The Impact of Tobacco Control Policies on Adolescent Smoking: Comparing Self-Reports and Biomarkers

Abstract

This paper provides new evidence on how tobacco control policies affect adolescent smoking as measured by self-reported measures and serum cotinine levels, a biomarker of nicotine exposure. I use data from the National Health and Nutrition Examination Surveys covering 1988–1994 and 1999–2012. Higher cigarette excise taxes lead to statistically significant decreases in smoking prevalence as measured by both self-reports and serum cotinine levels. Among self-reported smokers, cigarette excise taxes are associated with statistically significant reductions in serum cotinine levels but not in cigarette consumption. Among likely smokers, as defined by serum cotinine levels, I do not find that cigarette excise taxes reduce serum cotinine levels on the intensive margin, but I do find that tobacco control policies, especially policies directed at minors, may increase the incidence of misreported smoking status.