The consequences of health mandates on infant health: Evidence from a smoking-ban regulation

Abstract

Low- and middle-income countries, where more than four-fifths of the world’s smokers live, are far behind in implementing comprehensive smoking bans in public places. This paper studies the infant health consequences of a highly enforced smoking-ban law in Brazil that reduced exposure to smoking for workers in hospitality occupations. Using administrative data and a difference-in-differences strategy, we show that pregnant women’s decreased exposure to smoking improved birth outcomes. Vulnerable workers who were more likely to have unintended pregnancies benefited more from the smoking ban, highlighting the regulation’s distributional consequences. Back-of-the-envelope calculations suggest that the intervention is highly cost-effective, as the infant health benefits surpass enforcement-related costs. Furthermore, we show that several behavioral changes that could offset the regulation’s intended impact are unlikely to operate in our setting.