Research

Abstract We provide evidence on whether e-cigarette accessibility reduces planned smoking cessation. Substantial evidence indicates e-cigarettes and cigarettes are substitutes, but whether e-cigarettes compete with safer FDA-approved smoking cessation products, or whether they entice people to quit smoking that had no interest in quitting otherwise, is little understood and important from a public health and regulatory perspective. We study this question by using e-cigarette taxes as a proxy for e-cigarette accessibility, and studying the effect these taxes have on sales of over-the-counter nicotine replacement therapies (NRTs), prescriptions for smoking cessation pills, calls to state quitlines, and overall reports of cessation available in a large-scale health survey. We combine four national data sets from 2010 to 2021 in the United States with quasi-experimental difference-in-differences (DID) methods. Our findings imply that taxing e-cigarettes does not disrupt planned smoking cessation efforts. We can rule out effects larger than a 3.0% decrease or a 3.6% increase in NRT sales following a $1 e-cigarette tax increase.

Abstract The number of tubal sterilization procedures increased drastically in the United States in the 1970s due to legal and technological advances, quickly becoming the most popular form of contraception among married women. This method of permanent contraception afforded women almost perfect control over the end of their fertility. This paper studies how this increase in sterilizations affected completed fertility — particularly age at last birth — and female labor supply. Using variation across regions and over time in sterilization rates by age, I show that women more exposed to tubal sterilization at childbirth were less likely to have a subsequent birth. The increase in tubal sterilizations between 1965 and 1985 reduced women’s age at last birth by 1.9 years and the probability of childbirth after age 30 by over 30%. As women spent fewer years caring for young children following the diffusion of tubal sterilization, female labor force participation increased. I also find suggestive evidence that women were more likely to select into occupations that reward experience and tenure, consistent with the power of tubal sterilization to reduce the risk of career interruptions.

Abstract This paper studies the fertility effects of 1990s-era welfare reform in the US, which ended unconditional cash assistance to low-income mothers. I find that individuals more likely to be on welfare pre-reform —and thus more likely to be affected—experienced larger fertility declines after the reform relative to those less likely. Moreover, this effect is larger in states with more generous pre-reform welfare payments. Notably, fertility began to decline after 1992—several years before the 1996 Welfare Reform Act—and this decline was not driven by states implementing early reform policies in 1992 and 1993. These findings suggest that the effects were driven by women anticipating significant changes to the welfare system. A back-of-the-envelope calculation indicates that welfare reform in the 1990s may explain over 24% of the decline in overall U.S. fertility between 1992 and 2000.

Abstract How do sex education and its curriculum affect fertility? We study this question using a natural experiment in which the AIDS epidemic prompted states to mandate either abstinence-focused or comprehensive sex education in schools. We compare cohorts of women in treated states who were in school when the mandates were introduced to those who had recently graduated, relative to women in states without mandates. We show that teen births increased by 6.3 per 1,000 women in states mandating abstinence-focused HIV/AIDS education, bringing forward the timing of first births without affecting lifetime fertility. In contrast, we do not find fertility effects in states that mandated comprehensive sex education. The findings suggest that abstinence-focused curricula may unintentionally increase teen births by destigmatizing sexual activity while failing to provide information on contraception.