Many studies that investigate determinants of substance use focus on criminal justice sanctions, prices, and taxes. However, economic, policy, and resource environments also have the potential to affect decisions to use harmful substances. When environmental conditions change, effects on substance use can be indirect and unforeseen. This session includes three papers that explore effects of specific environmental variations on decisions to use specific harmful substances. The environments considered are availability of prenatal care in inner cities, political pressure on Congressional hearings vis-à-vis performance enhancing drugs, and welfare reforms that took place in the United States starting in the early 1990s.

The substances considered are cigarette smoking, performance-enhancing drugs, and illicit street drugs. The first paper examines mothers’ post-partum cigarette smoking as a function of access to prenatal care. The second paper examines the effect of political pressure on Congressional hearings and subsequent impacts on Major League Baseball's policies regarding performance enhancing drugs. The third paper estimates the effects of welfare reform on the use of illicit drugs by women at-risk for welfare participation. Together, this set of papers advances the literature on substance use by exploiting unique and exogenous environmental variations.

Presenting Author Bio: Nancy E. Reichman is Professor of Pediatrics at Robert Wood Johnson Medical School and Visiting Professor of Economics at Princeton University. She is an economist whose research focuses on socioeconomic determinants and consequences of child health. Some of her recent studies are on the effectiveness of prenatal care, effects of substance abuse during pregnancy, effects of children’s health on families, and effects of welfare, Medicaid, and other policies on the well-being of children and their families.