title: Tobacco expenditures and child health and nutritional outcomes in rural Bangladesh.
abstract: This study examined the relationship between tobacco prices and child health outcomes so as to assess the potential of improved child health outcomes resulting from less tobacco expenditure. In part, this paper was motivated by a study by. Efroymson et al. [(2001). Hungry for tobacco: An analysis of the economic impact of tobacco consumption on the poor in Bangladesh. Tobacco Control, 10, 212-217] suggesting that for the poorest households in Bangladesh, amongst whom malnutrition is widespread, shifting tobacco expenditures to expenditures on food would significantly improve the nutritional status of the household. We used data from a survey of 956 households conducted in rural Bangladesh between June 1996 and September 1997. The households were surveyed four times at approximately 4-month intervals during the 16-month period. We restricted our sample to households with children aged 2-10, and 600 households satisfied this criterion. The primary dependent variables for this study are three anthropometric indicators of child health and nutritional status: a standardized measure of height for age, a standardized measure of weight for height, and a standardized measure of weight for age. We also used measures of self-reported morbidity, including the incidence and duration of respiratory illness. We used regression methods on data averaged across survey rounds to estimate the relationship between tobacco prices and the outcome variables. Tobacco prices were found to be a significant determinant of height for age and weight for height for both boys and girls. Furthermore, the price of tobacco products is a significant predictor of weight for age for girls and the pooled sample. Our results suggest that higher tobacco prices would, for the most part, improve child health.
authors.affiliation: RTI International RTP, Department of Health, Social and Economic Research, North Carolina, USA. jnonnemaker@rti.org
authors.forename: James
authors.initials: J
authors.lastname: Nonnemaker
authors.forename: Mona
authors.initials: M
authors.lastname: Sur
mesh_terms: D001459:Bangladesh; D001827:Body Height; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D003361:Cost Allocation; D003430:Cross-Sectional Studies; D003906:Developing Countries; D005260:Female; D005502:Food / Q000191:economics; D006801:Humans; D008297:Male; D009749:Nutrition Surveys; D011203:Poverty / Q000191:economics; D011502:Protein-Energy Malnutrition / Q000191:economics* / Q000453:epidemiology; D012141:Respiratory Tract Infections / Q000191:economics / Q000453:epidemiology; D012424:Rural Population / Q000706:statistics & numerical data*; D012907:Smoking / Q000009:adverse effects / Q000191:economics*; D016540:Smoking Cessation / Q000191:economics; D012959:Socioeconomic Factors; D062789:Tobacco Products