Protect Young Mothers from Cigarettes, Help Their Babies? A Regression Discontinuity Study on Minimum Cigarette Purchase Age

Ji Yan, Washington University in St. Louis

A key target in the U.S. health policies is to reduce costly adverse birth outcomes to which prenatal smoking is one of the most significant contributors. This paper is the first to address whether implementing minimum cigarette purchase age of 21 at Pennsylvania can improve infant health through curbing young mother smoking. My research question is crucial because young mothers are more heavily engaged in smoking and more likely to have poor birth outcomes, and smoking prevalence among PA mothers also exceeds the national average. I find a 16 percent decrease in the average cigarettes smoked per day and a 20 percent decrease in LBW for mothers subject to the regulation. The 2SLS regression discontinuity estimates indicate smoking 1 more cigarette per day worsens infant health. For smokers, it reduces birth weight by 61.17 grams, increases LBW by 2.8 percentage points, and decreases the APGAR 1-min score by 0.13 points.