The effect of cigarette and alcohol consumption on birth outcomes

This paper uses Danish survey and register data to examine the effect of maternal inputs on child health at birth. The paper adds to the literature in several ways: First, while previous studies mainly have focused on maternal smoking, this paper factors in a larger number of maternal health behaviors, most importantly prenatal alcohol consumption. Second, it uses prenatal maternal reports on inputs and objective administrative data on child outcomes. Both features of the data reduce the threat of recall bias and measurement error. Third, the paper identifies the effect of health behaviors by exploiting variation between siblings. The results of the paper confirm and extend earlier findings. Maternal smoking decreases birth weight and fetal growth, with smaller effects in sibling models. The negative alcohol effect on birth outcomes is pronounced and remains intact in sibling models. Both effects suggest a dose-response relationship. Robustness checks suggest that the sibling sample represents the population of multiple mothers well and that smoking results are not driven by misclassification of smoking status.