Voter Preferences and State Regulation of Smoking

TLDR: In this paper, the authors examine whether voters' preferences for smoking restrictions in restaurants, bars, malls, indoor sporting events, and hospitals are consistent with state-level restrictions on smoking in each of these public areas.

Abstract: I. INTRODUCTION Tobacco taxation and smoking restrictions are two areas of regulation for which states have maintained a high level of control relative to the federal government. (1) Given this flexibility, states have established a wide range of restrictions on smoking in areas such as government workplaces, restaurants, bars. shopping malls, indoor arenas, and hospitals. (2) Although most states restrict smoking in hospitals, there is considerable variation among states in restrictions in other areas. In the 1998-99 period of this study, about two-thirds of states restricted smoking in restaurants, whereas only four states restricted smoking in bars. What has led to variation in smoking restrictions across states? In a democratic society one would expect voter preferences to play an instrumental role in determining which policies are enacted and which are not. This article provides the first empirical exploration of whether state-level smoking restrictions are consistent with preferences of the citizenry, taking into account both voting behavior and the role of smoking status in influencing whether an individual votes. Specifically, we examine whether voters' preferences for smoking restrictions in restaurants, bars, malls, indoor sporting events, and hospitals are consistent with state-level restrictions on smoking in each of these public areas. (3) Our research draws on public choice models of policy making by state and local governments. Voters' preferences typically play a central role, because voting affects legislators incentives to support regulations. (4) Public choice research also finds that nonvoter factors may influence state and local policy making. (5) In the case of smoking regulations, public health advocates or tobacco industry lobbyists might influence regulatory policies. The specific building block of our analysis of state restrictions on smoking is information on individuals' voting behavior, which we link to their smoking status and preferences over smoking restrictions. Our analysis uses measures of political pressure that account for individual preferences as well as their voting behavior. To examine the possible role of interest group pressures, we also control for nonvoter influences on smoking regulation, including the proportion of the state population who smoke, measures of state ideology, and size of the tobacco industry. With the exception of smoking in bars, there is majority support for smoking restrictions. Unsurprisingly, smokers are less supportive of restrictions than are nonsmokers. Nonetheless, even smokers demonstrate a high level of support for many restrictions. Smokers are also less likely to vote than are nonsmokers, even after controlling for other demographic factors. The lower voting rate diminishes voter opposition to antismoking regulation but is usually not critical in view of the substantial support that most smoking restrictions have among smokers. The political pressure indices for restrictions on smoking in each public area are generally significantly related to the probability that a state restricts smoking in that public area. The nonvoter factors, such as the smoking rate in the state and tobacco's role in the state economy, are rarely influential. Policy debates over the desirability of smoking restrictions emphasize possible health risks due to exposure to environmental tobacco smoke (ETS) and effects on business profitability. The primary argument for expanding smoking restrictions is to protect workers and customers from exposure to ETS. (6) As our results show, voters are generally supportive of smoking restrictions in public areas, which would thereby protect workers as well as themselves and other customers. However, there is a substantial controversy over the extent of health risks associated with exposure to ETS. The basis for the push by the U.S. Occupational and Safety Health Administration (OSHA) for increased smoking restrictions to protect workers is the highly controversial U. …

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Table 2 continued

Table 4. Descriptive Statistics for State Data

Table 6. Ordered Probit Regressions of Degree of Smoking Restrictions in Hospitalsa,b

Table 2 continued

Full text

This work was originally published as: Joni Hersch, Alison F. Del Rossi, and W.
Kip Viscusi, Voter Preferences and State Regulation of Smoking - 42 Economic
Inquiry 455 (2004).
1

VOTER PREFERENCES AND STATE REGULATION OF SMOKING
by
Joni Hersch,
a
Alison F. Del Rossi,
b
and
W. Kip Viscusi
c
JEL Classification: H70, I18, K32
August 22, 2003
Forthcoming Economic Inquiry
a. Harvard Law School, Cambridge, MA 02138; jhersch@law.harvard.edu
.
b. Department of Economics, St. Lawrence University, Canton, NY 13617;
adelrossi@stlawu.edu
.
c. Harvard Law School, Cambridge, MA 02138; kip@law.harvard.edu
. Viscusi’s research is
supported by the Harvard Olin Center for Law, Economics, and Business.

VOTER PREFERENCES AND STATE REGULATION OF SMOKING
ABSTRACT
Voters’ preferences for smoking restrictions in restaurants, bars, malls, indoor sporting events, and
hospitals are consistent with state-level restrictions on smoking in each of these public areas. This
analysis is based on constructed measures of political pressure that take into account both individual
preferences and voting behavior. Although smokers are less likely to vote than nonsmokers, their
lower voting rate does not substantially influence the probability that a state has a restriction. Other
factors, such as tobacco’s role in the state economy and state income, are rarely influential.

1. Introduction
Tobacco taxation and smoking restrictions are two areas of regulation for which states have
maintained a high level of control relative to the federal government.
1
Given this flexibility, states
have established a wide range of restrictions on smoking in areas such as government workplaces,
restaurants, bars, shopping malls, indoor arenas, and hospitals.
2
While most states restrict smoking
in hospitals, there is considerable variation among states in restrictions in other areas. In the 1998-
1999 period of this study, about two-thirds of states restricted smoking in restaurants, while only
four states restricted smoking in bars.
What has led to variation in smoking restrictions across states? In a democratic society one
would expect voter preferences to play an instrumental role in determining which policies are
enacted and which are not. This paper provides the first empirical exploration of whether state-
level smoking restrictions are consistent with preferences of the citizenry, taking into account
both voting behavior and the role of smoking status in influencing whether an individual votes.
Specifically, we examine whether voters’ preferences for smoking restrictions in restaurants, bars,
malls, indoor sporting events, and hospitals are consistent with state-level restrictions on smoking in
each of these public areas.
3
Our research draws on public choice models of policymaking by state
1
Federal involvement in tobacco regulation has been isolated to a few areas. It has had a primary role in
investigating and reporting the health consequences of tobacco use and in establishing restrictions on advertising and
labeling requirements. Congress has also passed laws specifying restrictions on smoking on domestic flights and in
facilities that serve children and receive federal funding. If states do not institute certain laws and enforce those
laws to decrease smoking and tobacco use among minors, they face significant reductions in the Substance Abuse
Prevention and Treatment block grant. See <http://www.samhsa.gov/csap/SYNAR/sydex.htm
> for details.
2
There are numerous local laws imposing smoking restrictions. Local laws that are perceived as successful can lead
to widespread adoption, and economic interests may also be influential. Once local laws are enacted, affected
enterprises may press for state regulation to avoid losing patrons to nearby cities. See “Smoke-Free, Statewide,”
Boston Globe, May 11, 2003, p. 10. On the other hand, seventeen states have some level of preemption of local
indoor smoking laws, which forbids lower-level jurisdictions from passing laws more stringent than those set at the
state level or simply forbids any different local laws. We address only state level restrictions in this paper, leaving
for future research the important question of interactions between state and local restrictions.
3
Studies that have examined the political economy of other types of smoking policies include Hunter and Nelson
(1992), Besley and Rosen (1998), and Nelson (2002), who empirically investigate the determinants of cigarette tax
rates. Jacobson et al. (1993) examine the evolution of anti-smoking legislation using six states as case studies.
1

and local governments. Voters’ preferences typically play a central role, as voting affects
legislators’ incentives to support regulations.
4
Public choice research also finds that non-voter
factors may influence state and local policy making.
5
In the case of smoking regulations, public
health advocates or tobacco industry lobbyists might influence regulatory policies.
The specific building block of our analysis of state restrictions on smoking is information on
individuals’ voting behavior, which we link to their smoking status and preferences over smoking
restrictions. Our analysis uses measures of political pressure that account for individual
preferences as well as their voting behavior. To examine the possible role of interest group
pressures, we also control for non-voter influences on smoking regulation, including the
proportion of the state population who smoke, measures of state ideology, and size of the tobacco
industry.
With the exception of smoking in bars, there is majority support for smoking restrictions.
Unsurprisingly, smokers are less supportive of restrictions than are nonsmokers. Nonetheless,
even smokers demonstrate a high level of support for many restrictions. Smokers are also less
likely to vote than are nonsmokers, even after controlling for other demographic factors. The
lower voting rate diminishes voter opposition to antismoking regulation, but is usually not
critical in view of the substantial support that most smoking restrictions have among smokers.
The political pressure indices for restrictions on smoking in each public area are generally
significantly related to the probability that a state restricts smoking in that public area. The non-
4
See Inman (1987) for an overview of political economy models of policy making.
5
Stigler (1971), Peltzman (1976), and Becker (1983) have modeled the role of political pressures from interest groups.
In many empirical studies, non-voter variables add explanatory power to the determination of public spending.
Ahmed and Greene (2000) find interest group models perform about as well as median voter models in explaining
local spending in New York state counties. Congleton and Bennett (1995) find support for both median voter and
special interest models in the determination of state highway expenditures. Stanton and Whitehead (1994) find
intergovernmental relations, state wealth, special interests, and other political variables are important determinants
of states’ air and water pollution control expenditures. Case et al. (1993) find a significant positive impact of
neighboring states’ spending on a state’s chosen funding.
2

Frequently asked questions

Q1. What are the contributions in this paper?

In this paper, the authors examine whether voters ' preferences for smoking restrictions in restaurants, bars, malls, indoor sporting events, and hospitals are consistent with state-level restrictions on smoking in each of these public areas. 

Q2. What are the future works in this paper?

The gap between voter support for smoking restrictions and the presence of such policies within a state suggests that state restrictions are likely to become more widespread in the future.