The association between consideration of future consequences and food intake is mediated by food choice motives in a French adult population

OBJECTIVES

Consideration of future consequences (CFC) distinguishes individuals who adopt behaviours based on immediate needs and concerns from individuals who consider the future consequences of their behaviours. We aimed to assess the association between CFC and diet, and testing the mediating role of food choice motives on this relationship.

DESIGN

Individuals (aged ≥ 18 years) completed the CFC-12 questionnaire in 2014, at least three 24-h dietary records, and a food choice motive questionnaire. A multiple mediator analysis allowed to assess the mediating effect of food choice motives on the cross-sectional association between CFC and diet, adjusted for socio-demographic factors.

SETTING

Data from the NutriNet-Santé cohort study.

PARTICIPANTS

27 330 participants.

RESULTS

CFC was associated with all food choice motives (P < 0·001), with the strongest positive associations for avoidance for environmental reasons, absence of contaminants and health motives and the strongest negative associations for innovation and convenience. Positive total effects were found between CFC and the consumption of healthy food groups (fruits and vegetables, whole-grain foods, legumes), and negative total effects for alcohol, meat and poultry and processed meat (P < 0·001). CFC was positively associated with diet quality (P < 0·001). Across food groups, major mediators of these relationships were higher health (8·4-32·6%), higher environmental (13·7-22·1 %) and lower innovation (7·3-25·1 %) concerns.

CONCLUSIONS

CFC was associated with healthier dietary intake, essentially mediated by a greater motivation of future-oriented participants for self-centred and altruistic outcomes, including health and environment. Focusing on the awareness of future benefits in public health interventions might lead to healthier dietary behaviours.

The international diffusion of food innovations and the nutrition transition: retrospective longitudinal evidence from country-level data, 1970-2010

INTRODUCTION

There is a lack of quantitative evidence on the role of food innovations-new food ingredients and processing techniques-in the nutrition transition.

OBJECTIVE

Document the distribution of food innovations across 67 high-income (HIC) and middle-income (MIC) countries between 1970 and 2010, and its association with the nutritional composition of food supply.

METHODS

We used all available data on food patents, as compiled by the European Patent Office, to measure food innovations. We considered innovations directly received by countries from inventors seeking protection in their territories, and those embedded in processed food imports. Food and Agricultural Organization data were used to estimate the associations between international diffusion of food innovations and trends in total food supply and its macronutrient composition, after adjusting for confounding trends in demand-side factors. We identified the role of trade by simulating the changes in average diet due to innovations embedded in food imports.

RESULTS

Trends in food innovations were positively and significantly associated with changes in daily per capita calorie supply available for human consumption in MIC between 1990 and 2010 (elasticity of 0.027, 95% CI 0.019 to 0.036). Food innovations were positively correlated with the share of animal and free fats in total food supply (elasticities of 0.044, 95% CI 0.030 to 0.058 for MIC between 1970 and 1989 and 0.023, 95% CI 0.003 to 0.043 for HIC between 1990 and 2010). Food innovations were associated with substitutions from complex carbohydrates towards sugars in total food supply for MIC after 1990 (elasticities of -0.037, 95% CI -0.045 to -0.029 for complex carbs, 0.082, 95% CI 0.066 to 0.098 for sugars). For these countries, the trade channel capturing access to innovations through imports of processed food played a key role.

CONCLUSION

Policy-makers should consider the impacts of the international diffusion of food innovations in assessing the costs and benefits of international trade regulations.

Mastery Is Associated With Weight Status, Food Intake, Snacking, and Eating Disorder Symptoms in the NutriNet-Santé Cohort Study

Mastery is a psychological resource that is defined as the extent to which individuals perceive having control over important circumstances of their lives. Although mastery has been associated with various physical and psychological health outcomes, studies assessing its relationship with weight status and dietary behavior are lacking. The aim of this cross-sectional study was to assess the relationship between mastery and weight status, food intake, snacking, and eating disorder (ED) symptoms in the NutriNet-Santé cohort study. Mastery was measured with the Pearlin Mastery Scale (PMS) in 32,588 adults (77.45% female), the mean age was 50.04 (14.53) years. Height and weight were self-reported. Overall diet quality and food group consumption were evaluated with ≥3 self-reported 24-h dietary records (range: 3-27). Snacking was assessed with an ad-hoc question. ED symptoms were assessed with the Sick-Control-One-Fat-Food Questionnaire (SCOFF). Linear and logistic regression analyses were conducted to assess the relationship between mastery and weight status, food intake, snacking, and ED symptoms, controlling for sociodemographic and lifestyle characteristics. Females with a higher level of mastery were less likely to be underweight (OR: 0.88; 95%CI: 0.84, 0.93), overweight [OR: 0.94 (0.91, 0.97)], or obese [class I: OR: 0.86 (0.82, 0.90); class II: OR: 0.76 (0.71, 0.82); class III: OR: 0.77 (0.69, 0.86)]. Males with a higher level of mastery were less likely to be obese [class III: OR: 0.75 (0.57, 0.99)]. Mastery was associated with better diet quality overall, a higher consumption of fruit and vegetables, seafood, wholegrain foods, legumes, non-salted oleaginous fruits, and alcoholic beverages and with a lower consumption of meat and poultry, dairy products, sugary and fatty products, milk-based desserts, and sweetened beverages. Mastery was also associated with lower snacking frequency [OR: 0.89 (0.86, 0.91)] and less ED symptoms [OR: 0.73 (0.71, 0.75)]. As mastery was associated with favorable dietary behavior and weight status, targeting mastery might be a promising approach in promoting healthy behaviors.

Clinical Trial Registry Number

NCT03335644 at Clinicaltrials.gov.

Associations between anxiety and the willingness to be exposed to COVID-19 risk among French young adults during the first pandemic wave

The COVID-19 outbreak has generated significant uncertainty about the future, especially for young adults. Health and economic threats, as well as more diffuse concerns about the consequences of COVID-19, can trigger feelings of anxiety, leading individuals to adopt uncertainty-reducing behaviours. We tested whether anxiety was associated with an increase in willingness to be exposed to the risk of COVID-19 infection (WiRE) using an online survey administered to 3,110 French individuals aged between 18 and 35 years old during the first pandemic wave and lockdown period (April 2020). Overall, 56.5% of the sample declared a positive WiRE. A one standard deviation increase in psychological state anxiety raised the WiRE by +3.9 pp (95% CI [+1.6, 6.2]). Unemployment was associated with a higher WiRE (+8.2 percentage points (pp); 95% CI [+0.9, 15.4]). One standard deviation increases in perceived hospitalisation risk and in income (+1160€) were associated with a -4.1 pp (95% CI [-6.2, 2.1]) decrease in the WiRE and +2.7 pp increase (95% CI [+1.1, 4.4]), respectively. Overall, our results suggest that both psychological anxiety and the prospect of economic losses can undermine young adults' adherence to physical distancing recommendations. Public policies targeting young adults must consider both their economic situation and their mental health, and they must use uncertainty-reducing communication strategies.

Economic Perspectives on Food Choices, Marketing, and Consumer Welfare

This contribution reviews the main normative and positive arguments that can used in the assessment of the costs and benefits of food marketing restrictions, focusing specifically on theoretical and empirical developments in the economics of advertising, consumer behaviour and industrial organization since the 70s.

Public health lessons from the soda taxes enacted in France in 2012 and modified in 2018

Background

In 2016, the WHO officially recommended sugar-sweetened beverage (SSB) taxation as a strategy to reduce consumption, stimulate product reformulation and generate revenues for health-related programmes. This recommendation was based on a number of studies and experiments amongst them the 2012 French SSB tax that was redesigned in 2018. In this presentation, we summarize the lessons learnt from the soda taxes in France and offer insights on their potential public health benefits.

Methods

Our rationale is structured according to the interdisciplinary perspective of the Soda-Tax research consortium (2019-2023), addressing: (1) the soda tax policy change process; (2) the impact on price and purchases; (3) the consumer receptiveness to the tax and; (4) its legal framework and potential application to other foods/nutrients.

Results

Our overview of evidence highlights that the process leading to the enactment of the 2012 tax was initially based on a public health justification that was later set aside in favour of budgetary concerns. The tax, whose rate was flat and low and whose scope was extended to artificially-sweetened drinks containing no added sugar, generated modest effects on SSB consumption. Yet, it was ground breaking and offered an opportunity to appreciate its equity, to document its acceptance through a population-based survey and its legal viability. Six years later, the new tax comes closer to international recommendations: it is framed within the scope of public health action, focuses on SSBs and its rate is indexed to the quantity of added sugar in the drink.

Conclusions

The Soda-Tax project will study the degree of policy learning that may have contributed to the evolution of the 2018 tax, as well as the conditions of its implementation, administratively more complex than the previous one. It will also explore the social acceptability of this new tax and the extent to which it results in higher SSB prices, lower consumption and changes in the market.

Key messages

The design of the 2012 French soda tax was not optimal for public health, but it set a precedent. The 2018 soda tax, closer to international recommendations, deserves further investigation.

Modelling the number of avoidable new cancer cases in France attributable to alcohol consumption by following official recommendations: a simulation study

AIMS

To predict the effects of perfect adherence to the French alcohol consumption guidelines, a maximum of 10 standard alcoholic drinks per week with no more than two standard alcoholic drinks per day, during a 36-year period (2014-50).

DESIGN

This simulation study is an adaption of the Sheffield Alcohol Policy Model. The dose-response relationship between alcohol consumption and alcohol-attributable cancer risks was defined by cancer site-specific risk functions, each modelled as a continuous risk. These estimates were used to compute the potential impact fraction (PIF) associated with alcohol consumption by cancer site.

SETTING

The French general adult population during a 36-year period (2014-50).

PARTICIPANTS

For the baseline scenario, the current distribution of consumption levels, the counterfactual scenario and perfect adherence to the French alcohol consumption guidelines, we generated for each gender and age group 1000 randomly distributed alcohol consumption values from calibrated group-specific gamma distribution.

MEASUREMENTS

The predicted number of new cancer cases among men and women in France between 2015 and 2050 that could have been prevented by following the French government's alcohol consumption guidelines.

FINDINGS

The simulation predicted that perfect adherence to the French government's alcohol consumption guidelines would prevent, on average, an estimated 15 952 cancer cases per year after the PIF reached its full effect, which would have represented 4.5% of new cancer cases in 2015. The number of averted cancer cases over the study period were highest for oral cavity, oropharynx and hypopharynx cancer (respectively, 118 462, 95% CI = 113 803-123 022 and 11 167, 95% CI = 10 149-12 229] for men and women; liver and intrahepatic bile ducts cancer (123 447, 95% CI = 112 581-133 404 and 2825, 95% CI = 2208,4095); colorectal cancer (89 859, 95% CI = 84 651-95 355 and 12 847, 95% CI = 11 545-14 245); and female breast cancer (61 649, 95% CI = 56 330-67 452).

CONCLUSION

This simulation study of the French general population predicted that perfect adherence to the French government's alcohol consumption guidelines (no more than 10 standard alcoholic drinks per week and two per day) would prevent almost 16 000 cancer cases per year.

The 'Eat Well @ IGA' healthy supermarket randomised controlled trial: process evaluation

Background

Successful implementation and long-term maintenance of healthy supermarkets initiatives are crucial to achieving potential population health benefits. Understanding barriers and enablers of implementation of real-world trials will enhance wide-scale implementation. This process evaluation of a healthy supermarket intervention sought to describe (i) customer, retailer and stakeholder perspectives on the intervention; (ii) intervention implementation; and (iii) implementation barriers and enablers.

Methods

Eat Well @ IGA was a 12-month randomised controlled trial conducted in 11 Independent Grocers of Australia (IGA) chain supermarkets in regional Victoria, Australia (5 intervention and 6 wait-listed control stores). Intervention components included trolley and basket signage, local area and in-store promotion, and shelf tags highlighting the healthiest packaged foods. A sequential mixed-methods process evaluation was undertaken. Customer exit surveys investigated demographics, and intervention recall and perceptions. Logistic mixed-models estimated associations between customer responses and demographics, with store as random effect. Supermarket staff surveys investigated staff demographics, interactions with customers, and intervention component feedback. Semi-structured stakeholder interviews with local government, retail and academic partners explored intervention perceptions, and factors which enabled or inhibited implementation, maintenance and scalability. Interviews were inductively coded to identify key themes.

Results

Of 500 customers surveyed, 33%[95%CI:23,44] recalled the Eat Well @ IGA brand and 97%[95%CI:93,99] agreed that IGA should continue its efforts to encourage healthy eating. The 82 staff surveyed demonstrated very favourable intervention perceptions. Themes from 19 interviews included that business models favour sales of unhealthy foods, and that stakeholder collaboration was crucial to intervention design and implementation. Staff surveys and interviews highlighted the need to minimise staff time for project maintenance and to regularly refresh intervention materials to increase and maintain salience among customers.

Conclusions

This process evaluation found that interventions to promote healthy diets in supermarkets can be perceived as beneficial by retailers, customers, and government partners provided that barriers including staff time and intervention salience are addressed. Collaborative partnerships in intervention design and implementation, including retailers, governments, and academics, show potential for encouraging long-term sustainability of interventions.

Trial registration

ISRCTN, ISRCTN37395231 Registered 4 May 2017.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12966-021-01104-z.

Impulsivity is associated with food intake, snacking, and eating disorders in a general population

Background

Impulsivity is a psychological trait linked to health issues such as obesity. However, few studies have explored the relation between impulsivity, dietary intake, and eating disorders (EDs) in a general population.

Objective

The aim of this cross-sectional study was to assess whether impulsivity was associated with energy intake, food-group consumption, snacking, and risk of EDs.

Design

In 2014, 51,368 adult participants from the NutriNet-Santé Study completed the 11th version of the Barratt Impulsiveness Scale (BIS-11), which assesses impulsivity. Food-group consumption and diet quality were evaluated by using ≥3 self-reported 24-h dietary records (n = 35,830), whereas snacking behavior was evaluated by an ad hoc question (n = 48,562). Risk of EDs was assessed with the Sick-Control-One-Fat-Food Questionnaire (SCOFF), and categories of ED (restrictive, bulimic, hyperphagic, and other types of EDs) were determined with the Expali algorithm (n = 48,824). Logistic and linear regressions were used to analyze the associations between impulsivity and energy intake, food-group consumption, diet quality, snacking, and risk of EDs, taking into account sociodemographic and lifestyle factors.

Results

Positive associations were found between impulsivity and consumption of alcoholic beverages and appetizers, whereas negative associations were found for fruit and vegetables, meat and poultry, processed meat, dairy products, milk-based desserts, and starchy foods. Impulsivity was positively associated with energy intake and negatively associated with diet quality. Impulsivity was also positively associated with snacking (OR: 3.32; 95% CI: 2.99, 3.68) and risk of EDs (OR: 3.02; 95% CI: 2.74, 3.33). The strongest associations were found for bulimic disorders (OR: 4.38; 95% CI: 3.66, 5.23) and hyperphagic disorders (OR: 2.91; 95% CI: 2.56, 3.31).

Conclusion

Impulsivity was associated with food intakes, snacking, and risk of EDs and could be taken into account in the promotion of healthy eating behavior. This study was registered at clinicaltrials.gov as NCT03335644.

Impulsivity and consideration of future consequences as moderators of the association between emotional eating and body weight status

Background

Emotional eating (EmE) is characterized by an over consumption of food in response to negative emotions and is associated with an increased weight status. Consideration of Future Consequences (CFC) or a low level of impulsivity could influence the association between EmE and weight status. The objective was to analyze the moderating influence of CFC and impulsivity on the relationship between EmE and BMI.

Methods

A total of 9974 men and 39,797 women from the NutriNet-Santé cohort study completed the revised 21-item Three-Factor Eating Questionnaire to assess their EmE, the CFC questionnaire (CFC-12) to assess their level of time perspective, and the Barratt Impulsiveness Scale (BIS-11) to assess their impulsivity. Weight and height were self-reported each year over a median follow-up of 5.3 years. The associations between EmE and repeated measures of BMI were estimated by multiple linear mixed-effects regression models stratified by gender, tertiles of the CFC, or tertiles of the BIS-11, taking into account sociodemographic and lifestyle factors.

Results

Overall, EmE was positively associated with BMI. CFC and impulsivity did not moderate the effect of EmE on changes of BMI per year, but quantitatively moderated the effect of EmE on overall BMI. In women, the strength of the association between EmE and weight status increased with CFC level. Difference of BMI slopes between a low and a high level of CFC was − 0.43 kg/m² (95% CI: -0.55, − 0.30) (p < .0001). In addition, the strength of the association between emotional eating and weight status increased with impulsivity level. Difference of BMI slopes between a low and a high level of impulsivity was + 0.37 kg/m² (95% CI: 0.24, 0.51) (p < .0001). In men, only individuals with a low CFC presented a stronger association of EmE with BMI.

Conclusions

Impulsivity and consideration of future consequences moderated the association between emotional eating and body weight status. This study emphasizes the importance of taking into account psychological traits in obesity prevention.

Electronic supplementary material

The online version of this article (10.1186/s12966-018-0721-1) contains supplementary material, which is available to authorized users.

Association between time perspective and organic food consumption in a large sample of adults

BACKGROUND

Organic food intake has risen in many countries during the past decades. Even though motivations associated with such choice have been studied, psychological traits preceding these motivations have rarely been explored. Consideration of future consequences (CFC) represents the extent to which individuals consider future versus immediate consequences of their current behaviors. Consequently, a future oriented personality may be an important characteristic of organic food consumers. The objective was to analyze the association between CFC and organic food consumption in a large sample of the adult general population.

METHODS

In 2014, a sample of 27,634 participants from the NutriNet-Santé cohort study completed the CFC questionnaire and an Organic-Food Frequency questionnaire. For each food group (17 groups), non-organic food consumers were compared to organic food consumers across quartiles of the CFC using multiple logistic regressions. Moreover, adjusted means of proportions of organic food intakes out of total food intakes were compared between quartiles of the CFC. Analyses were adjusted for socio-demographic, lifestyle and dietary characteristics.

RESULTS

Participants with higher CFC were more likely to consume organic food (OR quartile 4 (Q4) vs. Q1 = 1.88, 95% CI: 1.62, 2.20). Overall, future oriented participants were more likely to consume 14 food groups. The strongest associations were observed for starchy refined foods (OR = 1.78, 95% CI: 1.63, 1.94), and fruits and vegetables (OR = 1.74, 95% CI: 1.58, 1.92). The contribution of organic food intake out of total food intake was 33% higher in the Q4 compared to Q1. More precisely, the contribution of organic food consumed was higher in the Q4 for 16 food groups. The highest relative differences between Q4 and Q1 were observed for starchy refined foods (22%) and non-alcoholic beverages (21%). Seafood was the only food group without a significant difference.

CONCLUSIONS

This study provides information on the personality of organic food consumers in a large sample of adult participants. Consideration of future consequences could represent a significant psychological determinant of organic food consumption.

Globalisation and national trends in nutrition and health: A grouped fixed-effects approach to intercountry heterogeneity

Using a panel dataset of 70 countries spanning 42 years (1970-2011), we investigate the distinct effects of social globalisation and trade openness on national trends in markers of diet quality (supplies of animal proteins, free fats and sugar, average body mass index, and diabetes prevalence). Our key methodological contribution is the application of a grouped fixed-effects estimator, which extends linear fixed-effects models. The grouped fixed-effects estimator partitions our sample into distinct groups of countries in order to control for time-varying unobserved heterogeneity that follows a group-specific pattern. We find that increasing social globalisation has a significant impact on the supplies of animal protein and sugar available for human consumption, as well as on mean body mass index. Specific components of social globalisation such as information flows (via television and the Internet) drive these results. Trade openness has no effect on dietary outcomes or health. These findings suggest that the social and cultural aspects of globalisation should receive greater attention in research on the nutrition transition.

The Effect of Introducing a Minimum Price on the Distribution of Alcohol Purchase: A Counterfactual Analysis

We use counterfactual analysis techniques to evaluate the impact of a $2 minimum unit price (MUP) on the distribution of Australian (Victorian) household off-trade alcohol purchases. Our estimates suggest that a $2 MUP significantly reduces the purchases of at-risk households by up to -0.92 [90% CI: -1.55, -0.28] standard drinks at the highest quantiles and has substantially less effect on households purchasing at light and moderate levels. A $2 MUP may reduce the proportions of male and female shoppers purchasing at the public health threshold of more than two standard drinks per household member per day by -3.03 [90% CI: -4.83, -1.22] percentage points (relative variation: -17%); and -1.85 [90% CI: -2.60, -1.10] percentage points (relative variation:-22%), respectively. Implementing an MUP on alcohol thus promises significant positive impacts on public health. Copyright © 2016 John Wiley & Sons, Ltd.

Do High Consumers of Sugar-Sweetened Beverages Respond Differently to Price Changes? A Finite Mixture IV-Tobit Approach

This study compares the impact of sugar-sweetened beverages (SSBs) tax between moderate and high consumers in Australia. The key methodological contribution is that price response heterogeneity is identified while controlling for censoring of consumption at zero and endogeneity of expenditure by using a finite mixture instrumental variable Tobit model. The SSB price elasticity estimates show a decreasing trend across increasing consumption quantiles, from -2.3 at the median to -0.2 at the 95th quantile. Although high consumers of SSBs have a less elastic demand for SSBs, their very high consumption levels imply that a tax would achieve higher reduction in consumption and higher health gains. Our results also suggest that an SSB tax would represent a small fiscal burden for consumers whatever their pre-policy level of consumption, and that an excise tax should be preferred to an ad valorem tax.

Mandatory labels, taxes and market forces: An empirical evaluation of fat policies

The public-health community views mandatory Front-of-Pack (FOP) nutrition labels and nutritional taxes as promising tools to control the growth of food-related chronic diseases. This paper uses household scanner data to propose an ex-ante evaluation and comparison of these two policy options for the fromage blanc and dessert yogurt market. In most markets, labelling is voluntary and firms display fat labels only on the FOP of low-fat products to target consumers who do not want to eat fat. We here separately identify consumer preferences for fat and for FOP fat labels by exploiting an exogenous difference in legal labelling requirements between these two product categories. Estimates of demand curves are combined with a supply model of oligopolistic price competition to simulate policies. We find that a feasible ad valorem fat tax dominates a mandatory FOP-label policy from an economic perspective, but both are equally effective in reducing average fat purchases.

Happy house: spousal weight and individual well-being

We use life satisfaction and Body Mass Index (BMI) information from three waves of the GSOEP to test for social interactions in BMI between spouses. Social interactions require that the cross-partial effect of partner's weight and own weight in the utility function be positive. Using life satisfaction as a utility proxy, semi-parametric regressions show that the correlation between satisfaction and own BMI is initially positive, but turns negative after some threshold. Critically, this latter threshold increases with partner's BMI when the individual is overweight. The negative well-being impact of own BMI is thus lower when the individual's partner is heavier, which is consistent with social contagion effects in weight. However, this relationship may also reflect selection on the marriage market or omitted variables, and it is difficult to think of convincing instruments that would allow causality to be clearly established.

Schooling and smoking among the baby boomers - an evaluation of the impact of educational expansion in France

Post-war expansion of education in France transformed the distribution of schooling for the cohorts born between the 1940s and the 1970s. However, throughout this expansion the proportion with the highest levels of qualifications remained stable, providing a natural control group. We evaluate the impact of schooling on smoking, for the beneficiaries of the post-war expansion, by comparing changes in their outcomes across birth cohorts with changes within the control group. We uncover robust evidence that educational expansion contributed to a decline in smoking prevalence of 2.9 points of percentage for men and 3.2 points for women at the turn of the 21st century. Our results also suggest that the persistence of the schooling-smoking gradient is better explained by differences in the education-related opportunity costs of smoking than by differences in information about smoking dangers.

Social norms, ideal body weight and food attitudes

This paper uses French data on ideal body weight and food attitudes to analyse the role of social norms in the individual's weight control problem. A proxy measure of social norms is calculated by averaging individual perceptions of the ideal Body Mass Index (BMI) over all observations within a reference group. Testing for different definitions of the reference group, we find that individual representations of ideal body shape are differentiated mainly along gender and age lines. Social norms regarding body shape have a significant effect on perceptions of ideal BMI only for those women who want to lose weight, with an elasticity close to 0.5. For many women and for all men, ideal BMI is almost exclusively determined by habitual BMI. Last, ideal BMI predicts a number of attitudes towards food, while social norms do not. These results suggest that promoting medical norms regarding body shape should have little effect on individual food attitudes.

Don't give up on me baby: spousal correlation in smoking behaviour

We use nine waves of BHPS data to examine interactions between spouses in terms of a behaviour with important health repercussions: cigarette smoking. Correlation between partners' behaviours may be due to correlated effects, as a consequence of matching or information revealed by others' behaviours, or to endogenous effects generated by bargaining within marriage. A simple bivariate probit reveals a positive correlation between own current smoking and partner's past smoking, which is consistent with endogenous effects. However, after controlling for individual effects, we find that own current smoking and partner's past smoking are statistically independent: all of the correlation in smoking status works through the correlation in individual effects. As such the correlation in the raw smoking data is consistent with positive assortative matching in marriage over smoking, rather than bargaining within the couple or social learning.

Income-related reporting heterogeneity in self-assessed health: evidence from France

This paper tests for income-related reporting heterogeneity in self-assessed health (SAH). It also constructs a synthetic measure of clinical health to decompose the effect of income on SAH into an effect on clinical health (which is called a health production effect) and a reporting heterogeneity effect. We find health production effects essentially for low-income individuals, and reporting heterogeneity for the choice between the medium labels, i.e. 'fair' vs 'good' and for high-income individuals. As such, SAH should be used cautiously for the assessment of income-related health inequalities in France. It is however possible to minimize the reporting heterogeneity bias by converting SAH into a binary variable for poor health vs other health statuses.

Who does the hat fit? Teenager heterogeneity and the effectiveness of information policies in preventing cannabis use and heavy drinking

This paper models heterogeneity in the relationship between exposure to information at school or in the media and cannabis use and heavy drinking, using latent class techniques applied to data on French teenagers collected in 1993. Teenagers cluster in five classes which differ in their tastes for drunkenness and cannabis, and in the correlations between information exposure and cannabis use or heavy drinking. Teenager heterogeneity and habit-formation or precociousness effects limit the effectiveness of general information policies. Improving the impact of prevention requires that interventions be better targeted and personalised. We show how economic theory, latent class techniques and existing psychometric questionnaires can be used to build simple statistical tools for targeting prevention policies.

Health changes and smoking: an economic analysis

This article considers dynamic models of smoking under uncertainty, wherein individuals learn about the associated risks both through experimentation and observation. We use smokers' changes in self-reported health in long-run household panel data as an individualized measure of information about how dangerous smoking is for them. We find that own past health changes while smoking are often positively correlated with current cigarette consumption, implying learning. However, other household members' health changes have only a weak effect. We emphasize individual heterogeneity, using both fixed effects in the analysis of cigarette consumption and age and sex differences in how individuals react to health changes. We conclude that smokers do indeed react to personalized health information (but not necessarily from generalized information) and modify their behavior accordingly. The way in which they react differs sharply by sex and by age, suggesting that aggregate correlations may be misleading.

Do health changes affect smoking? Evidence from British panel data

This paper uses seven waves of British Household Panel Survey (BHPS) data to examine the link between health developments while smoking (both one's own and those of other smokers in the same household) and future cigarette consumption. We find those whose health worsens when smoking smoke less in the future, and are more likely to quit. This correlation is consistent with both a Grossman model of health demand (where all parameters are known) and with learning about the health consequences of smoking (where there is uncertainty). There is little effect on smoking from health developments amongst other smokers in the same household. As such, impersonal information provision may have less of an effect on smoking than the delivery of personalised health information, for example through the medical profession.