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Why Have Tobacco Control Policies Stalled? Using Genetic Moderation to Examine Policy Impacts

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  • Jason M Fletcher

Abstract

Background: Research has shown that tobacco control policies have helped produce the dramatic decline in use over the decades following the 1964 surgeon general’s report. However, prevalence rates have stagnated during the past two decades in the US, even with large tobacco taxes and expansions of clean air laws. The observed differences in tobacco control policy effectiveness and why policies do not help all smokers are largely unexplained. Objective: The aim of this study was to determine the importance of genetics in explaining response to tobacco taxation policy by testing the potential of gene-policy interaction in determining adult tobacco use. Methods: A moderated regression analysis framework was used to test interactive effects between genotype and tobacco policy in predicting tobacco use. Cross sectional data of US adults from the National Health and Nutrition Examination Survey (NHANES) linked with genotype and geocodes were used to identify tobacco use phenotypes, state-level taxation rates, and variation in the nicotinic acetylcholine receptor (CHRNA6) genotype. Tobacco use phenotypes included current use, number of cigarettes smoked per day, and blood serum cotinine measurements. Results: Variation in the nicotinic acetylcholine receptor was found to moderate the influence of tobacco taxation on multiple measures of tobacco use. Individuals with the protective G/G polymorphism (51% of the sample) responded to taxation while others had no response. The estimated differences in response by genotype were C/C genotype: b = −0.016 se = 0.018; G/C genotype: b = 0.014 se = 0.017; G/G genotype: b = −0.071 se 0.029. Conclusions: This study provides novel evidence of “gene-policy” interaction and suggests a genetic mechanism for the large differences in response to tobacco policies. The inability for these policies to reduce use for individuals with specific genotypes suggests alternative methods may be needed to further reduce use.

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  • Jason M Fletcher, 2012. "Why Have Tobacco Control Policies Stalled? Using Genetic Moderation to Examine Policy Impacts," PLOS ONE, Public Library of Science, vol. 7(12), pages 1-6, December.
    • Handle: RePEc:plo:pone00:0050576
    DOI: 10.1371/journal.pone.0050576
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    Cited by:

    1. Baker, Samuel & Biroli, Pietro & van Kippersluis, Hans & von Hinke, Stephanie, 2022. "Beyond Barker: Infant Mortality at Birth and Ischaemic Heart Disease in Older Age," IZA Discussion Papers 15291, Institute of Labor Economics (IZA).
    2. Fletcher, Jason & Kumar, Sanjeev, 2014. "Religion and risky health behaviors among U.S. adolescents and adults," Journal of Economic Behavior & Organization, Elsevier, vol. 104(C), pages 123-140.
    3. Nicholas W Papageorge & Kevin Thom, 2020. "Genes, Education, and Labor Market Outcomes: Evidence from the Health and Retirement Study," Journal of the European Economic Association, European Economic Association, vol. 18(3), pages 1351-1399.
    4. Jason M. Fletcher & Qiongshi Lu, 2021. "Health policy and genetic endowments: Understanding sources of response to Minimum Legal Drinking Age laws," Health Economics, John Wiley & Sons, Ltd., vol. 30(1), pages 194-203, January.
    5. Barth, Daniel & Papageorge, Nicholas W. & Thom, Kevin, 2017. "Genetic Ability, Wealth, and Financial Decision-Making," IZA Discussion Papers 10567, Institute of Labor Economics (IZA).
    6. von Hinke, Stephanie & Sørensen, Emil N., 2023. "The long-term effects of early-life pollution exposure: Evidence from the London smog," Journal of Health Economics, Elsevier, vol. 92(C).
    7. Bierut, Laura & Biroli, Pietro & Galama, Titus J. & Thom, Kevin, 2023. "Challenges in studying the interplay of genes and environment. A study of childhood financial distress moderating genetic predisposition for peak smoking," Journal of Economic Psychology, Elsevier, vol. 98(C).
    8. Biroli, Pietro & Zwyssig, Laura, 2021. "Moral Hazard Heterogeneity: Genes and Health Insurance Influence Smoking after a Health Shock," IZA Discussion Papers 14176, Institute of Labor Economics (IZA).
    9. van den Berg, Gerard J. & Modin, Bitte, 2013. "Economic Conditions at Birth, Birth Weight, Ability, and the Causal Path to Cardiovascular Mortality," IZA Discussion Papers 7605, Institute of Labor Economics (IZA).
    10. Rita Dias Pereira & Pietro Biroli & Titus Galama & Stephanie von Hinke & Hans van Kippersluis & Cornelius A. Rietveld & Kevin Thom, 2022. "Gene-Environment Interplay in the Social Sciences," Papers 2203.02198, arXiv.org, revised Aug 2022.
    11. Jason M. Fletcher, 2019. "Environmental bottlenecks in children’s genetic potential for adult socio-economic attainments: Evidence from a health shock," Population Studies, Taylor & Francis Journals, vol. 73(1), pages 139-148, January.
    12. Melanie Goisauf & Kaya Akyüz & Gillian M. Martin, 2020. "Moving back to the future of big data-driven research: reflecting on the social in genomics," Palgrave Communications, Palgrave Macmillan, vol. 7(1), pages 1-9, December.
    13. Yu.G. Myslyakova & E.A. Shamova & N.P. Neklyudova, 2020. "Social and Economic Genotype Territories of the Advancing Development on Example of the Ural Region," Journal of Applied Economic Research, Graduate School of Economics and Management, Ural Federal University, vol. 19(3), pages 310-328.

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