Do smokers respond to health shocks?

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2001-11-01

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Abstract

This paper reports the first effort to use data to evaluate how new information, acquired through exogenous health shocks, affects people's longevity expectations. We find that smokers react differently to health shocks than do those who quit smoking or never smoked. These differences, together with insights from qualitative research conducted along with the statistical analysis, suggest specific changes in the health warnings used to reduce smoking. Our specific focus is on how current smokers responded to health information in comparison to former smokers and nonsmokers. The three groups use significantly different updating rules to revise their assessments about longevity. The most significant finding of our study documents that smokers differ from persons who do not smoke in how information influences their personal longevity expectations. When smokers experience smoking-related health shocks, they interpret this information as reducing their chances of living to age 75 or more. Our estimated models imply smokers update their longevity expec-tations more dramatically than either former smokers or those who never smoked. Smokers are thus assigning a larger risk equivalent to these shocks. They do not react comparably to general health shocks, implying that specific information about smoking-related health events is most likely to cause them to update beliefs. It remains to be evaluated whether messages can be designed that focus on the link between smoking and health outcomes in ways that will have comparable effects on smokers' risk perceptions.

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10.1162/003465301753237759

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Smith, VK, DH Taylor, FA Sloan, FR Johnson and WH Desvousges (2001). Do smokers respond to health shocks?. Review of Economics and Statistics, 83(4). pp. 675–687. 10.1162/003465301753237759 Retrieved from https://hdl.handle.net/10161/2127.

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Scholars@Duke

Taylor

Donald H. Taylor

Professor in the Sanford School of Public Policy

Don Taylor is a health policy scholar who has studied rural health, identification of underserved areas, and the economics of smoking and cessation. For the past 20 years his work has focused on how society cares for the elderly and to what effect on individuals, families, public programs and inter-generational wealth. More recently he has focused on archival research methods that help to illustrate the role of Race in our history—individual, institutional, national. An emerging interest is consideration of how visual art and fiction might be more effective at making inequality of various types unacceptable culturally in a way that is more effective than data based and more traditional public policy-based appeals. All three of his degrees (Ph.D., Public Health, Health Policy and Management, 1995) are from the University of North Carolina at Chapel Hill. Taylor serves as the Director of the Social Science Research Institute (since 2019) and served two years as the elected leader of the Duke Faculty in the role of the Chair of the Academic Council (2017-19).

Sloan

Frank A. Sloan

J. Alexander McMahon Distinguished Professor Emeritus of Health Policy and Management

Professor Sloan is interested in studying the subjects of health policy and the economics of aging, hospitals, health, pharmaceuticals, and substance abuse. He has received funding from numerous research grants that he earned for studies of which he was the principal investigator. His most recent grants were awarded by the Robert Wood Johnson Foundation, the Center for Disease Control, the Pew Charitable Trust, and the National Institute on Aging. Titles of his projects include, “Why Mature Smokers Do Not Quit,” “Legal and Economic Vulnerabilities of the Master Settlement Agreement,” “Determinants and Cost of Alcohol Abuse Among the Elderly and Near-elderly,” and “Reinsurance Markets and Public Policy.” He received the Investigator Award for his work on the project, “Reoccurring Crises in Medical Malpractice.” Some of his earlier works include the studies entitled, “Policies to Attract Nurses to Underserved Areas,” “The Impact of National Economic Conditions on the Health Care of the Poor-Access,” and “Analysis of Physician Price and Output Decisions.” Professor Sloan’s latest research continues to investigate the trends and repercussions of medical malpractice, physician behavior, and hospital behavior.

Johnson

F. Reed Johnson

Professor in Population Health Sciences

F. Reed Johnson, PhD, has more than 40 years of academic and research experience in health and environmental economics. He has served on the faculties of several universities in the United States, Canada, and Sweden, and as Distinguished Fellow at Research Triangle Institute. He currently is Senior Research Scholar in the Duke Clinical Research Institute. As a staff member in the US Environmental Protection Agency’s environmental economics research program during the 1980s, Reed helped pioneer the development of basic non­-market valuation techniques which are widely used for benefit-cost analysis in health and environmental economics. He has designed and analyzed numerous surveys for measuring preferences for and value of health outcomes, health ­risk reductions, and improved environmental quality.

Dr. Johnson has over 140 publications in books and peer-reviewed journals. His research has been published in various medical journals, the Review of Economics and Statistics, Journal of Health Economics, Medical Decision Making, Health Economics, Value in Health, Journal of Policy Analysis and Management, and other journals. He has coauthored a book on techniques for using existing environmental and health value estimates for policy analysis.

His current research involves quantifying patients’ willingness to accept side­effect risks in return for therapeutic benefits and estimating general time equivalences among health states. He led the first FDA­ sponsored study on patients’ willingness to accept benefit-risk tradeoffs for new health technologies. The study was used to develop recent FDA guidance on submitting patient-preference data to support regulatory reviews of medical devices.

Areas of expertise: Clinical Decision Sciences, Health Measurement, Health Policy, and Health Economics


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