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The incidence of the healthcare costs of smoking

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  • Cowan, Benjamin
  • Schwab, Benjamin

Abstract

Smokers earn less than non-smokers, but much is still unknown about the source(s) of the smoker's wage gap. We build on the work of Bhattacharya and Bundorf (2009), who provide evidence that obese workers receive lower wages on account of their higher expected healthcare costs. Similarly, we find that smokers who hold employer-sponsored health insurance (ESI) receive significantly lower wages than their non-smoking peers, while smokers who are not insured through their employer endure no such wage penalty. Our results have two implications: first, the incidence of smokers’ elevated medical costs appears to be borne by smokers themselves in the form of lower wages. Second, differences in healthcare costs between smokers and non-smokers are a significant source of the smoker's wage gap.

Suggested Citation

  • Cowan, Benjamin & Schwab, Benjamin, 2011. "The incidence of the healthcare costs of smoking," Journal of Health Economics, Elsevier, vol. 30(5), pages 1094-1102.
    • Handle: RePEc:eee:jhecon:v:30:y:2011:i:5:p:1094-1102
    DOI: 10.1016/j.jhealeco.2011.07.003
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    References listed on IDEAS

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    1. van Ours, Jan C., 2002. "A pint a day raises a man's pay; but smoking blows that gain away," IZA Discussion Papers 473, Institute of Labor Economics (IZA).
    2. Jonathan Gruber, 2008. "The Tax Exclusion for Employer-Sponsored Health Insurance," NBER Chapters, in: Economic Analysis of Tax Expenditures, National Bureau of Economic Research, Inc.
    3. W. Kip Viscusi & Joni Hersch, 2001. "Cigarette Smokers As Job Risk Takers," The Review of Economics and Statistics, MIT Press, vol. 83(2), pages 269-280, May.
    4. Bhattacharya, Jay & Bundorf, M. Kate, 2009. "The incidence of the healthcare costs of obesity," Journal of Health Economics, Elsevier, vol. 28(3), pages 649-658, May.
    5. Miller, Vincent P. & Ernst, Carla & Collin, François, 1999. "Smoking-attributable medical care costs in the USA," Social Science & Medicine, Elsevier, vol. 48(3), pages 375-391, February.
    6. van Ours, Jan C., 2004. "A pint a day raises a man's pay; but smoking blows that gain away," Journal of Health Economics, Elsevier, vol. 23(5), pages 863-886, September.
    7. Irina B. Grafova & Frank P. Stafford, 2009. "The Wage Effects of Personal Smoking History," ILR Review, Cornell University, ILR School, vol. 62(3), pages 381-393, April.
    8. Phillip B. Levine & Tara A. Gustafson & Ann D. Velenchik, 1997. "More Bad News for Smokers? The Effects of Cigarette Smoking on Wages," ILR Review, Cornell University, ILR School, vol. 50(3), pages 493-509, April.
    9. M. Christopher Auld, 2005. "Smoking, Drinking, and Income," Journal of Human Resources, University of Wisconsin Press, vol. 40(2).
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    Cited by:

    1. Cowan, Benjamin & Schwab, Benjamin, 2016. "Employer-sponsored health insurance and the gender wage gap," Journal of Health Economics, Elsevier, vol. 45(C), pages 103-114.
    2. Lennon, Conor, 2022. "Employer-sponsored health insurance and labor market outcomes for men in same-sex couples: Evidence from the advent of pre-exposure prophylaxis," Economics & Human Biology, Elsevier, vol. 47(C).
    3. Namingit, Sheryll & Blankenau, William & Schwab, Benjamin, 2021. "Sick and tell: A field experiment analyzing the effects of an illness-related employment gap on the callback rate," Journal of Economic Behavior & Organization, Elsevier, vol. 185(C), pages 865-882.
    4. Haque, Samiul & Abedin, Naveen & Fakir, Adnan M. S. & Hannan, Rafe & Alam, Rafa, 2019. "Effects of smoking on agricultural productivity," 2019 Annual Meeting, July 21-23, Atlanta, Georgia 291149, Agricultural and Applied Economics Association.
    5. Kyung Min Lee & Chanup Jeung, 2021. "The incidence of the healthcare costs of chronic conditions," International Journal of Health Economics and Management, Springer, vol. 21(4), pages 473-493, December.
    6. Conor Lennon, 2018. "Who pays for the medical costs of obesity? New evidence from the employer mandate," Health Economics, John Wiley & Sons, Ltd., vol. 27(12), pages 2016-2029, December.
    7. Bhai Moiz, 2020. "The Earning Losses of Smokers," IZA Journal of Labor Economics, Sciendo & Forschungsinstitut zur Zukunft der Arbeit GmbH (IZA), vol. 9(1), pages 1-21, March.
    8. Conor Lennon, 2019. "Employer‐Sponsored Health Insurance and the Gender Wage Gap: Evidence from the Employer Mandate," Southern Economic Journal, John Wiley & Sons, vol. 85(3), pages 742-765, January.
    9. Lennon, Conor, 2021. "Are the costs of employer-sponsored health insurance passed on to workers at the individual level?," Economics & Human Biology, Elsevier, vol. 41(C).
    10. Cowan Benjamin & Tefft Nathan, 2012. "Education, Maternal Smoking, and the Earned Income Tax Credit," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 12(1), pages 1-39, October.
    11. Vidhura Tennekoon & Robert Rosenman, 2013. "Bias in Measuring Smoking Behavior," Working Papers 2013-10, School of Economic Sciences, Washington State University.

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    More about this item

    Keywords

    Smoking; Wages; Employer-sponsored health insurance; Compensating differential;
    All these keywords.

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health
    • J3 - Labor and Demographic Economics - - Wages, Compensation, and Labor Costs
    • J7 - Labor and Demographic Economics - - Labor Discrimination

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