Association of Cigarette Smoking with Changes in Macroeconomic Conditions

This study uses data from the 1987–2021 Behavioral Risk Factor Surveillance System and statelevel employment rates data from the US Bureau of Labor Statistics to estimate the association between macroeconomic conditions and cigarette smoking. We find that a one percentage point increase in employment rate is associated with a 0.4% increase in current cigarette smoking. This association is stronger among young adults aged 18-34 years (1.1%) than persons aged 35-64 years (0.4%); Black persons (1.4%) than white individuals (0.3%) or persons of other races/ethnicities (0.8%); and persons with a college education or better (0.8%) than those with some college education (0.4%). While we do not find any differences in the associations between males (0.3%) and females (0.4%), there was no association among elderly persons aged ≥ 65, Hispanics, and individuals with a high school diploma or lower educational attainment. However, we find evidence of attenuation in the associations over time, with no association in more recent survey data from 2011 to 2021. Based on the 2011–2021 data, we only find positive associations among persons aged 18-34 years (1.7%), Black individuals (1.2%), and persons with a college education or better (1.1%), and a negative association among persons with high school diplomas or lower education levels (-0.4%). We conclude that the economic condition and cigarette smoking relationship may have changed in recent years, especially after the Family Smoking Prevention and Tobacco Control Act in 2009 and the availability of electronic cigarettes in the US marketplace in 2007