Smoking status and subjective well-being

Abstract

Background/aims: A debate is currently underway about the Food and Drug Administration's (FDA's) methods for evaluating antitobacco regulation. In particular, the US government requires a cost-benefit analysis for significant new regulations, which has led the FDA to consider potential lost subjective well-being (SWB) of ex-smokers as a cost of any proposed antitobacco policy. This practice, which significantly limits regulatory capacity, is premised on the assumption that there is in fact a loss in SWB among ex-smokers.

Methods: We analyse the relationship between SWB and smoking status using a longitudinal internet survey of over 5000 Dutch adults across 5 years. We control for socioeconomic, demographic and health characteristics, and in a contribution to the literature, we additionally control for two potential confounding personality characteristics, habitual use of external substances and sensitivity to stress. In another contribution, we estimate panel fixed effects models that additionally control for unobservable time-invariant characteristics.

Results: We find strong suggestive evidence that ex-smokers do not suffer a net loss in SWB. We also find no evidence that the change in SWB of those who quit smoking under stricter tobacco control policies is different from those who quit under a more relaxed regulatory environment. Furthermore, our cross-sectional estimates suggest that the increase in SWB from quitting smoking is statistically significant and also of a meaningful magnitude.

Conclusions: In sum, we find no empirical support for the proposition that ex-smokers suffer lower net SWB compared to when they were smoking.

Keywords: Cessation; Economics; Public policy.