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Carmen Anthony Esposito

Ph.D Candidate

Job Market Candidate

Economics

About

References: John Tauras, Marcus Casey, and Jacob Robbins

Job Market Paper: Assessing the Public Health Effects of Tobacco 21 Laws on Maternal and Infant Outcomes

Abstract: This paper evaluates the impact of raising the minimum legal purchasing age for tobacco products from 18 to 21 (T21 laws) on maternal smoking behaviors and associated birth outcomes, including low birth weight, premature birth, and Cesarean delivery. Using birth certificate data from the National Center for Health Statistics (2014-2019), the study employs a differencein-differences and triple-difference framework to assess the effects of T21 laws on pregnant individuals aged 18-20 in states that enacted the policy before the federal implementation in December 2019. The analysis compares smoking behaviors and birth outcomes of mothers aged 18-20 to those aged 21-23 in these states. Results show no significant effect on smoking prevalence but a 7% reduction in the number of cigarettes smoked per month. Despite this reduction in smoking intensity, no significant improvements in adverse birth outcomes are observed, suggesting that while T21 laws may reduce smoking intensity, their effectiveness in improving maternal and infant health outcomes may be limited without additional interventions.