Session: Tobacco Control Programs
Room: Hollister McManus Lounge
Time: Tue 10:15-11:45

Presenter: Ji Yan (Washington University in St. Louis. Economics)

Discussant: Debjani KanjilalUniversity of Memphis

Abstract

This paper provides new evidence on the deadline by which pregnant smokers should quit to nullify the adverse impact of prenatal smoking on infant health. I address this issue using a large panel dataset of about 80,000 mothers with multiple births, which is much better than the small and selective cross sectional samples used in previous studies. I apply a mother fixed effect model to deal with the endogenous maternal smoking cessation decision and find the adverse impact of smoking on birth outcomes is nullified for those who quit in the first trimester. Mothers who smoke up to the second trimester will have remarkably worse birth outcomes. In particular, two third of the overall fetal growth rate slowdown is due to smoking within the second trimester. These results suggest that pregnant smokers should be advised to quit as early as possible especially before the end of the first trimester. My paper also shows the estimated adverse effect of smoking on birth weight and low birth weight would shrink by a third and over a half respectively if a researcher codes late quitters who quit smoking in the second trimester as nonsmokers when applying fixed effect models. I also find that a strongly promoted smoking cessation counseling is cost effective if it can make a pregnant smoker quit early in the first trimester and thus reduce the excess hospital cost of her newborn. Besides, low endowed smokers (late quitters or continuous smokers) do not appear to compensate for their newborns. Finally, it is widely known that poor health behavior such as smoking plays an important role in the intergenerational transmission when mothers give births, however my paper further shows more disadvantaged pregnant mothers can negatively affect their offsprings’ health and future wealth both because they are more likely to smoke and because they are less likely to quit early during pregnancy once they become smokers.

Key Terms

Prenatal Smoking, Smoking Cessation, Birth Weight, Low Birth Weight

Authors:

Ji Yan (Washington University in Saint Louis. Economics)