A Cigarette Tax and Childcare Mitigate Nicotine Exposure in Young Children
Daniel Berry, Lisa Gatzke-Kopp, Michael T. Willoughby, Clancy B. BlairOBJECTIVES
The detrimental effects of tobacco smoke on children’s health are well known. Although evidence suggests that cigarette excise taxes can reduce adult smoking, it remains unclear whether they reduce the nicotine levels of infants and toddlers—a developmentally vulnerable group. This study tested the effects of 2 North Carolina (NC) cigarette tax increases on children’s cotinine trajectories—a biomarker of nicotine exposure—from infancy to early childhood, as well the extent to which these effects were stronger for children spending fewer hours in childcare (ie, greater time in smoking households).
METHODS
Observational and salivary biomarker data were collected prospectively from children in NC and Pennsylvania (PA) as part of the Family Life Project, a longitudinal study of low-income families in rural contexts. The analytic sample included 1176 children (of 1292), who provided at least one saliva sample. Difference-in-differences/event-study estimators tested the impact of 2 NC cigarette excise tax increases (+$0.25 in 2005; +$0.05 in 2006) on children’s cotinine trajectories relative to a PA control group.
RESULTS
The larger tax increase predicted modest-to-moderate reductions in child cotinine levels (Δ −0.22 SD to Δ −0.40 SD). Effects were limited to children living in smoking households and emerged gradually over time. Contrary to expectations, tax effects were not stronger for children attending fewer childcare hours. However, within-child increases in childcare hours predicted reductions in cotinine levels regardless of state or tax phase.
CONCLUSIONS AND POLICY IMPLICATIONS
Tobacco taxation and childcare attendance may reduce nicotine exposure across infancy and early childhood.