Smoking Behavior and Early Retirement Due to Chronic Disability

This paper considers the long-term effects of smoking on disability retirement. Exploiting population-wide registry data from Sweden, we contribute to the literature by accounting for a much broader range of potential confounders. In particular, by the use of sibling and twin fixed effects, we account for unobserved heterogeneity in childhood environment and family characteristics. Moreover, we are able to control for detailed information on socioeconomic status, marital status and health. We also contribute by distinguishing between different diagnoses for which disability pension has been granted, thus shedding some light on the biological mechanisms linking smoking to disability retirement. Our data on smoking comes from the Swedish Medical Birth Registry, where the smoking behavior of every woman who has given birth in 1983 or later is recorded.

We demonstrate a strong association between smoking and disability retirement. Among individuals aged 50-64, smokers have a six percent higher probability of receiving (full) disability pension, which corresponds to a relative risk of 2.3. However, while the relationship remains significant when accounting for various confounders, the size of the effect is much attenuated. In particular, the magnitude is reduced by half when accounting for sibling fixed effects, pointing at the importance of family background factors associated with smoking behaviour. Effects are concentrated to mental disorders, but effects on neoplasms, nervous system, eye and circulatory conditions are also found. Finally, we document that the relationship between smoking and disability pension exhibits a strong socioeconomic gradient, with the effect being lowest for university graduates.