Substance Abuse Policy and Child Health Production
Prevalence of prenatal smoking (16%) and illicit drug use (6%) remains high. While studies have assessed how pregnant women respond to substance abuse policies, little is known about the longer-term intergenerational effects of these policies. The proposed session includes a cohesive set of three studies with assigned discussants, all of which seek to estimate these longer-term effects of maternal exposure to various policies and restrictions on their children’s health. The session makes two major contributions to the literature. First, the papers present intent-to-treat analyses, directly informing potential longer-term benefits of such policies, the omission of which would bias the cost-benefit calculus in policy debates. Second, all studies exploit plausibly exogenous policy variation, which inform the causal effects of in utero exposure to harmful substances on children’s development. Paper 1 capitalizes on cigarette tax hikes during pregnancy to assess how early-life exposure to cigarette smoke affects children’s health. Paper 2 exploits variation in comprehensive county/municipal-level smoking restrictions to assess effects on infants’ and older children’s health, while decomposing the effects into those driven by fetal exposure to maternal smoking versus environmental smoke and while accounting for potential compensatory behaviors by smokers in response to the bans. Paper 3 shifts the lens to illicit drug use, exploiting policy variation specific to pregnant women (as opposed to the general population) to estimate effects on maternal health behaviors and infant health. These papers can be broadly situated within the fetal origins literature, and generally confirm the importance of early life influences on later health.