Durable Disparity: The Emergence and Entrenchment of the Great American Smoking Gap

My dissertation consists of three papers that approach the origin and persistence of smoking in the United States from different angles. In my first paper, I study smoking patterns within families using the Panel Study of Income Dynamics. I connect the conceptual frameworks on intergenerational transmission of socioeconomic status to the current research on intergenerational reproduction of health. My results show that continuation of smoking between children and parents is conditional on the continuation of their socioeconomic status in adulthood. Children, who are upwardly or downwardly socioeconomically mobile relative to their parents, tend to adopt the health behaviors of their destination class, not their parents’ class. I critique scholarship that frames parents’ smoking as a risk factor for their children and point to the importance of social class and social class immobility in placing children at risk of smoking.

In the second study in my dissertation, I address the role of tobacco control policies in the emergence and then the maintenance of disparities in smoking. Using Behavioral Risk Factor Surveillance data and a database on all American smoke-free laws, I find these laws were most effective in lowering smoking among the least educated and had a leveling effect on the distribution of smoking in the states where they were enacted. I show that the absence of regulation in some states has contributed to the current spatial inequality in smoking. This paper, entitled “Laboratories of Inequality”, was awarded the Louise Johnson Scholar Award by the Medical Sociology Section of the American Sociological Association.

The third paper in my dissertation addresses the effectiveness of tobacco control policies among older adults. Using the Health and Retirement Study, a panel with geospatial markers, I find that older adults infrequently quit smoking in response to increases in cigarette prices or smoke-free laws in their local area. At a time when young people initiate into smoking considerably less often than their peers only a decade or two ago, I argue that, to remain effective, tobacco control policy will need to take into account the changed age composition of today’s population of smokers.