This research project will explore whether higher cigarette taxes and Clean Indoor Air (CIA) laws at the state level are associated with reductions in prenatal smoking, improvements in infant birthweight, and reductions in adverse health outcomes among pre-school children. This project will explore whether the above associations differ across race-ethnicity and across socio-economic status. The data will be drawn from several large, national-level, secondary datasets. It is well established that being exposed to maternal prenatal smoking has numerous deleterious health outcomes for children, including low birthweight and associated morbidities, and increased risk of certain types of cancer. There is also evidence that prenatal and postnatal exposure to Environmental Tobacco Smoke (ETS) is associated with deleterious health outcomes for children. State CIA laws are policies that directly target ETS. Earlier studies show that higher cigarette taxes lead to reduced smoking among adults, including pregnant women, and are associated with improved infant birthweight. Recent research shows that stricter CIA laws reduce smoking, and lead to smoke-free work environments. However, virtually no studies explore whether stricter CIA laws reduce smoking among pregnant women in specific, or whether such laws are associated with improved health outcomes for infants and young children. We will contribute to the literature by analyzing within a multivariate regression framework the relationship between CIA laws, cigarette taxes, and the following outcomes: prenatal smoking participation, infant birthweight, and mother-reported health problems for pre-school children. There is evidence that the prevalence of prenatal smoking and prenatal exposure to ETS varies by race-ethnicity and by education and SES. While ETS exposure has fallen among all non-smokers over the past decades, it is higher among some minority sub-populations than others. Thus, we will investigate whether the relationship between CIA laws, cigarette taxes, and our outcomes of interest differ across race-ethnicity and SES.
Prenatal smoking and prenatal and post-natal exposure to environmental tobacco smoke are also associated with many poor health outcomes for infants and children. This project explores where government tobacco policies at the state level -- specifically, more rigorous Clean Indoor Air laws and higher cigarette taxes -- can potentially help reduce prenatal smoking as well as these poor health outcomes. Thus, this project will help inform debates on the efficacy of state tobacco policies in improving health outcomes.