How does the affordable care act Medicaid expansion affect cigarette consumption?—The mechanism and heterogeneity

Research output: Contribution to journalArticlepeer-review


We examine the average effect of the affordable care act (ACA) Medicaid expansion on cigarette consumption as well as heterogeneous effects by consumer types, depending on whether they use anti-smoking products and their baseline level of cigarette consumption. Using the Nielsen homescan consumer panel and generalized difference-in-differences (GDD) method, we find that anti-smoking products can induce cigarette smoking among moderate and heavy smokers. However, the ACA Medicaid expansion reduces cigarette smoking through channels other than anti-smoking products. As a net result, the ACA Medicaid expansion leads to a reduction in smoking. Light smokers are the main beneficiaries of ACA Medicaid expansion—their average cigarette consumption reduces by over one pack per month.

Original languageEnglish
Pages (from-to)763-791
Number of pages29
JournalJournal of Consumer Affairs
Issue number3
StatePublished - Sep 1 2021

Bibliographical note

Funding Information:
We thank Carlos Lamarche, Tian Qiu, and seminar participants at Southern Agricultural Economics Association 2019 and University of Kentucky for their helpful comments and suggestions. We also thank the Nielsen Data sets for providing the data used in this research. Researcher(s) own analyses calculated (or derived) based in part on data from The Nielsen Company (US), LLC and marketing databases provided through the Nielsen Data sets at the Kilts Center for Marketing Data Center at The University of Chicago Booth School of Business. The conclusions drawn from the Nielsen data are those of the researcher(s) and do not reflect the views of Nielsen. Nielsen is not responsible for, had no role in, and was not involved in analyzing and preparing the results reported herein.

Publisher Copyright:
© 2021 American Council on Consumer Interests.

ASJC Scopus subject areas

  • Sociology and Political Science
  • Economics, Econometrics and Finance (all)


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