Do Minimum Wage Increases Improve Health Behaviors? The Example of Smoking

Background: Economic analyses of cigarette consumption suggest that smoking behavior is influenced by the price and affordability of cigarettes: Lower income smokers may increase cigarette consumption when wages go up. On the other hand, socioeconomic disadvantage may contribute to adverse health behaviors; mitigation of such factors may decreases smoking. Objective: To analyze the population response of per-capita cigarette consumption and smoking prevalence to changes in state minimum wage policies. Methods: Changes in cigarette consumption and smoking prevalence for years 1990-2012 were modeled in relation to state minimum wages using difference-in-difference models, controlling for state tobacco control policies, unemployment, and other state-characteristics. State-level data on per capita cigarette consumption were obtained from the CDC “STATE” System. Smoking prevalence data was gathered from the Behavioral Risk Factor Surveillance System. Results:  In the full population, each dollar increase in the minimum wage was associated with a 4.4% decrease in per capita cigarette consumption and a 3.4% relative decrease in smoking prevalence (both p<0.001).  In the BRFSS, associations were strongest among individuals reporting household income under $30,000 per year and weaker among higher income groups, as would be expected for a causal association. Conclusion: Despite the fact that minimum wage increases make cigarettes more affordable to low-income workers – who are especially likely to be smokers – they are associated with decreases in cigarette smoking at the population level. These results suggest that minimum wage policies have the potential to reduce smoking-related health disparities.