b;

Pollay, 1996). These and other critics have suggested that more appropriate

approaches include the examination of more disaggregated data and the analysis

of non-marginal changes in advertising expenditures, such as those that result

from significant restrictions or complete bans on cigarette advertising and

promotion.

To date, only one econometric study has examined the impact of cigarette

advertising employing individual level data and more appropriate measures of

advertising exposure. Lewit et al. (1981) used data on about 6,700 youth ages

12-17 years taken from Cycle III of the U.S. Health Examination Survey

conducted from 1966 through 1970. Based on measures of televised cigarette

advertising and counter-advertising, and self-reported information on time

spent watching television, Lewit and his colleagues estimated the number of

pro- and anti-smoking commercials each youth would have seen. Their estimates

provide support for the hypothesis that televised pro-smoking advertisements

significantly increased youth smoking.

There are a number of studies examining th e impact of restrictions and

bans on cigarette advertising on smoking. Many of the older studies look at

the impact of the U.S. ban on broadcast cigarette advertising that began

January 2, 1971 (Ippolito et al., 1979; Schneider et al, 1981; Bishop and Yoo,

1985; Porter, 1986; Baltagi and Levin, 1986; Kao and Tremblay, 1988;

McAuliffe, 1988; Seldon and Dooroodian, 1989; Seldon and Boyd, 1991; Simonich,

1991; Franke, 1994; Goel and Morey, 1995; Tremblay and Tremblay, 1995). In

general, these studies produced mixed evidence on the impact of the ban on

television and radio advertising. Most concluded that the ban did not

significantly reduce cigarette smoking in the U.S. A few suggested that the

marginal productivity of cigarette advertising fell after the ban (for

example, Tremblay and Tremblay, 1995). Several, including Hamilton (1972) and

Warner (1979), suggested that the net impact of the 1971 ban was to raise

cigarette consumption because it also led to the elimination of effective

Economics of Smoking - p. 74

anti-smoking commercials broadcast under the Fairness Doctrine (discussed

below). Schneider et al. (1981) supported this argument empirically,

concluding that the advertising ban led to a net increase of nearly 5% in per

capita tobacco consumption, in part due to a price reduction resulting from

the reduced costs associated with less advertising. In addition, they argued,

the advertising ban limited the provision of information to smokers concerning

the tar and nicotine content of different brands and, consequently, reduced

the likelihood that smokers would switch to lower tar and nicotine brands.

Others examined the impact of other country-specific restrictions,

including: the 1965 U.K. ban on televised cigarette advertising (Atkinson and

Skegg, 1973; Witt and Pass, 1984); the ban on advertising in electronic media

in Australia (Johnson, 1986; McLeod, 1986); the Finnish extension of its

television ad ban to other media ( Pekurinen, 1989, 1991); and Spain's partial

ban on broadcast advertising (Valdes, 1993). Hamilton (1977) presented

similar estimates from separate regressions for 11 countries over the period

1948-1973. These studies also produced mixed evidence on the effectiveness of

these partial bans. In general, they suggested that the bans led to a

temporary reduction in cigarette smoking, but that they had little impact in

the long run. However, more extensive restrictions coupled with anti-smoking

publicity, strong health warnings, and other activities appear to have led to

more permanent reductions in demand ( Pekurinen, 1989, 1991).

Still others have conducted cross-country analyses of the impact of

restrictions and bans on cigarette advertising and promotion (Hamilton, 1977;

Cox and Smith, 1984; Laugesen and Meads, 1991; and Stewart, 1993). These,

too, have yielded mixed findings. In addition to country-specific

regressions, Hamilton (1977) included models pooling some of the countries in

his sample. As in the country-specific models, he found no evidence that

advertising restrictions reduced cigarette demand. Cox and Smith (1984) took

an indirect approach to estimating the impact of advertising bans on demand.

Using data from 15 OECD countries, they sorted countries by their use of

Economics of Smoking - p. 75

legislative versus voluntary strategies to reduce smoking, where limits on

advertising reflected a more legislative strategy. Based on a series of

country-specific regression models, they concluded that smoking declines more

rapidly in countries that take a legislative approach to tobacco control,

suggesting that advertising restrictions are effective in reducing demand.

Laugesen and Meads (1991) pooled annual aggregate data from 22 OECD

countries for the period 1960-1986 in their examination of the impact of

advertising and promotion restrictions. Rather than focusing on a specific

type of restriction (e.g., a broadcast advertising ban), Laugesen and Meads

constructed an advertising restriction index that ranges from zero (no

restrictions) to 10 (complete bans on advertising and sponsorships coupled

with multiple, strong warning labels on cigarette packaging). Estimates from

this model imply that cigarette consumption would be about 6% lower with the

strongest restrictions than it would be with no restrictions. In their

preferred specification, to account for the lagged effects of advertising, the

coefficient on the advertising restriction index was interacted with time. In

this specification, Laugesen and Meads found that advertising restrictions

actually had a positive effect on cigarette demand through the early 1970s,

but then reduced consumption after 1973. Estimates for the final year of

their data implied that each additional point in the restriction index reduced

cigarette consumption by about 1.5 percent, well above their estimate for the

specification that does not allow the effect to vary over time. Laugesen and

Meads attributed the positive effects of the ban early in their sample to the

industry's ability to substitute other marketing activities for broadcasting

advertising in response to early restrictions. However, its ability to

substitute other media for banned media diminished over time as the

restrictions became more comprehensive.

Stewart (1992) raised a number of concerns about the approach taken by

Laugesen and Meads. Specifically, Stewart argued that errors in variables for

the dependent and several independent variables will bias the estimates on the

Economics of Smoking - p. 76

advertising restriction coefficients. In addition, he argued that the

Laugesen and Meads approach failed to account for unmeasured, country-specific

factors (i.e., culture, tastes, and attitudes) that should be important

determinants of cigarette consumption, and that the omission of these factors

leads to biased estimates of the advertising restriction coefficients.

Laugesen and Meads (1993) defended the estimates from their research, arguing

that after correcting for errors in the data, the estimates confirmed their

earlier finding that bans on advertising significantly reduce cigarette

consumption. The authors did not present these revised estimates in their

response, however.

Using data on 22 OECD countries for the period 1964-1990, Stewart (1993)

presented his own empirical analysis of the impact of restrictions on

cigarette advertising on demand. He estimated fixed effects models to control

for unmeasured country-specific influences on demand. Rather than using a

comprehensive measure of restrictions on cigarette advertising, however,

Stewart focused on bans on the televised advertising of cigarettes. Also, in

contrast to Laugesen and Meads, Stewart did not allow the impact of the

advertising restriction to change over time. He estimated that the ban on

cigarette advertising on television has had a positive but insignificant

impact on cigarette demand, consistent with the findings from several other

studies on the effects of broadcast advertising bans alone.

In late 1992 the United Kingdom's Department of Health reviewed the

evidence on the impact of cigarette advertising and restrictions on

advertising on cigarette demand (U.K. Department of Health, 1992). The "Smee

Report," known by the name of the project director, also contains two original

econometric analyses on the impact of advertising restrictions, one for Norway

and the other for Canada. Estimates from these analyses suggest that the

countries' relatively comprehensive advertising and promotion bans did lead to

significant reductions in smoking. Given this evidence as well as that from

the numerous qualitative and quantitative studies reviewed, the Smee Report

Economics of Smoking - p. 77

concluded that cigarette advertising has a positive impact on smoking and that

bans on advertising would reduce demand.

In a subsequent edited volume, critics of the Smee Report argued that it

was flawed in several ways, including the following : the literature review

omitted several qualitative and quantitative studies that found no impact of

advertising or ad restrictions on cigarette demand; the findings from some of

the literature reviewed are misstated; the empirical analyses contained

methodological and other errors ( Luik, 1994). Stewart (1994), for example,

compared the estimates for the countries common to his 1993 econometric

analysis with those presented in the Smee Report, concluding that advertising

bans in Norway, Finland and Canada have actually increased tobacco

consumption.27

The Smee Report, Saffer (1998), Stewart (1993), and others have

indicated several factors that complicate the ability of econometric analysis

to examine the impact on cigarette demand of restrictions on cigarette

advertising and promotion. The potential endogeneity of advertising

restrictions has not been carefully examined in any of the econometric

studies. Similarly, with the exception of Stewart (1993), social, cultural,

and other differences among countries have not been well controlled for in the

econometric research. However, efforts to control for these, using fixed

effects modeling for example, create severe multicollinearity problems that

make it difficult to isolate the impact of the advertising restrictions on

demand from other key determinants. Similarly, as Saffer noted, a majority of

the studies to date have examined the impact of restrictions on advertising in

one or two media, leaving firms free to substitute towards other media and to

develop new marketing approaches. The findings from several studies, which

suggest at best a temporary negative effect of a relatively limited set of

advertising restrictions, are consistent with the argument that effective

27 The Smee Report's estimate for Finland is based on the work by

Pekurinen (1989, 1991) rather than an original econometric analysis.

Economics of Smoking - p. 78

alternatives are developed in response to the ban. So to are the findings

from the few studies that have found that relatively comprehensive

restrictions significantly reduce demand.

4.3 Findings from the noneconomic literature

While econometric methods are powerful tools for examining the demand

for cigarettes and other tobacco products generally, they are relatively illsuited

for evaluating the effects of cigarette advertising and promotion and

related restrictions, as described above. Evidence from a number of other

disciplines, however, supports the argument that cigarette advertising and

promotion directly and indirectly increase cigarette demand (Warner, 1986a;

U.S. Department of Health and Human Services, 1989, 1994, 1996, 1998; U.K.

Department of Health, 1992).

A major source of noneconomic evidence is survey research and

experiments that assess reactions to and recall of cigarette advertising and

smoking behavior, particularly among children. These studies have concluded

that cigarette advertising is effective in getting children's attention and

that the ads are recalled, with strength of interest correlated with current

or anticipated smoking behavior or smoking initiation (U.S. Department of

Health and Human Services, 1989, 1994; Food and Drug Administration, 1996;

Goldstein et al., 1987; DiFranza et al., 1991; Evans et al., 1995; Pierce et

al., 1998). However, these studies generally cannot assess the potential

endogeneity between an interest in smoking and behavior (U.S. Department of

Health and Human Services, 1989, 1996).

Others have articulated logical arguments t hat conclude that cigarette

advertising and promotional activities are not consistent with the tobacco

industry's claim that the market for tobacco products is mature and that

marketing activities are designed to promote brand share rather than market

expansion. For example, Tye et al. (1987) calculated that cigarette firms'

battling only for brand share did not make financial sense in a U.S. market in

Economics of Smoking - p. 79

which the top two firms now control 75% of cigarette sales (and one company

has 95% of smokeless tobacco sales) and in which brand loyalty is notoriously

strong. The authors argued that if the industry believed its own brand-share

argument, it would have welcomed the opportunity for a legislated ban on

tobacco advertising, proposed in the U.S. Congress in the mid-1980s. Instead,

the industry fought the ban vigorously. Similarly, Warner (1986a) noted that

even if the industry is a mature or declining one, retaining existing

consumers and recruiting new ones would be particularly important in the

cigarette market in which about 5% of consumers are lost annually to cessation

and death. Finally, while the overall market may be mature, there are

segments of the market that appear to be potential growth markets, such as

youth in the U.S., for whom smoking prevalence has risen throughout the 1990s

(University of Michigan News and Information Services, 1997), or specific

minority groups, such as Hispanic females for whom smoking rates are well

below those of other groups of women (U.S. Department of Health and Human

Services, 1998). Substantial evidence, including recently released internal

industry documents (www.house.gov/commerce/TobaccoDocs/documents.html),

indicates that increasing shares of advertising and promotion activities have

been directed towards these growth or potential growth markets (U.S.

Department of Health and Human Services, 1989, 1994, 1998; U.K. Department of

Health, 1992; King et al., 1998; industry documents - need refs.).

Clearly, there is no "smoking gun" that proves that advertising and

promotion play a significant role in expanding or maintaining the market for

tobacco products, or that they do not. Examining all of the evidence

collectively, Warner (1986a) concluded that it is more likely than not that

advertising and promotion do stimulate cigarette consumption. However, he

also characterized the extent of the influence of advertising as unknown and

possibly unknowable.

To date, economists' contributions to the relevant body of knowledge

about cigarette advertising have been less numerous, and likely less

Economics of Smoking - p. 80

consequential, than in other areas of smoking and health, such as the highly

productive work on the relationship between cigarette price and demand,

reviewed in section 2. Still, the econometric research in this area has

offered important insights into the challenge of evaluating the effects of

advertising. The door is open for creative new work to follow.

5. Other tobacco control policies and demand

This section focuses on the impact on cigarette demand of some of the

more widely used tobacco control policies in addition to taxation and

advertising restrictions, including the dissemination of information on the

health consequences of smoking, restrictions on smoking in public places and

work places, and limits on youth access to tobacco products. Other policies,

such as the disclosure of tobacco product constituents and the funding of

school-based smoking prevention programs, have not been the subject of

economic analysis.

5.1 Health information and counter-advertising

In both the early 1950s and the mid-1960s, smoking-related "health

scares" received substantial public attention in the United States. The first

was prompted by coverage in the popular media of the then-new scientific

evidence linking smoking to lung cancer ( Wynder and Graham, 1950; Doll and

Hill, 1954). Illustrative was an article in the December, 1952 Reader's

Digest entitled "Cancer by the Carton" ( Norr, 1952). The second followed

release of the first Surgeon General's report on smoking and health (U.S.

Department of Health, Education, and Welfare, 1964), the first official

government document to label smoking a cause of lung cancer and to call for

"appropriate remedial action." Media attention to the report ranked it as

one of the year's most covered news stories.

The impact of these "health scares" has been the subject of extensive

econometric analysis (Sumner, 1971; Hamilton, 1972; Schmalensee, 1972;

Economics of Smoking - p. 81

Atkinson and Skegg, 1973; McGuiness and Cowling, 1975; Thompson and McLeod,

1976; Warner, 1977, 1981a, 1989; Ippolito et al., 1979; Fujii, 1980; Schneider

et al., 1981; Leu, 1984; Porter, 1986; Bishop and Yoo, 1985; Kao and Tremblay,

1988; Simonich, 1991; Pekurinen, 1989, 1991; Meier and Licari, 1997). In

general, these and other studies concluded that cigarette smoking fell

significantly in response to the new information on its health consequences.

Warner (1977, 1981a), for example, found that the public scares in the early

1950s significantly reduced smoking in 1953 and 1954, but that their negative

impact diminished through the decade. He concluded that the 1964 Surgeon

General's report led to an immediate 5% decline in cigarette consumption.

Schneider et al. (1981) estimated that U.S. per capita tobacco consumption was

about 39 percent lower in 1978 than it would have been in the absence of the

two health scares.

The evidence linking cigarette smoking to morbidity and premature

mortality led to a number of public policy efforts to disseminate information

on the health consequences of smoking. Numerous countries have adopted

policies requiring health warning labels on cigarette packaging and

advertising; in general, these warnings have become stronger and more

prominent over time. Non-econometric evaluations of warning labels have

concluded that small, inconspicuous labels that provide little specific

information about the consequences of smoking are generally ineffective.

However, multiple, strong, and direct messages that are prominently displayed

have been found to be effective (World Health Organization, 1997). The

limited econometric evidence also suggests that health warning labels have led

to small but significant reductions in cigarette smoking ( Abernethy and Teel,

1986; Tansel, 1993; Meier and Licari, 1997; Bardsley and Olekans, 1998).

Mass media "counter-advertising" campaigns have been widely used to

discourage cigarette smoking and other tobacco use. Econometric analyses of

anti-smoking publicity and paid counter-advertising generally, but not

universally, have concluded that these campaigns have significantly reduced

Economics of Smoking - p. 82

cigarette smoking (Hamilton, 1972; Warner, 1977, 1981a, 1989; Ippolito et al.,

1979; Metra Consulting Group, 1979; Fujii, 1980; Schneider et al., 1981;

Lewit et al., 1981; Porter, 1986; Abernethy and Teel, 1986; Baltagi and Levin,

1986; Stavrinos, 1987; Kao and Tremblay, 1988; Pekurinen, 1989, 1991;

Simonich, 1991; Tansel, 1993; Hu et al., 1994, 1995b, 1995c; Tremblay and

Tremblay, 1995; Goel and Morey, 1995; Hsieh et al., 1996). Much of the

econometric evidence from the U.S. is based on two major counter-advertising

campaigns: the anti-smoking messages broadcast in the late-1960s under the

Federal Communications Commission's Fairness Doctrine (Hamilton, 1972; Warner,

1977, 1981a, 1989; Ippolito et al., 1979; Fujii, 1980; Schneider et al.,

1981; Lewit et al., 1981; Porter, 1986; Baltagi and Levin, 1986; Simonich,

1991; Tremblay and Tremblay, 1995; Goel and Morey, 1995) and the anti-smoking

media campaign in California in the early 1990s, funded by an earmarked tax on

cigarettes (Hu et al., 1994, 1995b, 1995c).

From 1967 until January 2, 1971, the date television and radio

advertising of cigarettes was banned, anti-smoking messsages were broadcast to

"compensate" for pro-smoking advertisements, initially at the rate of one

anti-smoking message for every eight cigarette ads and eventually at a 1:3

ratio. Television time for these counter-advertisements was donated by

broadcasters under the Fairness Doctrine which required broadcasters to air

both sides of a controversial issue if one side was being aired. Per capita

cigarette consumption dropped four years in a row, for the first time in

history (Warner, 1977, 1979). Schneider et al. (1981) concluded that the

counter-advertising reduced per capita consumption by approximately 5%. Using

individual-level data on smoking among youth ages 12-17, taken from Cycle III

of the Health Examination Survey, Lewit and his colleagues (1981) found that

the anti-smoking messages significantly reduced youth smoking prevalence.

In 1988, California voters passed Proposition 99, the California Tobacco

Tax and Health Promotion Act. The Act raised the state cigarette tax by 25

cents per pack and earmarked 20 percent of new tax revenues for health

Economics of Smoking - p. 83

education programs to reduce cigarette smoking, including a statewide media

campaign. Similar tax increases with funds earmarked for counter-advertising

campaigns have been adopted in Massachusetts, Arizona, Oregon, and elsewhere.

In addition, part of the funds received by several other American states that

have recently settled lawsuits with the tobacco industry are earmarked for

counter-advertising campaigns. Hu and his colleagues (1994, 1995b) concluded

that California's anti-smoking media campaign has significantly reduced

smoking in California. They estimated an elasticity of cigarette sales with

respect to expenditures on the anti-smoking media campaign of -0.05 ( Hu et

al., 1995c). Comparing the impact of the tax increase with that of the media

campaign, they estimated that the tax increase reduced per capita cigarette

sales by over 27 packs, while sales declined by just under eight packs per

person in response to the media campaign. Early evidence from Massachusetts

suggests a comparable decline in sales after that state's tax-funded antismoking

campaign (Harris et al., 1996). Chaloupka and Grossman (1996)

concluded that similar counter-advertising campaigns financed by earmarked

cigarette taxes lead to significant reductions in both the prevalence of youth

smoking and average cigarette consumption by young smokers.

Econometric evidence from Greece ( Stavrinos, 1987), Finland (Pekurinen,

1989, 1991), Turkey (Tansel, 1993), Australia (Bardsley and Olekalns, 1998),

and the U.K. (Townsend, 1998) indicates that the U.S. experience is not

unique. In each of these studies, mass media campaigns aimed at reducing

cigarette smoking by providing information on the health consequences of

smoking were estimated to have led to significant reductions in smoking

prevalence and in cigarette consumption.

The evidence described above clearly indicates that cigarette demand has

declined in response to dissemination of new information on the health effects

of cigarette smoking. Viscusi (1990, 1991, 1992, 1995) and others have

concluded that individuals have heard and comprehended the health warnings and

are making rational, well-informed choices when it comes to smoking. Indeed,

Economics of Smoking - p. 84

as noted above Viscusi (1992) believes that smokers overestimate the risk of

dying from lung cancer as a result of smoking. As such, he suggested ( Viscusi,

1992, 1995) that the scope for further government intervention to reduce

cigarette smoking is relatively limited. Kenkel (1991), however, concluded

that while knowledge about the health effects of smoking is relatively common

and has significantly reduced smoking, it is incomplete. Moreover, his

estimates implied that improved health knowledge would lead to significant

changes in cigarette smoking, in contrast to his findings for health knowledge

concerning alcohol use and exercise. As was noted earlier, a wealth of

additional evidence further supports the view that, while general knowledge

concerning the health consequences of smoking is relatively widespread, it is

often superficial and does not extend to risks other than those associated

with lung cancer, heart disease, and chronic lung disease (U.S. Department of

Health and Human Services, 1989). Further, many smokers, particularly

including heavy smokers, do not personalize the health risks that they

acknowledge as applying to smokers "in general" ( Schoenbaum, 1997). Warner et

al. (1995), Brownson et al. (1992), Grossman et al. (forthcoming), and others

argue that some populations, particularly younger and less educated/low-income

groups, significantly understate the health consequences of smoking; for

example, children in particular may be prone to underestimate the risk of

becoming addicted.

5.2 Restrictions on cigarette smoking

As information on the health consequences of exposure to environmental

tobacco smoke (ETS) has become more widespread (U.S. Department of Health and

Human Services, 1986; U.S. Environmental Protection Agency 1992; Steenland,

1992; Steenland et al., 1996), governments at all levels have adopted policies

limiting smoking in public places and private workplaces. Beginning with

Arizona in 1973, states started adopting "clean indoor air" laws with the

explicit objective of limiting nonsmokers' exposure to ETS (U.S. Department of

Economics of Smoking - p. 85

Health and Human Services, 1986). In general, these laws prohibit smoking in

elevators, health care facilities, public transportation, indoor cultural and

recreational facilities, government buildings, public meeting rooms, schools,

shopping malls, and retail stores. The most extensive laws also include

restaurants and private workplaces. A recent World Health Organization (1997)

survey of tobacco control policies in 134 countries indicated that the vast

majority of countries now have some form of restriction on smoking in public

places.

Although the restrictions are primarily intended t o reduce nonsmokers'

exposure to ETS, they can also lead to significant reductions in cigarette

smoking since they reduce the smoker's opportunities to smoke or otherwise

raise the "cost" of smoking. This is particularly true for adult smokers

restricted from smoking at the workplace. In addition, restrictions on

smoking may alter the perceived norms related to smoking by changing attitudes

concerning the social acceptability of smoking (U.S. Department of Health and

Human Services, 1994).

A number of recent econometric and other studies have examined the

impact of smoking restrictions on cigarette demand in the U.S. and elsewhere

(Wasserman et al., 1991; Chaloupka, 1992; Chaloupka and Saffer, 1992; Keeler

et al., 1993; Chaloupka and Grossman, 1996; Evans et al., 1996; Chaloupka and

Wechsler, 1997; Chaloupka and Pacula, 1998a, 1998b; Ohsfeldt et al., 1998;

Bardsley and Olekalns, 1998; Townsend, 1998). In general, restrictions on

smoking in public places and private workplaces have been found to reduce both

smoking prevalence and average daily cigarette consumption among smokers.

Wasserman et al. (1991) estimated that expanding smoking restrictions from

those limiting smoking in a small number of relatively minor public places

(elevators, waiting rooms, etc.) to more comprehensive restrictions, including

restaurants and private workplaces, would reduce overall per capita smoking by

almost 6%. Similarly, Chaloupka and Grossman (1996) and Chaloupka and

Wechsler (1997) concluded that strong restrictions on smoking significantly

Economics of Smoking - p. 86

reduce both smoking prevalence and average daily cigarette consumption for

youth and young adults, respectively.

Using annual state-level data for 1975-1985, Chaloupka and Saffer (1992)

examined the possibility that smoking restrictions are endogenous. They found

that states with the strongest restrictions, those with limits on smoking in

private workplaces, were also the states in which anti-smoking sentiment was

relatively high and smoking was relatively low. After accounting for this,

Chaloupka and Saffer concluded that the strongest restrictions had no impact

on cigarette demand. However, they did find that relatively comprehensive

restrictions on smoking in public places (those including restaurants in

addition to a number of other public places) significantly reduced smoking

even after accounting for their potential endogeneity. In a more recent

analysis of this issue, using data from the September 1992, January 1993, and

May 1993 tobacco use supplements to the Current Population Survey, Ohsfeldt et

al. (1998) concluded that the strongest restrictions on smoking lead to

significant reductions in smoking prevalence, after accounting for their

potential endogeneity.

Evans and colleagues (1996) examined whether workplace restr ictions led

to self-selection, with nonsmokers attracted to worksites at which smoking was

not permitted and smokers seeking out worksites permitting smoking. Using

data from the 1991 and 1993 National Health Interview Surveys, the authors

examined self-reported information on whether or not workers were in firms

that had policies restricting smoking. If the respondent answered

affirmatively, more detailed information on the policies was collected. Evans

et al. estimated the impact of the restrictions on cigarette demand in a

simultaneous equations model that allows for individuals to self-select

worksites based on their smoking status and smoking policies. The authors

found that, after accounting for workers' potential self-selection, smoking

bans diminished the probability of adult smoking by 5%, while reducing average

daily cigarette consumption among smokers by 10%. As such, the authors

Economics of Smoking - p. 87

concluded that recent declines in smoking among workers relative to nonworkers

in the U.S. can be attributed to the growing number of workplace bans

on smoking.

5.3 Limits on youth access to tobacco products

According to the World Health Organization (1997), 43 countries ban the

sale of cigarettes to minors, typically by establishing a minimum legal

purchase age for cigarettes and restricting the distribution of free samples

of to underage youth. The non-economics literature provides mixed evidence on

the effectiveness of these youth access limits. A few studies have found that

raising retailer compliance with the minimum age laws reduces the prevalence

of youth smoking (Jason et al., 1996; Forster et al., 1998). Others, however,

have found little impact on youth smoking, even with high compliance by

retailers (Rigotti et al., 1998). A few recent econometric analyses have

examined the impact of these limits on youth tobacco use in the U.S.,

generally finding little or no impact on youth cigarette smoking and other

tobacco use (Wasserman et al., 1991; Chaloupka and Grossman, 1996; Chaloupka

et al., 1997; Chaloupka and Pacula, 1998a). Chaloupka and Grossman (1996)

attributed this to the relatively weak enforcement of these laws.

Chaloupka and Pacula (1998a) examined the impact of enforcement of and

compliance with the limits on youth access on youth smoking using data

collected in a special 1994 survey of state activities related to the Synar

amendment (Downey and Gardiner, 1996). This amendment requires states to

establish minimum purchase ages for tobacco products and to demonstrate that

these laws are being enforced by conducting random, unannounced compliance

checks of retailers selling tobacco products. Failure to do so can lead to

the loss of state block grant funds for substance abuse prevention and

treatment programs. Chaloupka and Pacula's estimates suggest that when the

limits on youth access are comprehensively and aggressively enforced and

highly complied with, they significantly reduce the prevalence of youth

Economics of Smoking - p. 88

smoking.

6. Agricultural policy and the macroeconomic implications of tobacco

Most of the policy-relevant economic research on tobacco has focused on

the arguments in the cigarette demand function, discussed in the preceding

sections. With a few exceptions, the literature cited has addressed how

policy variables directly influence smoking by individuals. There is another

domain in which economic issues arise and economic analysis has produced

important understanding, however: how policy effects on the economic welfare

of the industry indirectly influence smoking and health. In this section, we

examine the literature pertaining to two such issues, each of which has been

raised in the course of the social debate on the economic and health

consequences of tobacco.

The first involves economic policy intended to benefit the agricultural

sector of the U.S. tobacco industry : how the unorthodox regulation of

domestic tobacco growing in the U.S. affects the price and quantity of tobacco

grown, and through this channel influences the price and consumption of

cigarettes. The tobacco "subsidy" has been a source of contention within the

U.S. public health community for years, with most health professionals

believing that the "subsidy" encourages tobacco growing and thereby smoking.

As economists will appreciate immediately, the direct effect of a tobacco

price support system is the opposite: it discourages smoking by artificially

inflating the price of tobacco in cigarettes. Economic analysis has provided

insight into the extent of this effect, permitting policy analysts to consider

it in the broader context of the overall implications of the price support

program.

The second issue addresses the broad question of how dependent nations'

economies are on preservation of a robust tobacco industry for employment, tax

revenue, and a positive contribution to the trade balance. A central thrust

of the tobacco industry's strategy to combat tobacco control policies has long

Economics of Smoking - p. 89

been to argue that, regardless of the health consequences of its products, the

economic vitality of America (and other countries) depends on a strong tobacco

industry. In recent years, macroeconomic research has been undertaken in

several countries to challenge the premise with empirical evidence.

Prior to addressing these issues, this section opens with background on

both the global and U.S. tobacco industries.

6.1 Size and nature of the tobacco industry

6.1.1 The global industry

In 1983,28 an estimated 47 million people directly owed their

livelihoods, in whole or in part, to tobacco cultivation, product manufacture,

distribution, and retailing (representing 18.2 million full-time equivalent

jobs), with 30 million of these in farming (11 million FTEs), nearly half in

China alone.29 In addition, over 10 million people (8 million FTEs) were

employed in supplier industries, those providing materials and services to the

tobacco industry (e.g., harvesting tools and cigarette papers, insurance

coverage and transportation and shipping) (Agro-Economic Services, 1987).

In the 69 countries included in this evaluation of the global industry

(covering 90% of the world's population), an average of 0.3% of arable land

was devoted to tobacco, although tobacco accounted for 1.3% of full-time

agricultural employment, reflecting the labor intensity of tobacco growing.

Tobacco constituted 1% of total agricultural output, 0.8% of total

manufacturing output, and 3 percent of total retail sales ( Agro-Economic

Services, 1987).

International trade in tobacco and tobacco products represented 0.5% of

total exports and 0.4% of imports, the difference reflecting a robust

28 We are not aware of any contemporary figures on the size of the global

industry. The data presented here, covering the year 1983, suggest a rough

order-of-magnitude estimate of the industry's importance, albeit one that

likely underrepresents the contemporary industry given that tobacco

consumption has increased worldwide annually since that year.

29 China is the world's largest producer and consumer of cigarettes.

Economics of Smoking - p. 90

international contraband trade ( Agro-Economic Services, 1987) which appears to

have grown considerably in recent years ( Joosens, 1998). For a handful of

countries, tobacco exportation represents an international economic lifeline.

In Zimbabwe, for example, tobacco accounts for approximately one-third of the

country's export revenues (Chapman and Wong, 1990; "Zimbabwe...", 1998).

Tobacco's economic importance worldwide derives also from its use as a

source of governmental revenues. Excise (and other) taxation generates many

tens of billions of dollars annually. Several countries derive 10% or more of

total government revenues from tobacco taxation (Chapman and Wong, 1990).

6.1.2 The U.S. tobacco industry

In 1995, Americans spent $48.7 billion on to bacco products, most of it

on just under 490 billion cigarettes. In addition, U.S. farms and cigarette

companies shipped abroad, respectively, $1.4 billion worth of unmanufactured

tobacco leaf and $5 billion in manufactured product (Gale, 1997).

The five core sectors of the tobacco industry -- tobacco growing,

auction warehousing, product manufacturing, wholesale trade, and retail trade

-- collectively employ up to half a million Americans in tobacco-related

activity (Gale, 1997). Industry activity generates an additional 650,000 to 2

million spin-off jobs, representing purchases from suppliers and spending by

the recipients of incomes from tobacco product sales. 30 In 1992, the

30 Estimates of direct, indirect, and expenditure-induced employment are

taken from several sources, including Warner et al. (1996), Price Waterhouse

(1992), Tobacco Merchants Association (1995), and Gale (1997). The smallest

total employment associated with tobacco industry activity is Gale's estimate

of 1.2 million, although Gale also reported a high estimate of direct

employment (500,000). The largest total employment estimate is that of the

WEFA Group at 3 million jobs, although we believe that this and several other

industry-commissioned estimates rely on improbably large multipliers in

estimating expenditure-induced employment. Reviewing the Price Waterhouse

analysis, Arthur Andersen Economic Consulting (1993) identified what they

believed to be serious methodological flaws and concluded that "employment and

job loss figures are grossly inflated."

Other analysts have suggested that the industry substantially

underestimates employment associated with tobacco, since they fail to include

health care personnel who care for the victims of tobacco-produced diseases,

undertakers who bury them several years earlier than nonsmokers, professional

launderers who clean and repair smokers' clothing more frequently, and so on

Economics of Smoking - p. 91

emotional and political heart of the U.S. industry, tobacco farming, included

124,000 farms on which tobacco was grown in some 20 states. However, just

three states -- North Carolina, Kentucky, and Tennessee -- accounted for 82%

of the 91,000 farms officially designated as tobacco farms (defined by the

U.S. Department of Agriculture as farms on which tobacco accounts for at least

50% of sales). A further three states -- Georgia, South Carolina, and

Virginia -- accounted for an additional 10% of tobacco farms. Collectively,

these six southeastern tobacco states were responsible for a comparable

percentage of tobacco production as well ( Grise, 1995).

Estimating tobacco farm employment is difficult because so few farmers

rely exclusively on tobacco for their full-time economic activity. Employing

the arbitrary assumption that each job is half time (1000 hours), the USDA

estimated the number of tobacco farming jobs in 1995 at 156,000 (i.e., fewer

than 80,000 FTE jobs). The largest employment contribution associated with

tobacco was in the retail sector, however, with an estimated 257,000 jobs

spread all over the country. The other politically "visible" component of the

industry -- workers employed in cigarette manufacturing -- numbered only

25,600. They were concentrated primarily in only three cities in which the

vast majority of U.S. cigarettes are manufactured: Richmond, VA, Winston-

Salem, NC, and Louisville, KY (Gale, 1997).

Although the tobacco farmer is the "heart" of the industry in emotional

and political terms, economically the farmer appears to be little more than a

minor appendage. Domestically-grown tobacco represented only about 2% of the

domestic retail tobacco dollar in 1995, with imported tobaccos constituting

another 1-2%.31 Once one accounts for leases of tobacco-growing quotas, farm

supplies and equipment, overhead, and marketing costs, farm workers actually

took home only about 30% of tobacco farm gross receipts for their labor, under

(Schelling, 1986; Warner, 1987).

31 The tobacco crop value in 1995 was less than $2.6 billion, much of

which was exported as raw leaf or in manufactured cigarettes (Gale, 1997).

Economics of Smoking - p. 92

1% of the nearly $50 billion Americans spent on cigarettes and other tobacco

products. By comparison, the largest share of the tobacco dollar went to

manufacturing (38%), with additional major participants being wholesale and

retail trade (27%) and government, through excise taxation (26%) (Gale, 1997).

Although tobacco growing and cigarette manufacturing might seem like

excellent candidates for a highly competitive marketplace, they do not come

close to conforming to the economist's ideal of the smoothly functioning

unregulated competitive market. The manufacturing industry is characterized

by a high degree of concentration, with two companies, Philip Morris and R.J.

Reynolds, selling three-quarters of all cigarettes purchased in the U.S. and

three others (Brown & Williamson, Lorillard, and Liggett) accounting for the

vast majority of the rest; Philip Morris alone captures half the market (with

one of its brand lines, Marlboro, accounting for more than half of the

company's sales) (Kluger, 1996). Four other companies round out this highly

concentrated oligopoly. Although one can readily imagine barriers to entry

into the cigarette market (e.g., brand-name marketing advantages, distribution

channels, etc.), tobacco farming seems a less obvious domain for

noncompetitive forces. Nonetheless, this purely agricultural endeavor is not

subject to the conventional laws of supply and demand in the U.S. Rather, a

convoluted system of price supports and allotments regulates who can grow

tobacco, where and how much they can grow, and what minimum prices they can

expect at market. The existence of this system, and the concentration of the

industry in the six southeastern states, has been credited with responsibility

for the unusual political power wielded by the six tobacco bloc states in

Congress (Taylor, 1984; Warner, 1988; Gale 1997). We turn now to a

consideration of the nature of this system and its implications for both

tobacco agriculture and smoking and health.

6.2 The impact of the U.S. tobacco agriculture regulatory system

Economics of Smoking - p. 93

6.2.1 Nature of the system and its impact on tobacco farming32

Since the early 1930s, the U.S. federal governme nt has implemented a

variety of tobacco farm programs designed to limit tobacco growing and prop up

tobacco prices. Born of Depression-era concerns about the traumatic effects

on farmers of cyclical prices and the vagaries of the weather, the programs

have ensured stability but also limited innovation in production techniques

and farm size. Although the specifics of the programs have varied over time,

they have shared certain core elements in common : restriction of the supply

of tobacco, by restricting who can grow tobacco and how much they can grow,

and the assurance of minimum prices.

The tobacco farm programs began with the Agricultural Adjustment Act of

1933 through which cash payments were made to tobacco farmers who agreed to

limit production. The Agricultural Act of 1938 established the principle of

marketing quotas, with penalties for growers who exceeded them. Price

supports were originally set at 75% of base-period prices and have varied up

and down since then. The continued existence of the price support system

rested on a vote of tobacco farmers every three years. If two-thirds of the

farmers supported the system, as they have during each vote (with some minor

exceptions), legally enforceable marketing quotas are put in place.

The growers of tobacco, and the acreage they can farm, are limited

through a system of allotments, in essence a license to grow tobacco,

allocated to farms existing at the time the system was established. Under the

first of the allotment programs, only farmers possessing the allotments, or

renting or purchasing land with allotments, could grow tobacco. Since 1962,

however, farmers have been permitted to rent or purchase allotments without

having to use the allotment holder's land, although subject to a number of

restrictions as to type of tobacco and how far the quota could be transported

(e.g., some quotas could be applied only within the county of the allotment

32 This section's description of the tobacco agriculture program is based

on material from Capehart (1997), Grise (1995), and Zhang and Husten (1998).

Economics of Smoking - p. 94

holder). Supplies of tobacco were thus limited through allotments and

marketing quotas, as well as restrictions on imported tobacco. Quotas are

established based on the intended purchases by cigarette manufacturers,

anticipated exports and imports, and the amount of tobacco needed to achieve a

specified level of reserves. The Secretary of Agriculture can further adjust

the quotas by + 3% of the amount determined by formula.

The price support is based on a loan program through which farmers are

guaranteed a pre-specified minimum price. Farmers attempt to sell their

tobacco at auction. If the high bid does not at least match the loan price, a

farmer-owned cooperative purchases the tobacco at that guaranteed price, using

money loaned by the USDA's Commodity Credit Corporation (CCC). The

cooperative stores the tobacco as collateral for the CCC loan. When the

cooperative later resells the tobacco, it forwards the proceeds to the CCC to

cover the loan principal and interest.

Until 1982, general tax revenues were used to cover CCC losses.

Although the amounts of money involved were modest by federal government

program standards (Warner, 1988), the image of taxpayers' subsidizing the

growing of a product that health officials characterized as deadly became

politically untenable. As a result, Congress passed the No-Net-Cost Tobacco

Program Act of 1982 which eliminated the taxpayer subsidy. Since then,

farmers and buyers have paid an assessment per pound of tobacco to cover any

losses in the loan program. The federal government continues to cover the

cost of administering the program, as well as providing a variety of other

services to growers through the USDA. In 1993, the total federal outlay on

these activities was $26 million.

Over time, variations in the tobacco program have modified import

policies and imposed and then removed domestic-content requirements for U.S.

cigarette manufacturers, as well as tinkering with quota determination and

allocation, price support, and so on. For a discussion of specific revisions

of the relevant laws, see Capehart (1997) and Grise (1995).

Economics of Smoking - p. 95

The net effect of the program o n tobacco agriculture has been multifaceted.

It has brought the stability to the tobacco farm economy that it was

designed to ensure. It has restricted domestic tobacco supplies. The program

has clearly restricted tobacco farm size and limited the development of more

capital-intensive methods of tobacco farming; indeed, the growing of tobacco

entails greater labor intensity than for nearly all other U.S. crops. The

program has increased the price of domestic tobaccos and, as a consequence,

the price of cigarettes (discussed below). As a result of boosting prices, it

has likely restrained the amount of raw leaf exportation from the U.S. It has

created an economically entrenched political constituency, the allotment

holders, the principal beneficiaries of the program (Babcock and Foster,

1992).

6.2.2 Relevance of the tobacco program to smoking and health

The tobacco program has had two effects directly germane to the issue of

smoking and health, one ostensibly favorable, the other not. By restricting

the supply of tobacco and increasing its price, the program has likely boosted

the price of the finished product, cigarettes, and thereby decreased the

quantity demanded. The extent of this effect -- arguably the less important

of the two (Warner, 1988; Zhang and Husten, 1998) -- has been studied by

economists and is the focal point of this section. In contrast, by allocating

the right to grow tobacco, or to earn money by leasing allotments, to a select

group of citizens in the tobacco southeast, and by ensuring stable and

relatively high prices for farmers, the tobacco program has created a highly

concentrated economic and thus political interest that has long wielded

substantial power within the halls of Congress (Taylor, 1984; Babcock and

Foster, 1992). Long-time observers of both Congress and tobacco concur that

the existence of the tobacco bloc has thwarted the development of effective

tobacco-and-health policies frequently over the past 35 years (Taylor, 1984;

Fritschler and Hoefler, 1996).

Economics of Smoking - p. 96

Whether the consumption-discouraging effects of the increased price of

tobacco or the consumption-encouraging effects of a lack of aggressive federal

tobacco control policy have dominated has been the subject of some informed

speculation but no formal analysis. Having reviewed the evidence, both Warner

(1988) and Zhang and Husten (1998) concluded that the latter was more

important than the former, but in each case this conclusion rested as much on

the finding that the direct effect of the tobacco program on cigarette price

was very small. It is here that economic analysis has provided useful

empirical evidence.33

The economic effects of the tobacco price support program have been the

subject of formal economic analysis for at least three decades (Johnson,

1965). Since the mid-1980s, four analyses have estimated the impact of

abandonment of the tobacco price support program on tobacco supplies and

prices. Using a simultaneous equations model of the supply of and demand for

tobacco and cigarettes, which included the possibility of substitution of

foreign for domestic tobaccos, Sumner and Alston (1985) estimated that

eliminating the program in 1983 would have reduced the price of U.S. tobacco

by 20-30%. The authors estimated an increase in domestic tobacco output of

50-100% or more with supply restrictions ended, with cigarette manufacturers

likely to buy more domestic tobacco and exports likely to double. Reflecting

this expanded output, Sumner and Alston estimated that tobacco growing

revenues would have risen by 15-60% despite the price decrease. Because

domestic tobacco represented under 10% of the retail price of cigarettes, the

authors concluded that the price support program boosted the retail price of

cigarettes by no more than 3%.34 Employing a price elasticity of demand of -

33 This analysis has been particularly useful simply to help correct the

misimpression of the lay public that the tobacco price support program, or the

"tobacco subsidy," as it is more commonly referred to, has directly encouraged

smoking by encouraging tobacco growing. The public has not generally

appreciated that, to the contrary, the program has limited the quantities of

tobacco grown and brought to market.

34 Sumner and Alston (1985) assumed that tobacco price increases

attributable to the price support system would be fully passed on to retail

Economics of Smoking - p. 97

0.3, they estimated that the direct effect of the price support program was to

decrease the demand for cigarettes by about 1%. A decade later, economists at

the USDA produced a similar if less detailed analysis that supported Sumner

and Alston's findings. Grise (1995) concluded that the price support program

raised domestic tobacco prices by 30-40%. He estimated that this tobacco

price effect raised cigarette prices by 1-2%.

Still more recently, researchers at the federal Office on Sm oking and

Health (OSH) in the Centers for Disease Control and Prevention analyzed

contemporary data and determined that the price support program increased

tobacco prices by 18-23% (Zhang et al., 1997). In contrast with the early

1980s, domestic tobacco accounted for only 3% of cigarette retail price in

1991. This decline in the domestic tobacco farm value share of retail

cigarette value reflected several developments pertaining to the amount and

price of domestic tobaccos. First, the amount of tobacco employed in

manufacturing a given number of cigarettes has declined significantly since

the 1980s, as it has since well before then (from the early 1950s to the

present, the amount of tobacco per cigarette has declined by over a third

(Congressional Research Service, 1994)). This has resulted from reduced

wastage, in part as a consequence of new production technologies that allow

manufacturers to blend in parts of the tobacco plant previously discarded,

such as tobacco stems, and to expand the volume of tobacco per unit of weight

(called "puffing"). It also reflects a shift in demand from relatively largebarreled

cigarettes, some unfiltered, to filtered and small-diameter

cigarettes.

A second reason for the decline in the domestic tobacco share of the

consumers. This is a reasonable assumption. Although the evidence is mixed,

most previous research has characterized the tobacco industry as a constantcost

industry. Research has also demonstrated that the industry has exploited

its oligopolistic character with a strong price-leadership model, passing on

more than 100% of federal excise tax increases (Harris, 1987). A recent study

concluded that the industry engages in a minor amount of price discrimination

by state, passing along slightly more than states' excise tax increases

(Keeler et al., 1996). Obviously, the permeability of state borders limits

the extent of such price discrimination.

Economics of Smoking - p. 98

cigarette dollar is manufacturers' increasing reliance on less expensive

imported tobaccos. At various times, as much as a third or more of the

tobacco in U.S. cigarettes has been imported. From 1980 to 1991, for example,

the imported tobacco share rose from 29% to 35%. More recently, the share of

imported tobaccos quickly decreased and then increased. 35 The 1993 Omnibus

Budget Reconciliation Act (OBRA) included a provision requiring that 75% of

the tobacco in U.S.-manufactured cigarettes be domestically grown. Shortly

after the domestic content provision was implemented, it was determined to be

inconsistent with the requirements of the General Agreement on Tariffs and

Trade (GATT). It was replaced in September 1995 by a complicated tariff-rate

quota (TRQ) designed to restrict imports but to conform to GATT

requirements.36

A third factor in the declining share of cigarette expenditures

attributable to domestic tobacco has been the stability of tobacco prices

compared to more rapidly inflating prices for the manufactured product. From

1980 to 1991, the farm price of tobacco rose only 18%. During the same

period, cigarette price increased 187%.

Accounting for the reduced role of domestic tobacco in cigarette price,

Zhang and colleagues concluded that the tobacco price support program likely

increased the retail price of cigarettes by no more than 1%. To assess the

impact on smoking, the researchers employed a more recent estimate of the

price elasticity of demand for cigarettes and then allocated half of the price

response to decisions of whether or not to smoke and the other half to number

35 Imported and domestic tobaccos are not perfect substitutes. Tobaccos

come in numerous varieties, each with its own characteristics, and soil and

weather conditions combine to alter those characteristics from one growing

location to another. As a consequence, the world price of tobacco does not

necessarily reflect the marginal price. Some American-grown tobaccos, prized

by cigarette manufacturers, can command a higher-than-average price on world

markets.

36 The TRQ imposes quotas on imported tobaccos by exporting country, with

imports above quota levels subject to a 350% ad valorem duty. However, most

of the duty is refunded if the excess imported tobacco is included in

cigarettes made in the U.S. for export.

Economics of Smoking - p. 99

of cigarettes per day per continuing smoker. Given these assumptions, they

estimated that the direct effect of the tobacco price support program was to

decrease the number of smokers by 0.14%. As such, they concluded that the

beneficial effect of the price support program, from a public health point of

view, was very modest at best.37

In the most recent attempt to evaluate the implications of the tobacco

price support system, Brown (1998) examined a mix of likely provisions in

comprehensive federal tobacco control legislation that would directly affect

domestic tobacco growing. Combining the effects of eliminating the price

support program with adoption of a $1.50 per pack federal cigarette excise tax

increase, he predicted a long-run decline in tobacco leaf price of 20-30%, not

inconsistent with the OSH estimates, which did not incorporate an excise tax

increase.

The consistency of the findings from these studies provid es strong

support for the conclusion that the direct effect of the U.S. tobacco price

support program on discouraging smoking, by virtue of raising cigarette

prices, is very small.

6.3 The contribution of the tobacco industry to the economy

6.3.1 States and nations

Since the late 1970s, the U.S. tobacco industry has commissioned

numerous prominent economics consulting firms to produce estimates of the

industry's contributions to employment, incomes, and tax revenues for the

country as a whole, the individual states, and occasionally specific cities

and counties (Wharton Applied Research Center, 1979; Chase Econometrics, 1985;

37 The authors' assumptions are subject to challenge. In particular, as

indicated earlier in this chapter, most of the research on cigarette price

elasticities to date suggests that the dominant effect of increasing prices on

adult consumption is to lower daily cigarette consumption for continuing

smokers, rather than decrease smoking prevalence. The OSH authors' estimate

of the impact on numbers of smokers is so small, however, that alternative

assumptions will not alter the qualitative conclusion that the impact on

smoking is very small.

Economics of Smoking - p. 100

Price Waterhouse, 1990, 1992; Tobacco Merchants Association, 1995; American

Economics Group, 1996b). When tobacco control policy measures have been under

consideration by legislative bodies, industry representatives have used the

findings from these analyses to try to convince legislators that adoption of

the policy would inflict economic damage on the state's or nation's citizens,

in particular by causing widespread loss of jobs (Warner, 1987). In a few

instances, the industry's consultants have observed in their formal written

reports to their clients that alternative spending patterns would generate

compensating employment (Chase Econometrics, 1985; American Economics Group,

1996a)38. When meeting with legislators, however, the industry's

representatives have never mentioned this.

That the decline or demise of one economic activity would be replaced by

alternative economic activity, each of which would eventually produce

comparable national levels of employment, is obvious to economists. The

compensating benefits of replacement economic activities are not generally

contemplated by the lay public, however. As such, legislators, journalists,

and other members of the public are susceptible to the industry's argument

that reduced purchase of tobacco products will lead to substantial economic

dislocation, and that such dislocation exacts a high price from communities.

The industry has used its estimates in two ways: to indicate the overall

significance of tobacco in the economies of the states and the nation as a

whole; and to make projections of lost jobs and tax revenues that would result

from the adoption of specific tobacco control policy measures.

To respond to this argument, economists have performed macroeconomic

analyses that essentially complete the analysis initiated by the industry's

38 In the most telling example of this, buried in chapter V of volume 1 of

the detailed technical report prepared by analysts at Chase Econometrics

(1985) is the acknowledgment that money not spent on tobacco products would be

reallocated to other spending, and that nationwide (combining tobacco and

nontobacco states), the economic results with and without tobacco "would be

substantially the same." The report authors explicitly observed that

compensatory responses to the absence of tobacco spending "that would occur

automatically within the Chase Econometrics Macroeconomic Model...were

constrained from taking place within [the firm's] analysis."

Economics of Smoking - p. 101

consultants. Where the industry-sponsored studies estimate the gross economic

contribution of tobacco -- the numbers of jobs, earnings, taxes paid -- the

independent studies estimate the net contribution, i.e., the benefit of

tobacco-related economic activity after one considers the implications of

redistribution of the same resources to alternative uses. Researchers at the

University of Michigan employed the REMI Model (Regional Economic Models,

Inc.) (Treyz, 1993) to estimate how both declining tobacco consumption and the

complete elimination of tobacco consumption would affect employment in the

state of Michigan (Warner and Fulton, 1994) and in the principal regional

economies of the U.S., as defined by the U.S. Bureau of Economic Analysis

(BEA) (Warner et al., 1996). The study of the effects on Michigan was

intended to demonstrate how declining tobacco consumption impacts the economy

of a nontobacco state, since nontobacco states comprise the large majority of

U.S. states and they have often been the targets of the industry's economic

argument. The study of the regional economies of the U.S. was intended to

contrast effects within the southeast tobacco-state region (consisting of half

the 12 states in the BEA's southeast region) with implications for the 8

nontobacco regions (one, "southeast nontobacco," consisting of the six

nontobacco states in the BEA's southeast region).

To illustrate the procedure (the basics of which were conceptually

identical for the two studies), in the regional analysis the researchers first

generated a baseline forecast of the economies of each of the 9 regions for

the years 1993 to 2000, assuming no changes in the expected pattern of

spending on tobacco (which included an expected annual decline in consumption,

based on the trend in the decade preceding the period of the simulation). The

eight-year period selected for the simulation was intended to permit analysis

of dynamic short- and medium-run impacts on the regional economies. To

evaluate the gross contribution of tobacco to employment, analogous to what

the industry's consultants have done, the researchers then generated an

alternative forecast in which all of the expected spending on tobacco was

Economics of Smoking - p. 102

removed from the baseline forecast. Comparison of the two forecasts, with and

without tobacco spending, permitted assessment of the amount of employment

associated with tobacco spending, by region, economic sector, and year. To

estimate the net employment implications resulting from consumers devoting

their former tobacco expenditures to other goods and services, the analysts

reallocated this amount according to consumers' normal spending patterns, with

tobacco excluded. Net employment was estimated by comparing the employment

projections in the baseline simulation with those from the simulation in which

tobacco spending is reallocated to other goods and services.

To examine the implications of a more realistic scenario which might be

expected if effective tobacco control policy measures were adopted, namely an

increasing rate of decline in tobacco product consumption, the researchers

assumed that the recent historical rate of decline would double. The

simulations were repeated with the appropriate amount of tobacco spending

removed (gross model) and reinjected into the alternative goods and services

(net model).

In the first study, Warner and Fulton (1994) demonstr ated that in a

nontobacco state, declining spending on tobacco products would increase the

state's employment, and that this effect would persist over several years.

The finding reflected the fact that tobacco products represent imports for

Michigan (and other nontobacco states). Since some of the reallocated

spending would be devoted to goods and services produced within the state,

more state spending would recycle within Michigan, thereby producing more

Michigan-based jobs. Although this is obvious to economists, it represented a

revelation to many noneconomists in the policy community.

In the second study (Warner et al., 1996), the researchers found that

with either a decline or the complete elimination of domestic tobacco

spending, each of the eight nontobacco regions would gain employment during

the period studied, while the southeast tobacco region would lose employment.

The study further demonstrated that the losses within the tobacco region

Economics of Smoking - p. 103

would be considerably smaller than those suggested by the industry's analyses,

which again have never included the effects of alternative spending, which

would benefit the tobacco states as well as the nontobacco states. One of the

study's most important conclusions was that plausible declines in tobacco

consumption would have exceedingly small impacts on employment even in the

southeast tobacco region. Under the more realistic scenario, the estimated

loss of 36,600 jobs in the region by the year 2000 would amount to only 0.2%

of regional employment.

Similar analyses have been performed in other countries. The idea was

first introduced by Allen (1993) in a qualitative consideration of the

economic implications of the tobacco industry in Canada. Subsequently, Buck

and colleagues (1995) used an input-output model to study the employment

implications of tobacco in the United Kingdom. Most recently, van der Merwe

(1998b) evaluated the same issue in South Africa. Despite variations in basic

methods (e.g., input-output vs. dynamic models) and more specific assumptions

(most notably, the nature of the alternative spending pattern), all of these

studies have arrived at the same conclusion : spending on tobacco does not

generate greater employment for the country in question than would alternative

spending patterns.

The tobacco industry's consultants report on other industry-related

impacts in addition to employment. The two most important are the tax

revenues generated by spending on tobacco and the positive contribution of

tobacco to certain countries' trade balances. No non-industry analysis has

attempted to evaluate the net effects of reductions in tobacco spending on

these two variables. The results are obvious, however. For most countries,

reductions in tobacco spending would produce reductions in government

revenues, reflecting the fact that cigarettes, unlike most other products, are

subject to excise taxation. Thus, governments that succeed in reducing tobacco

consumption through tobacco control policies generally will need to seek

alternative sources of revenue to replace those lost due to declining tobacco

Economics of Smoking - p. 104

product sales. The one exception, of course, is a sales reduction occasioned

by an increase in an excise tax. In this instance, as is discussed earlier in

the chapter, government revenues will rise at the same time that consumption

falls.

Reductions in spending on tobacco could adversely affect the balance of

payments in those countries in which exports of tobacco and tobacco products

exceed imports. However, tobacco exports play a truly central role in the

balance of payments in only a handful of countries; most notably, Zimbabwe

relies on tobacco for approximately a third of its foreign exchange earnings

(Chapman and Wong, 1990; "Zimbabwe...", 1998). In contrast to the net

exporters, in countries in which tobacco product imports exceed exports,

decreasing consumption could improve the trade balance (Warner and Fulton,

1995).

6.3.2 Tobacco farm communities

As the regional analysis of the U.S. demonstrated, reductions in tobacco

product sales can harm the economies of specific areas of countries highly

dependent on tobacco economic activity. That analysis also demonstrated,

however, that plausible policy-induced decreases in tobacco consumption would

have extremely modest effects on employment within the United States' major

tobacco region (Warner et al., 1996).

Less clear, however, and likely more important from both a political and

humanitarian point of view, is the impact of declining tobacco sales on the

local communities that are most heavily dependent on tobacco farming or

product manufacture. In the popular mind in the U.S., large numbers of

counties in North Carolina, Kentucky, and the four other tobacco states are

virtually wholly dependent on tobacco farming. 39 Substantial decreases in

39 Because, compared with tobacco growing, cigarette manufacturing

involves many fewer, higher paid workers whose employment is concentrated in

three economically diversified cities, public sympathy resides more with the

farmers. The remainder of this section focuses exclusively on tobacco farming

communities.

Economics of Smoking - p. 105

tobacco product sales would, it is widely believed, wreak havoc with these

communities' economies. Sympathy with this view has led to the inclusion of

significant benefits to tobacco farmers in all of the comprehensive tobacco

control legislative proposals under consideration by the U.S. Congress in

1998.

According to work by agricultural economists, however, the image

distorts a more benign reality. Relatively few tobacco counties in the U.S.

are so dependent on tobacco that plausible policy-induced decreases in tobacco

consumption would inflict serious economic hardship. Indeed, Gale (1998)

stated recently that he expects merely a continuation of the kinds of economic

adjustments that tobacco farmers have been making for decades; and, he

observed, tobacco farm communities today have more diversified economies upon

which to draw in making those adjustments than in years gone by. He

summarized the essence of the situation by noting, "Tobacco has an important

historical role in many Southern communities. Today, however, tobacco plays a

minor economic role in most local economies where it is grown" (p. 43).

That the importance of tobacco farming within the tobacco belt states

has diminished substantially is made clear by data supplied by the Economic

Research Service (ERS) of the USDA. From 1964 to 1993, the number of tobacco

farms declined from 330,000 to 124,000. 40 Domestic consumption of

domestically-produced tobaccos has declined from 1.6 billion pounds in 1952 to

900 million pounds in 1993. Adjusted for inflation, the value of domestically

grown tobacco has fallen.

For most tobacco farmers, tobacco growing represents only part-time,

seasonal work. Further, most tobacco farms are small, with over 70% having

annual gross sales of less than $20,000. Nearly two-thirds of farm operators

40 The decline in the number of farms is not matched by declining acreage

devoted to tobacco. During the most recent six years for which data are

available, the number of farms fell from 179,000 to 124,000, but acreage

increased from 587,000 to 745,000 acres. This trend toward larger farms,

permitted by relaxation of some of the stricter limitations of the quota

system, would greatly accelerate were the price support program ended.

Economics of Smoking - p. 106

work off of their farms, as well as on them, with 42% working off-farm at

full-time jobs (Gale, 1998). Also telling are data indicating that the share

of income from all farming, not just tobacco, in tobacco counties fell from 5%

in the early 1970s to well under 2% today. The ERS classifies counties as

"farm dependent" if earnings from all farming constitute at least a fifth of

the county's total earnings. By this definition, there were only 27 "farm

dependent" tobacco counties in the U.S. in the mid-1990s, out of 424 tobacco

counties.41 And among these farm dependent tobacco counties, only one derives

a majority of its farm receipts from tobacco. The next four most tobaccodependent

derive 25-35% of their farm earnings from tobacco, while the

remaining 22 counties each receives less than 5% of its farm earnings from

tobacco sales. Most tobacco counties are not classified as "farm dependent."

Across all tobacco counties, the USDA estimates that tobacco sales account

for approximately a fifth of total farm receipts. However, there are a number

of counties on the North Carolina-Virginia border and in eastern Kentucky in

which tobacco's share of farm sales exceeds 70%.

To put the role of tobacco into perspective, USDA calc ulates the ratio

of tobacco gross receipts to total proprietor and labor income within a

county. By this measure, almost half of tobacco counties (199) have a

tobacco-income ratio of less than 0.01. Only 33 counties have a ratio

exceeding 0.1 (Gale, 1998). USDA also calculates an index of a tobacco

county's ability to replace tobacco income through economic growth in other

sectors. The index measures the ratio of annual growth in inflation-adjusted

local personal income from all sources to tobacco gross receipts. USDA

interprets an index value exceeding 1.0 as meaning that the county is creating

sufficient new economic opportunities to potentially completely replace

tobacco income. Approximately half of all tobacco counties have index values

greater than 1.0 (Gale, 1997).

41 A tobacco county is a county in which tobacco is grown for commercial

purposes.

Economics of Smoking - p. 107

All told, the evidence indicates that America's tobacco farming

communities are far less dependent on tobacco than is widely believed. That

abrupt declines in tobacco consumption would inflict severe economic pain on

selected individuals is almost certainly true; that many others would

experience temporary economic dislocation is certainly possible. The notion,

however, that realistic policy-induced decreases in tobacco consumption would

wreak havoc throughout much of the tobacco belt is simply not consistent with

the evidence. Appeals to the welfare of tobacco farmers may resonate

politically; but economically they appear to have little justification. 42

Indeed, the major economic losers would be the allotment holders, a less

politically-appealing group of people.

7. Conclusion

In the complicated ethical, social, and political domain of tobacco

policy, economic analysis has introduced a base of objective and increasingly

sophisticated knowledge into debates in which rhetoric has often dominated.

Particularly with regard to the crucial issue of how price influences the

demand for tobacco products, and how taxation affects price, economists have

contributed empirically-based insights that, in many instances, have played

essential roles in guiding the formulation of tobacco control policy. Indeed,

it is no exaggeration to credit the work of economists with the contemporary

global interest in using tobacco taxation as perhaps the primary tool of

tobacco control policy.

In the process of examining the empirical relationship between tobacco

price and consumption, economists have contributed to the evolving theoretical

and methodological literature on the effects of addiction on consumer demand.

A "problem" in the traditional economic model of rational economic behavior,

addiction is now receiving the attention that promises important future

42 In the absence of data on the economic vitality of tobacco-growing

regions in other countries, these conclusions cannot be extended to tobacco

farm communities outside of the U.S.

Economics of Smoking - p. 108

contributions of both a conceptual and empirical nature. Public health policy

making will be enriched in the process.

In addition to addressing issues of taxation, price, and demand,

economic research has also offered important understanding of the effects of

other tobacco policy measures, ranging from media counteradvertising to the

introduction of restrictions on smoking in public places. The work of

economists has lent perspective to emotional issues in debates on tobacco

policy, such as the implications of tobacco control for employment both inside

and outside of tobacco-dependent regions of states and countries.

In other areas, economics researc h has been less successful in answering

policy questions. A notable example involves the politically central issue of

whether cigarette advertising increases consumption, and whether ad bans

decrease it. Econometric research has contributed empirical evidence to the

debate, but without offering much by way of resolution. In part this reflects

limitations inherent in econometric methods; in part it reflects the

inadequacy of the data needed to quantify "advertising" (and exposure to it)

and evaluate its consequences. Recent work on the impacts of national

advertising bans, both partial and complete, shows promise but is decidedly in

its infancy.

In addition to having enlightened debates on tobacco policy, economic

analysis of smoking serves a broader purpose as well, one not examined in the

present chapter. Constituting by far the largest body of economic research on

the consumption of addictive substances, utilizing the best data available,

economic research on smoking informs both research and policy debates on other

addictive substances (Warner et al., 1990; Warner, 1991). This is

particularly important in the case of illicit drugs, such as marijuana and

cocaine, for which the availability of useful data has been severely

constrained. More generally, understanding the economics of tobacco lends

insight into a whole host of social, political, and economic issues, such as

the political economy of product regulation and the relationship between, and

Economics of Smoking - p. 109

even meaning of, consumer sovereignty and paternalism.

The use of tobacco, and particularly cigarette smoking, constitutes one

of the great public health plagues of the latter half of the 20th century, one

sure to define much of global health status far into the 21st century as well.

As such, it is critical to understand the determinants of tobacco use,

perhaps especially those that can be addressed by public policy. Using the

conventional tools of their trade, often in novel and creative ways,

economists have been at the forefront of advancing knowledge in this central

area of public health. The impressive body of work described in this chapter

augers a bright future for the contribution of economics to grappling with

what will soon become the leading cause of disease and death worldwide.

Economics of Smoking - p. 110

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