From Freakonomics, a link to this paper by David Cutler and Edward Glaeser. Here’s the abstract:

While Americans are less healthy than Europeans along some dimensions (like obesity), Americans are significantly less likely to smoke than their European counterparts. This difference emerged in the 1970s and it is biggest among the most educated. The puzzle becomes larger once we account for cigarette prices and anti-smoking regulations, which are both higher in Europe. There is a nonmonotonic relationship between smoking and income; among richer countries and people, higher incomes are associated with less smoking. This can account for about one-fifth of the U.S./Europe difference. Almost one-half of the smoking difference appears to be the result of differences in beliefs about the health effects of smoking; Europeans are generally less likely to think that cigarette smoking is harmful.

This is an interesting problem, partly because evidence suggests that anti-smoking programs are ineffective, but there is a lot of geographic variation in smoking rates across countries, as well as among U.S. states (and among states in India too, as S. V. Subramanian has discussed). It’s encouraging to think that better education could reduce smoking rates.

Amazingly, “in Germany only 73 percent of respondents said that they believed that smoking causes cancer.” Even among nonsmokers, only 84% believed smoking caused cancer! I’d be interested in knowing more about these other 16%. (I guess I could go to the Eurobarometer survey and find out who they are.)

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There are a couple things in the paper I don’t quite follow. On page 13, they write, “there is a negative 38 percent correlation coefficient between this regulation index and the share of smokers in a state. A statistically significant negative relationship result persists even when we control for a wide range of other controls including tobacco prices and income. As such, it is at least possible that greater regulation of smoking in the U.S. might be a cause of the lower smoking rate in America.” But shouldn’t they control for past smoking rates? I imagine the regulations are relatively recent, so I’d think it would be appropriate to compare states that are comparable in past smoking rates but differ in regulations.

Finally, there’s some speculation at the end of the paper about how it is that Americans have become better informed than Europeans about the health effects of smoking. They write, “while greater U.S. entrepreneurship and economic openness led to more smoking during an earlier era (and still leads to more obesity today), it also led to faster changes in beliefs about smoking and ultimately less cigarette consumption.” I don’t really see where “entrepreneurship” comes in. I had always been led to believe that a major cause of the rise in smoking in the U.S. in the middle part of the century was that that the GI’s got free smokes in their rations. For anti-smoking, I had the impression that federalism had something to do with it–the states got the cigarette taxes, and the federal government was free to do anti-smoking programs. But I’m not really familiar with this history so maybe there’s something I’m missing here.

P.S. Obligatory graphics comments:

Figures 1 and 2 should be a scatterplot. Figure 3 should lose the horizontal lines, display every 20 years (not every 10) on the x-axis, and rescale the y-axis to be in cigarettes per day (rather than per year, as it appears to be). Figure 4 should be square, with both axes on a common scale, and just label all the countries (not a problem if the axes are limited to the range of the data (basically, 20%-50%, not 10-60), also remove those distracting horizontal lines, Figure 5 should also remove the horizontal lines (and use the same y-scale as the new figure 4, and give the country names), Figure 6 should label all 50 states (with 2-letter abbreviations) and jitter the points slightly in the x-direction (also restrict the y-range to that of the data and, again, remove those lines), ditto on Figure 7. There’s also a problem with Figures 6 and 7. According to Fig 7, the US smoking rate is 19%, but according to Fig 6, the smoking rate is above 20% for all but two of the states. What am I missing here? Fig 8, again, would be improved by removing those horizontal lines and restricting the x and y-axes to the range of the data (thus giving room for more data). Same for Figures 9 and10 (and, again, use 2-letter abbreviations, also do income on the log scale to be consistent with Figure 8). And Fig 11 (this time, spell out the country names and ditch the dots–there will be plenty of room when the graph has been rescaled. Table 1 should be in some natural order (e.g., increasing income, or increasing smoking rate), not alphabetical (as Howard Wainer and others have emphasized). Actually I’d prefer it as a graph, but I won’t press the point. Similarly for Tables 2,3,4 (actually, I’d put them all in 1 table (if not a graph)) so that the infor can be better compared.

Anyway, it’s a fascinating paper and I’m sure will inspire lots of analysis of individual-level survey data.