Association for Public Policy Analysis & Management

Smoking and drinking during pregnancy are main reasons of adverse birth outcomes including low birth weight or slow fetal growth rate. In  this research I aim to estimate the impacts of smoking and drinking during pregnancy on infant birth outcomes. There are, however,  some concerns that there might be some risky factors to affect both smoking (or drinking) behavior and infant birth outcomes. To deal with this concern, I exploit the minimum legal tobacco purchasing age (hereafter MLTPA) and the minimum legal drinking age (hereafter MLDA) as instruments for smoking and drinking status of young pregnant women around the legal cutoff ages for smoking and drinking.

My research design is based on a simple idea: to the extent that MLDA and MLTPA laws have been enforced, age cutoffs for drinking and purchasing cigarette yields the different probability to access alcohol and cigarette for young pregnant women on either side of legal age cutoffs. Hence, I can identify the effect of MLDA and MLTPA laws on infant birth outcomes using the fact that the discontinuous jump in drinking and smoking during pregnancy at cutoff ages, caused by MLDA and MLTPA laws, can solely lead to another discontinuous jump in infant birth outcomes, which is called the fuzzy regression discontinuity research design.

I will use the restricted National Vital Statistics Natality Birth Data for the 1993 to 2012 periods to estimate the effect of maternal drinking and smoking on infant birth outcomes, such as birth weight, the incidence of low birth weight, gestational period, and APGAR scores. The key main variable of outcome variables in this study is an infant birth weight. Birth weight is of interest for two reasons. First, infant health measured by birth weight is predictive in terms of shortvand long term perspectives. According to fetal origin hypothesis, since nutrition in utero may bevpersistent and latent, it can lead to adult health problems as well as childhood health problems. Invaddition to adult health, birth weight is a predictor of educational attainment, IQ, and earnings in the future. Birth weight can be transmitted intergenerationally and poor birth weight can be aggravatedvby the intergenerational transmission of poor income. Hence, when it comes to explain the income inequality in the United States, health inequality has become an important factor of income inequality and birth weight has made up the large portion of health inequality. Secondly, although one does not smoke or drink now, smoking or drinking a long time ago can aect some health problem now. On the other hand, birth outcomes including birth weight may indicate the impact of smoking and drinking directly and immediately through infants. Therefore, birth weight should be the main focus in the U.S. health policies.