Insurance Benefits Research Articles

An Evaluation of China’s Basic Pension Insurance Benefit Adjustment Policy to Ensure Sustainability, Guarantee, and Fairness

Pension benefit adjustment is an effective measure to ensure the basic living standards of retirees, improve people’s livelihood, and maintain social harmony and stability. This study uses the entropy weight TOPSIS method to measure and evaluate the effectiveness of the implementation of pension benefit adjustment policy in 31 provinces in China from three dimensions of sustainability, guarantee, and fairness. The Dagum Gini coefficient is used to analyze the pension benefit adjustment effects in China’s four major regions and the sources of differences among the three subsystems. Finally, the dynamic evolution of the effect of pension benefit adjustment was analyzed using kernel density estimation. The following conclusions were achieved: (1) Sustainability indicator scores are declining, while guarantee and fairness indicator scores are both on the rise, indicating that provinces are placing greater emphasis on fairness and ensuring the basic living standards of retirees in pension benefit adjustments; (2) The overall variation in the impact of pension benefit adjustments is decreasing, with regional disparities being the primary source of overall variance; (3) Pension benefits in the eastern region have increased significantly, while there are significant variations among provinces in the central and western regions. The adjustment effect for pension benefits in the northeastern region is poor and requires further enhancement. These findings provide valuable policy basis for achieving the sustainability, guarantee, and fairness of pension funds.

Moving opportunistically: Interstate migration after medicaid expansion.

The large-scale expansion of Medicaid eligibility following the Affordable Care Act provides an ideal setting to explore whether changes to state-provided health insurance benefits predict migration across state lines. Using the American Community Survey's person-level data from 2009 to 2019 about moving during the prior 12 months, we examine whether Medicaid's selective expansion after the Affordable Care Act prompted in-migration to states that greatly expanded Medicaid eligibility for the populations most targeted by the expansion. We find that states expanding Medicaid by the largest margin was related to higher in-migration, equating to 0.23 percentage points greater annual population growth in the target population, 0.42 percent for the disabled subpopulation, and 0.25 percent for the parent subpopulation. Our results translate to 56,659 interstate moves after Medicaid enrollment growth. The effect was concentrated among individuals who previously lived close to a state's border. The implications of this study are that high-needs individuals in certain states may be impacted by welfare magnets and modestly prone to being undercounted in projected government expenditures.

Fitness-to-work considerations in the paradigmatic pain condition of headache disorder.

Headache disorders are common, including in the working population. Clinicians caring for patients with headache need to be aware of work-related factors as potential causes or triggers of headache disorders, and consider the impact of headache on fitness-to-work, especially in safety-sensitive and decision-critical roles. Such fitness-to-work determination should include individualized consideration of the nature of the headache disorder itself, the pattern of the headache, the impact of sleep deprivation on the headache as it relates to fitness to do shiftwork, medication and substance side effects, fitness-to-work implications of associated medical or psychiatric conditions, and the potential of symptom feigning or malingering for secondary gain. As clinicians often struggle with fitness-to-work determinations, a structured approach to fitness-to-work assessments in headache conditions and other pain conditions would improve clarity for clinicians and increase the quality of care provided to patients, with potential benefits for workplace safety and policy in this arena as well.

Practical and economic challenges of implementing group auricular acupuncture treatment for chronic pain in primary care.

Although growing numbers of patients seek acupuncture for pain management, few acupuncturists with insurance credentialing work in the conventional medical settings. This has resulted in increasing frustration among patients wishing to receive acupuncture in primary care settings as part of their insurance benefits. A course of eight weekly sessions of group auricular acupuncture (AA) for chronic musculoskeletal pain was implemented in a US primary care clinic and billed to insurance. The process of implementing group AA is described, including patients and researchers' perceptions of their experience. We also examined various hypothetical scenarios for reimbursement based on relative value units (RVUs) based on Centers for Medicare and Medicaid (CMS) billing/coding. Recruitment was greatly limited by COVID-19 requirements for social distancing and administrative hurdles, such that only four patients participated, three of whom attended all eight sessions. Seven additional Medicare patients were excluded due to concerns that acupuncture would not be covered. Participants reported mostly positive experiences with both AA and the group model of care. Based on our hypothetical reimbursement scenarios, in the fee-for-service model, group sessions appear to be economically more viable when staffed by non-physician acupuncturists credentialed for insurance reimbursement. For example, for a group of six patients each receiving acupuncture would be anticipated to generate 3.60 RVUs, whereas a physician seeing three individual patients consecutively for return office visits at CMS Evaluation and Management (E/M) level 3 could generate at least 4.11 RVUs. Offering group AA services in primary care clinics might increase access to acupuncture for patients with chronic pain. Although patients appreciated quicker access to acupuncture through group visits, and the group visit experience itself, logistical and economic barriers remain a challenge for sustainable group-based acupuncture visits.

Utilizing Propensity Score Matching Analysis to Examine the Effects of Postsecondary Education on the Employment Outcomes of Young Adults with Mental Illnesses

Background Helping young adults with mental illnesses attend college will increase their chances of being employed with benefits, which can pave the way for a successful career and a middle-class life. Objective This study sought to examine whether receiving vocational rehabilitation (VR) services of four-year college or university training would lead to improved employment outcomes for young adults with mental illnesses. Methods Based on the Rehabilitation Services Administration (RSA)-911 data, a propensity score matching technique was employed to create a comparison group of young adults with mental illnesses who did not receive college or university training and a treatment group of those who did. The quasi-experimental design investigated differences in the employment outcomes between the two groups. Results Analyses revealed that the group who received college or university training was more likely to be engaged in competitive integrated employment upon exit from the VR program than the matched comparison group who did not receive the training. Participants with mental illnesses who received college or university training and had secured competitive integrated employment at the time of exit not only had significantly higher hourly wages and worked more hours per week than did non-college or university training recipients, they were also more likely to obtain employer-subsidized health insurance benefits. Conclusions College and university training is positively related to employment outcomes for young people with mental illnesses. Implications for state VR counsellors are discussed.

Associations between regional supply and integration of home and community-based service providers and risk of institutionalization: Evidence from South Korea

Abstract Background and Objectives To examine whether the regional density of integrated home and community-based services (HCBS) providers affects long-term care (LTC) service utilization pattern and institutionalization risk in South Korea. Research Design and Methods This observational study utilized data from the National Health Insurance Service (NHIS) on individuals aged 65 and older who became newly eligible for LTC insurance benefits in 2018. The final sample excluded individuals admitted to long-term care hospitals during the previous year or those living away from home, resulting in a total of 91,302 individuals included in the study. We analyzed the impact of regional HCBS and integrated care provider density on four outcomes: choice of HCBS over LTC facilities (LTCF) as first LTC service, intensity and comprehensiveness of HCBS use, and risk of institutionalization within a year. Results Higher regional densities of integrated care providers are associated with increased odds of using HCBS as the first LTC service (Odds Ratio 1.066, model 1, p<0.01). Increased density was also associated with higher odds of using multiple HCBS (Odds Ratio 1.108, model 1, p<0.01). Additionally, higher density of integrated care providers was associated to decreased risk of institutionalization into LTC facilities (Hazard Ratio 0.98, model 1, p<0.01). Discussion and Implications The density integrated care providers significantly reduce institutionalization rates, by increasing the possibility of choosing HCBS over LTCF as their first LTC service and using a more comprehensive combination of HCBS services. Further investment in integrated care models may enhance the effectiveness of LTC systems.

A parametric insurance policy for beekeepers and honey production: random forest regressions and real-world pricing

Abstract In the past years, climate change has affected honey production more and more and the reduction has become a significant risk for beekeepers. In this paper, we discuss the pricing of a parametric insurance policy drafted to cover the potential losses in terms of honey production due to unfavorable weather conditions: the payment of the insurance benefit is triggered by the breaching of predefined thresholds of a weather index, measured over specific relevant periods. The effectiveness of the coverage is verified by the means of random forests, where the honey production is forecast under different real-world weather scenarios and the beekeepers’ loss is compared with the insurance benefit reimbursed (or not) by the policy. The random forest technique is put along with more common ones, such as ordinary least squares regression and mixed linear models. A practical example is given for the Italian market, where the pricing is derived and assessed for three different zones: North, Centre, and South.

The Impact of Financial Coverage on Hearing Aid Utilization Rates Within the Military Health System.

To investigate hearing aid utilization rates among populations with varying hearing aid insurance benefits. A retrospective cohort study was performed. A total of 377 patients were included in the study after being identified through consecutive, hearing loss-related otology clinic visits. With respect to hearing aid benefits, patients were separated into full, partial, and no coverage populations. Chart reviews identified if a patient underwent hearing aid evaluation and fitting. Audiometric data were collected. Chi-square tests of independence and two-sided Z-tests were used for statistical analysis. ANOVA single-factor analysis testing was used to analyze pure tone averages (PTA) and word recognition scores (WRS) data. The 377 patients who met criteria included: full insurance coverage (n = 210, mean age = 45 years), partial coverage (n = 82, mean age = 65 years), and no coverage (n = 85, mean age = 54 years). The full- and partial-coverage populations each had significantly higher hearing aid utilization rates (78% and 79%, respectively) than the no-coverage population (49%, p < 0.001). No statistical difference in mean PTA or WRS was noted among the three coverage categories. Patients with at least partial financial coverage are more likely to acquire hearing aids than those without despite similar degrees of hearing loss. This implies that the out-of-pocket cost of hearing aids is a primary impediment to hearing aid adoption and provides a useful road map for public and private insurers considering hearing aid coverage. Level III (retrospective cohort study) Laryngoscope, 2025.

Evaluating Producer Welfare Benefits of Whole-Farm Revenue Insurance

Agricultural insurance is by far the most popular risk management tool used in Iran. Despite many years of experience, Iran’s current insurance policy has not managed to protect all producers in the sector. The basic principle of whole-farm insurance consists of pooling all the insurable risks of a farm into a single policy and overcoming most of the major impediments to existing policies. This study aimed to evaluate the benefits of whole-farm insurance (WFI) in Zanjan province of Iran. This study employed historical farm-level and county-level data from 1982 to 2021 to estimate yield and price density functions and predict future values. Parametric and non-parametric approaches were utilized to calculate farmers’ expected compensation and guaranteed and simulated revenues. The premium rates were then calculated using the PQH simulation and Cholesky decomposition and compared under three scenarios: the single-crop, double-crop, and triple-crop options. Finally, farmers’ welfare benefits were compared under the three scenarios with the no-insurance case. The results demonstrate that WFI provides lower loss ratios compared to yield insurance and crop-specific insurance. Furthermore, producer welfare can be improved when they insure at least one crop compared to no-insurance. For example, the welfare benefits of insuring wheat, barley, alfalfa, wheat–barley, wheat–alfalfa, barley–alfalfa, and barley–alfalfa in terms of cost reduction to producers at 75% coverage are 8.8, 1.8, 2.9, 1.2, 0.9, and 1.8, respectively. Therefore, we recommend that the Iranian Agricultural Insurance Fund adopts WFI as a new risk management tool. This policy has the potential to decrease insurance premiums and administrative costs while improving the certainty equivalents and benefits to farmers through crop insurance.

Impact of driver licensing renewal policies on older driver crash involvement and injury rates in 13 states, 2000–2019

BackgroundMotor vehicle crashes are the second leading cause of injury death among adults aged 65 and older in the U.S., second only to falls. A common state-level approach to mitigating older adult crash risk is the implementation of driver license renewal policies which vary largely between states and data on their effectiveness in preventing crashes and injuries are limited. To fill this gap, the aim of this study is to examine the association between state driver license renewal policies and older driver crash and injury rates.MethodsHistorical crash data, license renewal policy data, and other relevant policy and demographic data were gathered from 13 U.S. states (CO, IL, IA, KS, MN, MO, NE, ND, OH, SD, UT, WI, WY) for years 2000 through 2019, inclusive. Main exposures included six license renewal policies: renewal period, in-person renewal frequency, vision testing, knowledge testing, on-road drive testing, and mandatory physician reporting. The primary outcomes were crash and injury rates per 100,000 population.ResultsThe study population included 19,010,179 crash-involved drivers aged 40 and older. State policies became less restrictive in many states over the study period, even for drivers aged 75 and older, resulting in longer times between renewals and fewer in-person renewal requirements. Loosening of in-person renewal from every time to less than every time was associated with increased crash rates, among drivers aged 65 to 74 (RRcrash = 1.08, 95% CI: 1.01–1.16). A longer duration between in-person renewals was associated with increased injury rates among drivers 75 and older (RRinjury = 1.18, 95% CI: 1.00–1.39).ConclusionsGenerally, state policies became less restrictive and resulted in longer required intervals between license renewal. Loosening of driver license renewal policies was associated with increased crash and injury rates. However, safety benefits of restrictive older driver licensing policies should be carefully weighed against costs to older adult well-being and quality of life following licensure loss. Additional methods to assess fitness to drive are necessary to identify the mechanisms behind the increased rates.

Centering historically minoritized populations to design effective messages about an evidence-based policy to advance social equity.

Researchers have raised concerns that messages describing racial disparities in social outcomes can reduce or polarize support for public policies to address inequality. We questioned this assumption by testing the impact of carefully crafted messages about child tax credit (CTC) expansion. We conducted two randomized message trials, study 1 using Prolific's nonprobability panel (n = 1,402) and study 2 using SSRS's Opinion Panel, a web-based probability sample of US adults (n = 4,483). Each study included comparably sized subsamples of Black, Hispanic, and White respondents from across the political spectrum. Study 1 compared six candidate messages to a control message and identified promising message strategies for replication. Study 2 compared two messages advocating for CTC expansion-one emphasizing policy benefits to all children (universalist) and the other describing benefits to all but even greater benefits to Black and Hispanic children (targeted universalist)-to a control message simply describing the policy. Primary outcomes were policy support and policy advocacy intentions. Study 2 tested preregistered hypotheses and conducted additional exploratory analyses using linear models. Both treatment messages produced greater policy support and advocacy intentions than the control message among Black and Hispanic respondents (Cohen's d 0.12 to 0.28). The universalist message also produced greater policy support than the control message among White respondents (Cohen's d = 0.16). The targeted universalist message did not reduce policy support or advocacy intentions among White and Republican respondents. Well-designed messages emphasizing policy efficacy can promote support for a redistributive tax policy across racial, ethnic, and political identities.

Factors associated with Catastrophic Healthcare Expenditure in communities of Lagos Nigeria: A Megacity experience.

Each year, millions of people in low-and middle-income countries such as Nigeria are forced into poverty and financial ruin due to out-of-pocket (OOP) healthcare expenses. Our study assessed the prevalence and determinants of Catastrophic Healthcare Expenditure (CHE) experienced by households in Lagos, Nigeria. A descriptive community-based cross-sectional survey was conducted on 2492 households in Lagos from December 2022 to March 2023 in 4 Local Government Areas (LGAs) using a multistage sampling technique. Data was collected using pre-tested semi-structured questionnaires, and analysis was performed using STATA 15.0 software. Univariate, bivariate, and binary logistic regression analyses were conducted with statistical significance set at p<0.05, and a 95% Confidence Interval was calculated for the adjusted odds ratio (OR). The study revealed that 15% of households experience catastrophic health expenditure (CHE). Gender, marital status, educational level, occupation, personal income, health perception, household location, and health insurance enrollment were significantly associated with CHE. Additionally, gender, religion, income, household location, and self-rated health status were significant predictors of household CHE, with adjusted odds ratios of 4.42, 2.45, 1.00, 1.07, and 1.69, respectively. CHE is more prevalent among people with lower socio-economic status, urban residents, and those lacking health insurance. It is crucial to implement targeted initiatives to raise awareness about the benefits of health insurance and simplify the enrollment process for vulnerable groups, thereby alleviating the financial strain of healthcare expenses.

A review of studies assessing the benefits of clean air and climate mitigation policies for child and adult health

A review of studies assessing the benefits of clean air and climate mitigation policies for child and adult health

Vehicle or power grid? Subsidy policy performance evaluation of China's plug in hybrid electric vehicles promotion and power grid cleaning construction

China has implemented strong incentives to promote the market of plug-in hybrid electric vehicles (PHEVs). The increase of PHEV will lead to an increase in electricity consumption, and more power generation will also lead to more carbon dioxide emissions. Therefore, it is necessary to evaluate the environmental benefits of the subsidy policy. In this study, we calculated the CO2 emission reduction and the increase of grid power generation and the CO2 emission from the investment and construction of clean energy power generation facilities caused by the subsidy of PHEV from 2016 to 2020, and evaluated the effect of PHEV subsidy through the multi-period DID model. The results show that replacing ICEV with a PHEV will reduce CO2 emissions by 12.38 kg per 100 km. Under the existing grid structure and power generation conditions, the promotion of PHEV will have a positive impact on CO2 emissions, but the effect is short-lived. Without considering other costs, the investment in clean energy power generation facilities at this stage will achieve better CO2 emission reduction effect than the promotion of PHEV.

Psychological distress in adolescence and later economic and health outcomes in the United States population: A retrospective and modeling study.

Federal policy impact analyses in the United States do not incorporate the potential economic benefits of adolescent mental health policies. Understanding the extent to which economic benefits may offset policy costs would support more effective policymaking. This study estimates the relationship between adolescent psychological distress and later health and economic outcomes and uses these estimates to determine the potential economic effects of a hypothetical policy. This analysis estimated the relationship between psychological distress in those aged 15 to 17 years in 2000 and economic and health outcomes approximately 10 years later, accounting for an array of explanatory variables using machine learning-enabled methods. The cohort was from the National Longitudinal Study of Youth 1997 and nationally representative of those aged 12 to 18 years in 1997. The cohort included 3,343 individuals under age 18 years in round 4 who completed the Mental Health Inventory-5 (MHI-5). Round 1 captured 50 explanatory variables that covered domains of potential confounders, including basic demographics, neighborhood environment, family resources, family processes, physical health, school quality, and academic skills. The exposure included a binary variable of clinically significant psychological distress (MHI-5 score of less than or equal to 3) and a categorical variable of symptom severity on the MHI-5. Outcomes covered domains of employment, income, total assets at age 30 years, education, and health approximately 10 years later. Forty-seven percent of the cohort were black and Hispanic, and 4.4% had past-month clinically significant psychological distress. Past-month clinically significant psychological distress in adolescence led to a 6-percentage-point (95% confidence interval [CI] [-0.08, -0.03]) reduction in past-year labor force participation 10 years later and $5,658 (95% CI [-6,772, -4,545]) USD fewer past-year wages earned. We used these results to model the labor market impacts of a hypothetical policy that expanded access to mental health preventive care and reached 10% of youth who would have otherwise developed clinically significant psychological distress. We found that the hypothetical policy could lead to $52 (95% credible interval [51,54]) billion USD in federal budget benefits over 10 years from labor supply impacts alone. This study faced limitations, including potential unmeasured confounding, missing data, and challenges to generalizability. Our findings showed the impacts of adolescent mental health policies on the federal budget and found potentially large effects on the economy if policies achieve population-level change.

String Stable Bidirectional Platooning Control for Heterogeneous Connected Automated Vehicles

Article String Stable Bidirectional Platooning Control for Heterogeneous Connected Automated Vehicles Dengfeng Pan * School of Science, Computing and Engineering Technologies, Swinburne University of Technology, Melbourne, VIC 3122, Australia * Correspondence: E-mail: dengfengpan@swin.edu.au Received: 8 August 2024 Accepted: 18 September 2024 Published: 27 December 2024 Abstract: In vehicular platoons, disturbances can be amplified significantly downstream in the platoon if not adequately addressed, potentially leading to traffic jams or collisions. This paper tackles the challenge in maintaining string stability of heterogeneous vehicular platoons under a bidirectional communication topology and a refined constant time headway spacing policy. First, unlike the commonly used constant spacing policy and constant time headway policy, a refined constant time headway policy that combines the benefits of constant spacing and constant time headway policies is presented to enhance platooning safety while maintaining traffic efficiency. Second, a distributed adaptive estimator is designed such that each follower ensures its real-time estimation on the inaccessible leader's full states. The proposed estimators also well accommodate the heterogeneity among vehicles, allowing distinct inertial lag parameters of the vehicle longitudinal dynamics. Third, leveraging a bidirectional communication topology, a distributed scalable platoon controller is developed to guarantee the desired individual stability and string stability requirements of the vehicle platoon without the need of any global information of the communication topology. Formal sufficient conditions are provided on the existence of the desired estimator and controller gains. Finally, numerical simulations are conducted to verify the efficacy of the derived theoretical results. The simulations highlight the string stability and superiority of the proposed spacing policy, demonstrating the effectiveness of the proposed platooning control method.

Long-term Effects of Local Area New Deal Work Relief in Childhood on Late Life Depression.

To investigate whether childhood exposure to local area New Deal emergency employment work relief activity was associated with lower depressive symptoms in late life. This study utilized individual-level data from the Wisconsin Longitudinal Study (WLS) linked to the full count 1940 census. New Deal emergency employment programs were the largest non-wartime expansion in government led infrastructure, services, and employment policy in U.S. history. We used within county variation in WLS participants' exposure to emergency employment work relief activity during childhood (ages 0-3) to examine its association with depressive symptoms in late life. We examined depressive symptoms at three ages, 53-55, 65-67, and 72-74 but with a focus on depressive symptoms at ages 72-74 as a marker for late-life depression. Children who lived in neighborhoods with moderate or high levels of emergency employment work relief activity exhibited 14-18% lower depressive symptom scores at ages 72-74 compared to those from neighborhoods with low activity. These findings were consistent across various measures of late-life depressive symptoms, different model specifications, and after accounting for prior depressive symptoms. The study highlights the long-term mental health benefits of economic policies aimed at mitigating concentrated economic downturns among the most impacted individuals. Childhood exposure to New Deal work relief reduced depressive symptoms in older age, particularly new onsets of depressive symptoms at ages 72-74. These results suggest social policies aimed at maintaining economic activity in downturns can have long-term positive impacts on population mental health.

A Community-Engaged, Mixed-Methods Approach to Prioritizing Needs in a Statewide Assessment of Community Cancer Needs.

Kentucky has the highest all-site cancer incidence and death rate in the US. In 2021, the University of Kentucky Markey Cancer Center convened a steering committee to conduct a statewide community cancer needs assessment (CNA). The goal of the final CNA phase was to gather community input on prioritizing Kentucky's cancer-related needs and ways to address them. In 2021, we recruited 162 people to participate in online concept mapping, a participatory mixed method, to explore connections and identify priority areas. Fifty-one community members and 111 organizational partners participated in survey-based activities to prioritize 80 items representing key CNA findings and discussion groups to explore key focus areas and strategies for Kentucky communities. Concept maps display perceived similarity of the 80 items and a 6-cluster solution. High-priority focus areas included lung cancer screening, smoking, human papillomavirus (HPV) vaccination, and disparities driven by social determinants among rural, Appalachian, Black, and Hispanic residents. High-priority strategies to address needs included expanding health communication on risks, screening guidelines, and insurance benefits; patient navigation; accessible, culturally appropriate treatment information and self-efficacy in treatment decisions; access to care through financial assistance, mobile clinics, and at-home screening; and patient-provider trust and communication. Our findings indicate the utility of the concept mapping process to facilitate the prioritization of wide-ranging catchment area needs and ways to address them. Moving forward, the prioritized focus areas and strategies can inform Kentucky's new state cancer plan and future research to reduce the state's cancer burden and disparities.

Cross-sectional relationships of circadian misalignment and rest-activity rhythms with occupational attainment in UK Biobank participants.

Circadian misalignment and disrupted rest-activity rhythms have been linked to adverse health and educational outcomes, yet few studies have considered their relationships with economic outcomes. We investigate associations between multiple accelerometer-measured circadian misalignment traits (Composite Phase Deviation and the Sleep Regularity Index) and rest-activity rhythm traits (Inter-daily Stability, Intra-daily variability and relative amplitude), with occupational attainment, measured using the average wage paid to an individual's occupation. We use data from 20 356 UK Biobank participants who wore an accelerometer (2013-16), provided employment data for the year they wore the accelerometer, and supplied covariate data at recruitment (2006-10). We use linear regression, with incremental adjustments for four sets of covariates, and stratify our analysis by sex. Our findings provide mixed evidence on the relationship between circadian misalignment and occupational attainment, varying by the measure of circadian misalignment used, and sex. We find fragmented rest-activity rhythms to be associated with higher occupational attainment, which is counterintuitive. Since circadian misalignment is a modifiable trait, our results suggest potential benefits of policies aimed at reducing circadian misalignment, such as altering work schedules and reducing bright light exposure in the evening. Further research is needed to elucidate the mechanisms through which rest-activity rhythms may impact economic outcomes.

Causal Effect of Smoking and Cessation on Tooth Loss.

To estimate the causal effects of smoking and cessation on tooth loss using instrumental variable (IV) analysis. Data from the Behavioural Risk Factor Surveillance System (BRFSS), conducted from 1995 to 2006, 2008, 2010, and 2012 in 50 U.S. states and Washington DC, were merged with cigarette pack prices and smoking ban data from the CDC 'Tax Burden on Tobacco' and 'State Tobacco Activities Tracking and Evaluation' (STATE) System. Prices and bans served as IVs for ever smoking and cessation in a control function IV model for self-reported edentulism and loss of 6+ teeth. IV models were adjusted for age, sex, race/ethnicity, educational attainment, type 2 diabetes, state unemployment rates, state health expenditures, and state fixed effects. Ever smoking cigarettes increased the risk of edentulism by 2.6% (95% CI: 2.3%-2.8%) and the risk of loss of 6+ teeth by 10.7% (95% CI: 10.0%-11.3%). Smoking cessation reduced risks of edentulism and loss of 6+ teeth by 7.6% (95% CI: -7.8% to -742%) and 13.5% (95% CI: -13.7% to 13.3%), respectively. This study provides robust evidence that smoking increases tooth loss risk, while cessation significantly reduces it, emphasizing the oral health benefits of tobacco control policies.