Online Program

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

Wednesday, November 4, 2015

Richard Grucza, PhD, MPE, Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO
Laura Bierut, MD, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
Michael Hur, MBA, MSW, Washington University School of Medicine, St. Louis, MO
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.

Learning Areas:

Public health or related public policy
Social and behavioral sciences

Learning Objectives:
Explain why the presented results, showing decreases in cigarette consumption and smoking prevalence in response to minimum wage increases, might differ from those predicted from from the classical economics perspective.

Keyword(s): Tobacco Use, Health Disparities/Inequities

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal investigator of several federal and non-federal grants investigating the link between state policies and alcohol, tobacco and other drug use. Among my interests is the use of state policies as natural experiments to investigate hypotheses about the etiology of health behaviors.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.