Cigarette Taxation and Pregnancy: Policy-Based Estimates of the Price Elasticity of Smoking during Pregnancy

Cigarette taxation has long been a policy tool used to incentivize healthier behavior. Pregnant women are a group of particular interest in this context due to their unique position to pass health capital down to the next generation. This paper reviews the literature on the tax and price responsiveness of pregnant women to smoking during pregnancy. I first discuss the use of cigarette taxes as a natural experiment and the econometric specifications typically used in the literature. I continue to review overall trends in the tax responsiveness of smoking during pregnancy as well as results by subgroups. Next, I discuss evidence on how facing a tax during pregnancy might uniquely effect women’s decision to smoke. I conclude with a discussion of how taxes have been extended into second-stage effects on birth outcomes and future avenues of research. I generally find evidence of pregnant women responding to tax increases, although the elasticities have decreased in magnitude in more recent years. This is consistent with the story suggesting that the least addicted smokers quit in the 1990s, leaving less elastic smokers in the 2000s. Furthermore, women seem to be more responsive to taxes during pregnancy than before pregnancy. Overall, cigarette taxes can be used to evaluate health outcomes, which is a fertile area for future research.