Progress 10/01/08 to 09/30/09
Outputs
OUTPUTS: Professor Kenkel participated in the following events that contributed to the goals and objectives of the project and helped disseminate the results to the research and public policy communities: Presentation: "Smoking Bans and Individual Consumer Behavior," Swiss School of Public Health, PhD Seminar on Health Economics and Policy, Crans-Montana, Switzerland, February 2, 2009. Presentation: "The Economics of Health Promotion and Disease Prevention: Private Profits and Public Health," invited plenary address at the Finnish Conference in Health Economics, Helsinki, Finland, February 6, 2009. Presentation: "Impact of Restaurant Smoking Bans on the Demand for Smoking and Restaurant Food," International Health Economics Association 7th World Congress on Health Economics, Beijing, China, July 13, 2009. Presentation: "Promotion to Physicians and Consumers," conference for authors of chapters of the Oxford Handbook on The Economics of the Bio-pharmaceutical Industry, Philadelphia, PA, Nov. 21, 2009. PARTICIPANTS: Not relevant to this project. TARGET AUDIENCES: Not relevant to this project. PROJECT MODIFICATIONS: Not relevant to this project.
Impacts
Professor Kenkel has a research agenda focused on the economics of life course health behaviors related to cigarette smoking, obesity, and alcohol use. Because of the health consequences of these behaviors, they are considered to be among the leading preventable causes of death in the U.S. and in many other countries. In a new study published in 2009, Professor Kenkel and his colleagues examine the determinants of life course smoking in China. With a total population of more than 1.4 billion people where more than 31 percent of adults smoke, China has become the world's largest producer and consumer of cigarettes. Professor Kenkel and his co-auhtors use data from the China Health and Nutrition Survey (CHNS) to follow individuals over their whole lives and to analyze their decisions to both start and stop smoking. This research extends the small but growing body of economic research on smoking in China. The life-course approach emphasizes that current smoking participation reflects a decision to start and a series of past decisions to not quit. The study explores how the determinants of smoking initiation differ from the determinants of smoking cessation. The results, consistent with some previous empirical evidence, that Chinese smoking is not strongly related to the price of cigarettes. Based on the results, Professor Kenkel and his colleagues offer some speculative hypotheses that might guide future research on the economics of smoking in China. It seems especially useful to compare the broad patterns we document with the experiences of other countries.
Publications
- Kenkel, Donald, Dean Lillard, and Feng Liu (2009). "An Analysis of Life Course Smoking Behavior in China." Health Economics 18: S147-S156.
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Progress 10/01/07 to 09/30/08
Outputs
OUTPUTS: Professor Kenkel participated in the following events that contributed to the goals and objectives of the project and helped disseminate the results to the research and public policy communities: Presentation: "Excise Tax Avoidance: The Case of State Cigarette Taxes," Department of Economics, University of Indiana - Purdue University at Indianapolis, February 21, 2008. Member, Workshop on Understanding and Controlling the Demand for Illegal Drugs, Committee on Law and Justice, National Academy of Sciences, Washington DC, March 14, 2008. Presentation: "Excise Tax Avoidance: The Case of State Cigarette Taxes," Department of Economics, Stonybrook University, April 8, 2008. 2008 S T Lee Fellowship at the New Zealand Institute of Competition and Regulation (ICSR) based at Victoria University of Wellington, June - July 2008. Presentation: "The Power of Persuasion: Can Advertising Help You Quit Smoking" Co-sponsored by the ISCR, the Health Services Research Centre of Victoria University of Wellington, and the Wellington Health Economics Group, 16 June 2008. Presentation: "Impact of Restaurant Smoking Bans on Demand for Smoking and Restaurant Food," Econometric Society Australasian Meeting, 9 - 11 July 2008, Wellington, New Zealand. Presentation: "The Power of Persuasion: Can Advertising Help You Quit Smoking" Department of Economics, University of Auckland, New Zealand, 16 July 2008. Testimony: at a hearing on The Role of Social Sciences in Public Health, Subcommittee on Research and Science Education, House Committee on Science and Technology, U.S. Congress, September 18, 2008. Presentation: "Education, Social Capital, and Health: An Empirical Framework," Workshop on Social Capital and Health, IRDES & OECD, Paris, 10 -11 October 2008. Presentation: "Excise Tax Avoidance: The Case of State Cigarette Taxes," Association of Public Policy Analysis and Management annual meetings, Los Angeles California, November 6, 2008. PARTICIPANTS: Not relevant to this project. TARGET AUDIENCES: Not relevant to this project. PROJECT MODIFICATIONS: Not relevant to this project.
Impacts
Professor Kenkel has a resaerch agenda focused on the economics of life course health behaviors related to cigarette smoking, obesity, and alcohol use. Because of the health consequences of these behaviors, they are considered to be among the leading preventable causes of death in the U.S. In one study, Professor Kenkel and his colleagues study the impact of cigarette taxes on young adults' decisions to start, quit, and re-start smoking. They find little evidence that taxes deter smoking initiation, but some evidence that quit decisions are more sensitive to taxes. In another study, Professor Kenkel and his colleagues explore how consumer exposure to direct-to-consumer advertising of pharmaceutical products on television varies with socio-economic status and race. The researchers create and use unique data on individual consumers' potential exposure to DTC advertisements for products that treat conditions ranging from high cholesterol to toenail fungus. Professor Kenkel and his colleagues find that some disadvantaged groups, most notably Blacks, are exposed to substantially more DTC advertisements. Unemployed consumers and others who do not work full time are also exposed to substantially more DTC advertisements. Weaker patterns suggest that consumers with less schooling and lower incomes also tend to be exposed to more DTC advertisements for some products. On the other hand, uninsured consumers are exposed to fewer DTC advertisements, but the magnitude of the difference is relatively small. For some product category advertising, such as cholesterol, these results suggest that DTC advertising may address important health disparities.
Publications
- DeCicca, Philip, Donald Kenkel, and Alan Mathios (2008). "Cigarette Taxes and the Transition from Youth to Adult Smoking: Smoking Initiation, Cessation, and Participation." Journal of Health Economics 27 (4): 904-917.
- Dollahite, Jamie, Donald Kenkel, and C. Scott Thompson (2008). "An Economic Evaluation of the Expanded Food and Nutrition Education Program." Journal of Nutrition Education and Behavior 40 (3): 134-143.
- Avery, Rosemary J., Donald Kenkel, Dean R. Lillard, Alan Mathios, and Hua Wang (2008). "Health Disparities and Direct-to-Consumer Advertising of Pharmaceutical Products." In: Advances in Health Economics and Health Services Research 19: 71-94.
- Cawley, John and Donald Kenkel, co-editors (2008). The Economics of Health Behaviours, Volumes I - III. The International Library of Critical Writings in Economics, An Elgar Reference Collection, Edward Elgar Publishing, Cheltenham UK and Northampton, MA, USA.
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Progress 10/01/06 to 09/30/07
Outputs
Professor Kenkel participated in the following events that contributed to the goals and objectives of the project and helped disseminate the results to the research community: Discussant, "Health Insurance and Ex Ante Moral Hazard: Evidence from Medicare." American Economics Association Annual Meetings, January 5, 2007, Chicago, Illinois. Presentation: "Advertising and Smoking Cessation," Tinbergen Institute, Amsterdam, the Netherlands, March 27, 2007. Presentation: "The Evolution of the Schooling-Smoking Gradient." Population Association of America 2007 Annual Meeting, New York, New York, March 29, 2007. Presentation, "Advertising and Smoking Cessation," Center for Health and Social Sciences, the Harris School, University of Chicago, Chicago Illinois, April 12, 2007. Presentation: "The Evolution of the Schooling-Smoking Gradient." National Bureau of Economic Research Health Economics Spring Program Meeting, Cambridge Massachusetts, April 13, 2007. Meeting of Experts
on the Economics of Prevention, Organisation for Economic Co-operation and Development, Paris, France, April 27, 2007. Presentation: : "The Evolution of the Schooling-Smoking Gradient." International Health Economics Association 6th World Congress, July 8th - 11th, 2007, Copenhagen, Denmark. Discussant, "The Effects of Retirement on Physical and Mental Health Outcomes," International Health Economics Association 6th World Congress, July 8th - 11th, 2007, Copenhagen, Denmark.. Lectures, "Economics of Substance Abuse," European Science Days Summer School on "Health Economics" in Steyr, Austria, July 13-14, 2007. Member, Workshop on Understanding and Controlling the Demand for Illegal Drugs, Committee on Law and Justice, National Academy of Sciences, Irvine, California, Oct. 12-13, 2007. Presentation: "Might Direct-to-Consumer Advertising of Pharmaceutical Products Reduce Health Disparities?" For a conference titled "Beyond Health Insurance: Public Policy to Improve Health," University
of Illinois at Chicago, November 15-16, 2007. Presentation: "Might Direct-to-Consumer Advertising of Pharmaceutical Products Reduce Health Disparities?" University of Zurich, Zurich Switzerland, December 5, 2007.
Impacts
Professor Kenkel has a research agenda focuses on the economics of life course health behaviors related to cigarette smoking, obesity, and alcohol use. Because of the health consequences of these behaviors, they are considered to be among the leading preventable causes of death in the U.S. In one study, Professor Kenkel and his colleagues study the impact of smoking cessation product advertising. To measure potential exposure, they link survey data on magazine-reading habits and smoking behavior with an archive of print advertisements. They find that smokers who are exposed to more advertising are more likely to attempt to quit and to successfully quit. While some increased quitting involves product urchases, Kenkel and his colleagues find that product advertisements also prompt cold turkey quitting. Identifying the causal impact of advertising is difficult because advertisers target consumers. Although reverse causality could bias the estimates upward, the baseline
results are not sensitive to a series of checks. Professor Kenkel also continues to work with various colleagues to extend his research into consumer demand for alcohol and cigarettes. In an econometric study he finds that caregiver advice has an important effect to reduce alcohol consumption by pregnant women. In a study of youth smoking, he develops and demonstrates the usefulness of a new measure of state anti-smoking sentiment.
Publications
- Avery, R., D.S. Kenkel, D. Lillard and A. Mathios. 2007. Regulating Advertisements: The Case of Smoking Cessation Products. Journal of Regulatory Economics 31 (2):185-208.
- Terza, J.V., D. Kenkel, T-F. Lin and S. Sakata. 2007. Econometric Analysis of Prenatal Advice as a Preventive Measure for Fetal Alcohol Syndrome. Health Economics. Forthcoming in print, published on line ahead of print in Wiley InterScience.
- Kenkel, D.S., D. Lillard, A. Mathios and V. Plassman. 2007. Who Kicks the Habit and How They Do It: Socioeconomic Differences across Methods of Quitting Smoking in the USA. Social Science & Medicine 64: 2504-2519.
- Avery, R., D.S. Kenkel, D. Lillard and A. Mathios. 2007. Private Profits and Public Health: Does Advertising Smoking Cessation Products Encourage Smokers to Quit? Journal of Political Economy 115 (3):447-481. (June). Also NBER Working Paper 11938, January 2006.
- DeCicca, P., D. Kenkel, A. Mathios, Y-J. Shin and J-Y. Lim. 2007. Youth Smoking, Cigarette Prices, and Anti-Smoking Sentiment. Health Economics, forthcoming in print, published on line (2007) ahead of print in Wiley InterScience.
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Progress 01/01/06 to 12/31/06
Outputs
Professor Kenkel has a research agenda focuses on the economics of life course health behaviors related to cigarette smoking, obesity, and alcohol use. Because of the health consequences of these behaviors, they are considered to be among the leading preventable causes of death in the U.S. In one study, Kenkel and his colleagues explore the role of schooling in smoking and obesity. The positive association between schooling and health is well-known, but social scientists disagree on the pathways involved. One causal pathway is through health information, where general schooling helps consumers respond to new information about the health consequences of behaviors such as smoking and obesity. Kenkel and his colleagues found evidence that the health returns to high school completion include a reduction in smoking. They found little evidence that high school is associated with a lower probability of being overweight or obese. They also found that the health returns to GED
receipt are much smaller than the returns to more traditional high school completion. Another study explores how advertisements for smoking cessation products have been regulated. Because of their proven effectiveness, these products could be the key to meeting public health goals to reduce smoking. However, in some ways, advertising of smoking cessation products has been more heavily regulated than cigarette advertising. The empirical results show that when products move from prescription to over-the-counter status, advertising increases substantially. In a third study, Kenkel extends his previous research on approaches to the value of health. This issue is a key input into cost-benefit analysis and cost-effectiveness analysis of health policies.
Impacts
This project is providing useful information to public health policy makers on the impact and costs of economic prevention policies. Improvements in schooling and the regulation of pharmaceutical advertising have the potential to prevent disease and promote health. Yet all of these policies also impose costs on the American public that must be compared to reliable estimates of the benefits.
Publications
- Kenkel, D., D. Lillard, and A. Mathios. 2006. The Roles of High School Completion and GED Receipt in Smoking and Obesity. Journal of Labor Economics 24 (3): 635-660.
- Kenkel, D. 2006. WTP- and QALY-Based Approaches to Valuing Health for Policy: Common Ground and Disputed Territory. Environmental and Resource Economics 34: 419-437.
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Progress 01/01/05 to 12/31/05
Outputs
Professor Kenkel has a research agenda focuses on the economics of life course health behaviors related to cigarette smoking, obesity, and alcohol use. Because of the health consequences of these behaviors, they are considered to be among the leading preventable causes of death in the U.S. In one study, Kenkel and his colleagues used longitudinal data on young adult smoking to make several contributions to economic research on smoking (DeCicca, Kenkel, and Mathios 2005). First, they explored the role of past taxes as determinants of current smoking status. Second, they focused on smoking decisions among young adults who face different cigarette taxes over time because they move across states. Looking at the results as a whole, they suggest that the standard approach in previous studies yields misleading evidence on the impact of higher taxes on young adult smoking. When Kenkel and his colleagues controlled for past taxes, or looked at respondents who faced a different
tax rate because they moved to a new state, they found little evidence that current smoking participation is responsive to current taxes. A related study explored the role anti-smoking sentiment plays in decisions by youth and young adults to smoke. A paper reporting these results is under revision for invited re-submission to a peer-reviewed journal in health economics. A third study explores the role of schooling in smoking and obesity. The positive association between schooling and health is well-known, but social scientists disagree on the pathways involved. One causal pathway is through health information, where general schooling helps consumers respond to new information about the health consequences of behaviors such as smoking and obesity. Kenkel and his colleagues found evidence that the health returns to high school completion include a reduction in smoking. They found little evidence that high school is associated with a lower probability of being overweight or obese. They
also found that the health returns to GED receipt are much smaller than the returns to more traditional high school completion. A paper reporting these results is under revision for invited re-submission to a special issue of peer-reviewed journal in labor economics. Two additional studies explore the role of advertising of smoking cessation products. Two papers presenting the results have been submitted to peer-reviewed journals in economics. Professor Kenkel also continues to contribute to research on the economics of alcohol control policy. Supported by the National Institute on Alcohol Abuse and Alcoholism, he has completed a study of the impact of a large hike in alcohol taxes in the state of Alaska. He found that in general, the tax hike was more than fully passed through to the prices consumers pay for alcoholic beverages in both on- and off-premise outlets.
Impacts
This project is providing useful information to public health policy makers on the impact and costs of economic prevention policies. Alcohol and cigarette taxation and the regulation of pharmaceutical advertising all have the potential to prevent disease and promote health. Yet all of these policies also impose costs on the American public that should not be ignored.
Publications
- Kenkel D.S. 2005. Are alcohol tax hikes fully passed through to prices? Evidence from Alaska. American Economic Review Papers & Proceedings 95 (2): 273-277.
- Lynch, W., Y. Chikamoto, K. Imai, T-F Lin, D.S. Kenkel, R. J. Ozminkowski, and R. Z. Goetzel. 2005. The association between health risks and medical expenditures in a Japanese corporation. American Journal of Health Promotion. Special Issue. January/ February 2005 Supplement: 238-248.
- DeCicca, P., D.S. Kenkel, and A.D. Mathios. 2005. The fires aren't out yet: Higher taxes and young adult smoking. In: Advances in Health Economics and Health Services Research. (B. Lindgren and M. Grossman, eds.), Volume 16, 301-320, 2005.
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Progress 01/01/04 to 12/31/04
Outputs
The project explored several important aspects of the economics of health promotion. The first item on Professor Kenkels research agenda is on the economics of life course smoking initiation and cessation. Smoking has been called the leading preventable cause of death in the U.S., and perhaps in the world. Kenkel and his colleagues completed a set of studies of youth and young adult smoking. The first study explores the role anti-smoking sentiment plays in decisions by youth and young adults to smoke. The results suggest that individuals who live in states with higher levels of anti-smoking sentiment are much less likely to smoke. But controlling for anti-smoking sentiment, the results provide no support for the common claim that higher taxes or prices discourage youth smoking. A paper reporting these results has been submitted to a peer-reviewed journal in health economics. The next two studies focus on the importance of decomposing smoking participation (whether
someone currently smokes) into a series of smoking initiation and cessation decisions. One paper reporting the results was presented at the Lund Conference on the Economics of Substance Abuse, in Lund, Sweden, August 12-13 2004. This paper has also been submitted for publication in an edited volume from that conference. Another paper on the economics of young adult smoking will be presented at the American Economic Association annual meetings in January 2005. Professor Kenkel and his colleagues are also continuing to make progress on an econometric study of the determinants of smoking cessation decisions by adults. This study has received additional funding from the National Cancer Institute and the Merck Foundation (the philanthropic branch of Merck, Inc.) Kenkel and his colleagues have published a paper reporting a cross country analysis of tobacco control policies and smoking over the life course, and another methodological study on econometric analysis of retrospective smoking
data. The second item on Professor Kenkels research agenda is to continue to contribute to research on the economics of alcohol control policy. He is currently supported by the National Institute on Alcohol Abuse and Alcoholism for a study of the impact of a large hike in alcohol taxes in the state of Alaska, focusing on whether the tax hike is fully passed through to consumer prices. A paper reporting preliminary results will be presented at the American Economic Association meetings in January 2005.
Impacts
This project is providing useful information to public health policy makers on the impact and costs of economic prevention policies. Alcohol and cigarette taxation, physician interventions, and the regulation of pharmaceutical advertising all have the potential to prevent disease and promote health. Yet all of these policies also impose costs on the American public that should not be ignored.
Publications
- Kenkel DS, Lillard DL, and Mathios AD. 2004. A Cross Country Analysis of Tobacco Control Policies and Smoking Over the Life Course, Journal d Economie Medicale 22 (3): 131-143.
- Kenkel DS, Lillard DL, and Mathios AD. 2004. Accounting for Misclassification Error in Retrospective Smoking Data. Health Economics 13: 1031-1044.
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Progress 01/01/03 to 12/31/03
Outputs
The project explored several important aspects of the economics of health promotion. First, Professor Kenkel continues to contribute to economic research on tobacco control policy. Smoking has been called the leading preventable cause of death in the U.S., and perhaps in the world. Kenkel and his colleagues have launched an econometric study of the determinants of smoking cessation decisions by adults. This study has received additional funding from the National Cancer Institute and the Merck Foundation (the philanthropic branch of Merck, Inc.) In addition to the role cigarette taxes may play in smoking cessation decisions, this project will explore if direct-to-consumer advertising increases awareness of smoking cessation pharmaceutical products. In this way, pharmaceutical advertising may help increase smoking cessation and achieve some of the same goals as public service anti-smoking campaigns. Ironically, however, in many ways advertisements for smoking cessation
products are more heavily regulated than cigarette advertisements. The research team has completed a paper on the impact of regulations on decisions by producers to advertise smoking cessation products in magazines. Second, Professor Kenkel continues to contribute to research on the economics of alcohol control policy. He is a co-Principal Investigator with Professor Joseph Terza of Pennsylvania State University on a research project titled Econometric Analysis of FAS Preventive Interventions funded by the National Institute on Alcohol Abuse and Alcoholism. This project is estimating the impact of policy tools including higher taxes, warning posters and labels, and physician advice on alcohol consumption by pregnant women. With other support from the NIAAA, Professor Kenkel is studying the impact of a large hike in alcohol taxes in the state of Alaska, focusing on whether the tax hike is fully passed through to consumer prices. Third, Professor Kenkel is continuing his research on
economic evaluation methods for health interventions, focusing particularly on the link between cost-benefit analysis and cost-effectiveness analysis of health policies. With Jamie Dollahite, Kenkel has two papers under submission that report results of cost-benefit and cost-effectiveness analyses of the New York State Expanded Food and Nutrition Education Program. Professor Kenkel was invited to speak at a multi-agency sponsored conference on the link between cost-benefit and cost-effectiveness analysis of health, and at an EPA-sponsored conference on the valuation of child health.
Impacts
This project is providing useful information to public health policy makers on the impact and costs of economic prevention policies. Alcohol and cigarette taxation, physician interventions, and the regulation of pharmaceutical advertising all have the potential to prevent disease and promote health. Yet all of these policies also impose costs on the American public that should not be ignored.
Publications
- Kenkel, D., Lilliard, D. and Mathios, A. 2003. Smoke or Fog? The Usefulness of Retrospectively Reported Information about Smoking. Addiction 98 (2003): 1307-1313.
- Kenkel, D. 2003. Using Estimates of the Value of a Statistical Life in Evaluating Consumer Policy Regulations. Journal of Consumer Policy 26 (1) (March 2003): 1-21.
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Progress 01/01/02 to 12/31/02
Outputs
The project explored several important aspects of the economics of health promotion. Smoking has been called the leading preventable cause of death in the U.S., and perhaps in the world. Professor Kenkel continues to contribute to economic research on tobacco control policy. In 2002 Professor Kenkel and his colleagues published results from a study completed earlier of youth smoking. In contrast to many previous studies, Kenkel and his colleagues found little evidence that higher cigarette taxes substantially reduce youth smoking initiation. They speculate that general trends in disapproval of smoking, and the influence of peers, may be more important determinants than taxes or economic influences. Kenkel and his colleagues have launched an econometric study of the determinants of smoking cessation decisions by adults. This study has received additional funding from the National Cancer Institute and the Merck Foundation (the philanthropic branch of Merck, Inc.) In
addition to the role cigarette taxes may play in smoking cessation decisions, this project will explore if direct-to-consumer advertising increases awareness of smoking cessation pharmaceutical products. In this way, pharmaceutical advertising may help increase smoking cessation and achieve some of the same goals as public service anti-smoking campaigns. The research team has completed two related papers comparing life course smoking behavior and tobacco control policies in Britain, Germany, the Russian Federation, and the U.S. In July 2002, these papers were presented at a conference in Berlin and at a European Health Economics conference in Paris. Professor Kenkel is also working with a colleague from Penn State University on an econometric analysis of policies to prevent fetal alcohol syndrome (FAS). Preliminary results suggest that higher alcohol taxes will reduce alcohol consumption by pregnant women, a step in the right direction to prevent FAS. He and his colleagues also have a
paper under review that extends and applies an econometric approach to yield reliable estimates of the effect of physician advice on reducing drinking during pregnancy. He has received a supplement to his earlier award from the National Institute on Alcohol Abuse and Alcoholism to study the impact of a recent large hike in taxes on alcoholic beverages in the state of Alaska. Professor Kenkel also continues to work on the problem of valuing health for policy, as part of the cost-benefit analysis of health policies. He has published a book chapter proposing a new method to estimate the costs of investments in prevention, when prevention requires consumers to give up pleasurable consumption activities. Professor Kenkel was an invited speaker at a conference sponsored by the U.S. Environmental Protection Agency on the possibilities of linking the willingness to pay approach of cost-benefit analysis with the quality-adjusted life year approach used in cost-effectiveness analysis of health
care interventions.
Impacts
This project is providing useful information to public health policy makers on the impact and costs of economic prevention policies. Alcohol and cigarette taxation, drunk driving laws, physician interventions, and nutrition education all have the potential to prevent disease and promote health. Yet all of these policies also impose costs on the American public that should not be ignored.
Publications
- Kenkel, D., Lillard, D. and Mathios, A. 2003. Tobacco Control Policies and Smoking Cessation: A Cross Country Analysis. Proceedings of the 2002 Fifth International Conference of German Socio-Economic Panel Study Users (GSOEP 2002) E. Holst, J. Hunt, and J. Schupp editors. Schmollers Jahrbuch (Journal of Applied Social Science Studies), Vol. 123, Number 1, 2003.
- Kenkel, D. and Mathios, A. 2002. Gateway Effects': Insights from Economics are Needed. Commentary on Andrew R. Morral, Daniel F. McCaffrey, and Susan M. Paddock, Reassessing the Marijuana Gateway Effect. Addiction 97 (December 2002), p. 1505.
- Kenkel, D., DeCicca, P. and Mathios, A. 2003. Putting Out the Fires: Will Higher Taxes Reduce the Onset of Youth Smoking? Journal of Political Economy 110 (1) (February 2002): 144-169.
- Kenkel, D. 2002. Investments in Prevention: Health Economics and Healthy People. In Lindgren, B (ed) Individual Decisions for Health. London: Routledge.
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Progress 01/01/01 to 12/31/01
Outputs
The project continues to explore the economics of health promotion from several perspectives. Taking a broad perspective on multiple unhealthy behaviors, Professor Kenkel and his research colleagues published an article that develops an economics-based conceptual framework to explain gateway effects, where youth problem behavior often begins with substances that are legal for adults - cigarettes and alcohol - and then progresses to illicit substances including marijuana and cocaine. Professor Kenkel has also begun a project that explores broadly the economic costs and benefits of the U.S. government's 'Healthy People' planning process. He presented a working paper from this project at the International Health Economics Association meeting in York England. Other components of the project's research portfolio address specific prevention issues related to alcohol, nutrition, and tobacco policies. Professor Kenkel published two co-authored articles on the prevention of
alcohol problems. The first is an economic study of drunk driving deterrence. In the second study, an econometric approach is developed and applied to yield reliable estimates of the effect of physician advice on reducing drinking to prevent hypertension. Supported by the National Institute on Alcohol Abuse and Alcoholism, Kenkel has an on-going study of economic interventions including taxation to prevent fetal alcohol syndrome. With a colleague from Nutrition, Professor Kenkel has nearly completed an economic evaluation of the New York State Expanded Food and Nutrition Education Program. A progress report was presented at a USDA-hosted conference in Washington DC in October 2001. Professor Kenkel has several research projects at various stages on the economics of tobacco control. His co-authored paper on youth smoking was presented at the American Council of Consumer Interests, where it was awarded the 2001 Applied Consumer Economics Award. Professor Kenkel and his colleagues have
completed a working paper summarizing the results of the first phase of their economic study of smoking cessation. Professor Kenkel presented this paper at three conferences: the 12th Annual Health Economics Conference, June 3 - 4, 2001, Durham NC; the International Health Economics Association Third International Conference, July 22 - 25, 2001, University of York, United Kingdom; and the National Bureau of Economic Research Summer Institute in Health Economics, August 1, 2001, Cambridge Massachusetts. Applications for additional funding to extend the research on smoking cessation have been submitted.
Impacts
This project is providing useful information to public health policy makers on the impact and costs of economic prevention policies. Alcohol and cigarette taxation, drunk driving laws, physician interventions, and nutrition education all have the potential to prevent disease and promote health. Yet all of these policies also impose costs on the American public that should not be ignored.
Publications
- Kenkel, D., Mathios, A. and Pacula, R. 2001. Economics of Youth Drug Use, Addiction and Gateway Effects. Addiction 96, Number 1, Special Issue, January 2001, 151-164.
- Kenkel, D. and Koch, S. 2001. Deterrence and Knowledge of the Law: The Case of Drunk Driving. Applied Economics 33, 2001, 845-854.
- Kenkel, D. and Terza, J. 2001. The Effect of Physician Advice on Alcohol Consumption: Count Data Regression with an Endogenous Treatment Effect. Journal of Applied Econometrics 16, 2001, 165-184.
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Progress 01/01/00 to 12/31/00
Outputs
The project's economic studies of the impact of public policies on smoking and drinking behavior are progressing well. During this period, Professor Kenkel and his research colleagues prepared and submitted research papers reporting their completed study of the effects of cigarettes taxes on youth smoking. They also began a new study of the impact of cigarette taxes and other policies on decisions by adult smokers to quit. Professor Kenkel completed and published two critical reviews. The first review, prepared for a World Bank project on prevention of tobacco use, focused on the role of consumer information in smoking decision. The second review, prepared for the National Institute on Alcohol Abuse and Alcoholism, focused on the impact of alcohol taxes and prices on alcohol consumption and alcohol-related problems. There was also substantial progress on the economic evaluation of prevention policies. Professor Kenkel attended the Society for Prevention Research (May
31 2000, Montreal) and served as the co-leader of a Workshop on Economic Analysis and Preventive Interventions. He also presented an invited paper at a conference on Valuing the Health Benefits of Food Safety, sponsored by the FDA, USDA, CDC, EPA, and others, held September 13 - 15, 2000, College Park Maryland. In November 2000, Kenkel presented his research on Cost-Effectiveness Analysis, Market Failures, and Prevention Policy at the American Public Health Association, Health Economics Study Session (November 12, 2000, Boston speaker). Professor Kenkel completed and published a review article on the social costs of alcohol use, and a book chapter that provides an overview of economics research on prevention. He has begun a new research project on the economic evaluation of nutrition education programs.
Impacts
The project is providing useful information to public health policy makers on the likely impact and costs of economic prevention policies. The research on youth smoking suggests that higher taxes may not be as effective in reducing smoking initiation as previously thought. Cigarette and alcohol taxes, and other public policies, appear to have different impacts on different populations, which requires careful analysis of prevention policy choices.
Publications
- Alcohol Use and Social Cost. Encyclopedia of Criminology and Deviant Behavior, Clifton D. Bryant, Editor-in-Chief. Brunner-Routledge, 2000.
- Consumer Information and Tobacco Use (with Likwang Chen). In Jha P and FJ Chaloupka, Editors. Tobacco Control in Developing Countries. Oxford University Press, 2000, pp. 177-214.
- Prevention, in the Handbook of Health Economics, A.J. Cuyler and J.P. Newhouse, editors. North-Holland, 2000, pp. 1675-1720.
- Effects of Changes in Alcohol Prices and Taxes, in the Tenth Special Report to the U.S. Congress on Alcohol and Health. National Institute on Alcohol Abuse and Alcoholism, 2000, pp. 341-354.
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