Research

Tobacco consumption during pregnancy poses significant risks to maternal and neonatal health. In 2011, Mexico implemented a large nationwide increase in tobacco excise taxes. Because the policy was applied uniformly across the country and detailed smoking data are limited, identifying causal effects is particularly challenging. Using comprehensive vital statistics records on all singleton live births in Mexico, we apply a regression discontinuity in time design to evaluate the short-term impact of a 250% increase in the excise tax on tobacco products on newborn health outcomes. Our findings provide evidence of moderate short-term increases in birth weight after the tax hike. Although the effects diminish over time and show sensitivity to model specification, they may indicate potential long-term public health benefits. This study provides new evidence on the effects of nationwide tobacco tax increases on birth outcomes in middle-income countries.

Background: Food insecurity is standardly measured at the household level or for groups of household members. However, food hardships may differ for individuals within households. Summative measures of people’s individual experiences of food insecurity are needed.

Objective: This study aims to develop and analyze psychometrically sound multi-item scales of people’s individual experiences of food insecurity. It further aims to examine whether and how the distributions of personal food insecurity differ across age groups, from household food insecurity, and with people’s observed characteristics.

Design: We analyze questionnaire data on personal food security outcomes, household food security outcomes, and other characteristics. Participants/setting: The subjects participated in the 2005–2006 through 2009–2010 cycles of the National Health and Nutrition Examination Survey in the United States. Main outcomes: The main outcomes are five-item scales of personal food insecurity for children under age 12, young adolescents aged 12–15, and people aged 16 and over.

Analysis: The study develops the personal food insecurity scales through factor analyses and polytomous Item Response Theory models and analyzes characteristics that contribute to the scale outcomes through multivariate regressions.

Results: The article develops personal food insecurity scales that are related to but distinct from the standard household scales, with different scales being needed to capture the experiences of our three age groups. Children younger than 12 have much lower risks of personal food insecurity than other age groups, while young adolescents have higher risks than other groups. Among adults, women and people between the ages of 31 and 65 have higher risks of personal food insecurity but similar risks for household food insecurity.

Background: The role of diet in health is well established and, in the past decade, more attention has been given to the role of food choices in the environment. The agricultural sector produces about a quarter of the world’s greenhouse gas emissions (GHGE), and meat production, especially beef, is an important contributor to global GHGE. Our study aimed to address a fundamental gap in the diet-climate literature: identifying consumers who are receptive to making dietary changes, and the effect of their potential changes on GHGE, diet healthfulness, and diet costs.

Methods: Dietary data on US individuals from a nationally representative survey were linked to food-related GHGE. We identified individuals receptive to changing their diets (“potential changers”) as those who reported trying US dietary guidance and were likely to agree that humans contribute to climate change. We assessed GHGE, diet healthfulness measured by the Healthy Eating Index (HEI), and diet costs before and after hypothetical changes replacing either beef or meats with poultry or plant-protein foods.

Findings: Our sample comprised 7,188 individuals, of whom 16% were potential changers. These were disproportionately women, highly educated, or had higher income compared with individuals deemed not likely to change. Replacing 100% of beef intake in potential changers with poultry reduced mean dietary GHGE by 1.38 kg CO₂-equivalents per person per day (95% CI 1.19–1.58), a 35.7% decrease. This replacement also increased mean HEI by 1.7% and reduced mean diet costs by 1.7%. We observed the largest changes when replacing all beef, pork, or poultry intake with plant-protein foods (GHGE decreased by 49.6%, mean HEI increased by 8.7%, and dietary costs decreased by 10.5%). Hypothetical replacements in the potential changers alone resulted in whole population reductions in 1-day dietary GHGE of 1.2% to 6.7%, equivalent to 22–126 million fewer passenger vehicle km.