Contributed Papers in Health Economics
Sunday, Jan. 7, 2018 8:00 AM - 10:00 AM
- Chair: Michael Fitzmaurice, JMF Associates
Does E-cigarette Advertising Encourage Adult Smokers to Quit?
AbstractCurrently, there is extremely contentious policy debate concerning the regulation of e-cigarettes. At the heart of this regulatory debate are fundamental questions regarding whether e-cigarettes will draw cigarette smokers away from a dangerous habit or lure new initiates into tobacco use and lead to a new generation of nicotine addicts. The purpose of this paper is to shed light on one side of the debate just outlined by investigating whether e-cigarette advertising on television and in magazines encourage adult smokers to quit. To preview our results, the answer to this question is a tentative yes for TV advertising but no for magazine advertising. We use extremely detailed information on TV viewing patterns and magazine issues read in the Simmons National Consumer Survey and match this information to all e-cigarette ads aired on national and local broadcast and cable stations and all ads published in magazines from Kantar Media. The match yields estimates of the number of ads seen and read by each survey respondent in the past six months. We find that an additional ad seen on TV increases the number of adults who quit smoking by almost 1 percent relative to a mean quit rate of 9 percent in the past year.
Health Insurance and Mortality
AbstractUsing microdata on all U.S. death certificates from 1999-2015, we examine the relationship between the health insurance expansions under the Affordable Care Act and mortality. We use several identification approaches, the main being a "differences in differences" (DiD) study design that compares trends in mortality in Medicaid expansion states relative to non-expansion states, after versus before Medicaid expansion. We study deaths from a broad set of healthcare amenable causes, as well as specific top causes of mortality (cancer, heart disease, diabetes, and respiratory disease), for persons under age 65; most of our specifications focus on the 55-64 age range. We examine heterogeneity among subgroups particularly affected by Medicaid expansions, through separate specifications by education, gender, and race/ethnicity. We supplement the DiD with a triple-difference specification using mortality among those aged 65-74 (hence already Medicare insured). We also assess effects from the total impact of the ACA rather than just the Medicaid expansion by examining counties that benefited disproportionately in insurance gains. Our results do not indicate detectable effects on healthcare-amenable mortality following ACA expansion; we review the past literature to place our findings in context of studies that do and do not find a relationship between health insurance and mortality. We then use simulation methods to investigate the power of our research design to detect plausible effect sizes. We conclude that despite investigating a variety of specifications in our paper, population-level analyses of ACA mortality effects are underpowered, and the size of effects that could be detectable with reasonable power are implausibly large. Put differently, this also implies the confidence intervals around our estimates do not rule out fairly large effects. Our findings indicate that it would be extremely challenging for a study of mortality relying on death certificate microdata to detect effects of ACA expansion on population
- I1 - Health