Political Context, Policies, and Health Behaviors: The Case of Tobacco

Ashley Fox, Mount Sinai School of Medicine
Rakesh Yumkham, Mount Sinai School of Medicine

We assess how state political context affects the adoption of two tobacco related policies and subsequent declines in smoking rates using state-level panel data over a fifteen year period (1996-2011). The study draws on publicly available data from the Centers for Disease Control (CDC) to construct a longitudinal dataset of cigarette excise taxes, indoor smoking policies, state smoking prevalence and demographic characteristics from 1996 to 2011. Political context is measured in terms of state vote share for Republican or Democratic presidential candidates and a well validated measure of state political culture. Using repeat measure GEE, we assess the relationship between state political context and state smoking prevalence rates adjusting for demographic characteristics and state policies. We find that more conservative states have seen lower declines in smoking prevalence and that this relationship is only partly explained by state smoking policies.