The European Journal of Health Economics

, Volume 16, Issue 4, pp 391–405 | Cite as

The Icelandic economic collapse, smoking, and the role of labor-market changes

  • Thorhildur ÓlafsdóttirEmail author
  • Birgir Hrafnkelsson
  • Tinna Laufey Ásgeirsdóttir
Original Paper


Smoking is related to health deterioration through increased risk of various diseases. Changes in this health behavior could contribute to the documented health improvements during economic downturns. Furthermore, the reasons for changes in behavior are not well understood. We explore smoking behavior in Iceland before and after the sudden and unexpected economic crisis in 2008. Furthermore, to explore the mechanisms through which smoking could be affected we focus on the role of labor-market changes. Both real income and working hours fell significantly and economic theory suggests that such changes can affect health behaviors which in turn affect health. We use individual longitudinal data from 2007 to 2009, incidentally before and after the crisis hit. The data originates from a postal survey, collected by The Public Health Institute in Iceland. Two outcomes are explored: smoking participation and smoking intensity, using pooled ordinary least squares (OLS) and linear probability models. The detected reduction in both outcomes is not explained by the changes in labor-market variables. Other factors in the demand function for tobacco play a more important role. The most notable are real prices which increased in particular for imported goods because of the devaluation of the Icelandic currency as a result of the economic collapse.


Iceland Economic collapse Health behavior Smoking Labor market Work hours Individual income 

JEL Classification

I10 I12 I15 J23 E32 



Financial support from the University of Iceland Research Fund, Edda Center of Excellence, and the Icelandic Research Fund (IRS, grant number 130611-051) is gratefully acknowledged. We express our gratitude to The Directorate of Health in Iceland (previously The Public Health Institute of Iceland) for provision of the data. We also thank Professors Michael Grossman and Gylfi Zoega for constructive comments.

Supplementary material

10198_2014_580_MOESM1_ESM.docx (51 kb)
Supplementary material 1 (DOCX 51 kb)


  1. 1.
    Neumayer, E.: Recessions lower (some) mortality rates: evidence from Germany (vol. 58, pg 1037, 2004). Soc. Sci. Med. 59(9), 1993 (2004). doi: 10.1016/j.socscimed.2004.02.018 CrossRefGoogle Scholar
  2. 2.
    Ruhm, C.J.: Are recessions good for your health? Q. J. Econ. 115(2), 617–650 (2000)CrossRefGoogle Scholar
  3. 3.
    Tapia Granados, J.A.: Recessions and mortality in Spain, 1980–1997. Eur. J. Popul. 21(4), 393–422 (2005). doi: 10.1007/s10680-005-4767-9 CrossRefGoogle Scholar
  4. 4.
    Grossman, M.: Concept of health capital and demand for health. J. Polit. Econ. 80(2), 223–225 (1972)CrossRefGoogle Scholar
  5. 5.
    Xu, X., Kaestner, R.: The business cycle and health behaviors. In: National Bureau of Economic Research. Working Paper No. 15737 (2010)Google Scholar
  6. 6.
    World Bank: Tobacco control at a glance. Washington, DC. (2009). Accessed 20 Dec 2013
  7. 7.
    Grossman, M.: Individual behaviors and substance use: the role of price. In: National Bureau of Economic Research. Working Paper No. 10948 (2004)Google Scholar
  8. 8.
    McClure, C.B., Valdimarsdóttir, U.A., Hauksdóttir, A., Kawachi, I.: Economic crisis and smoking behaviour: prospective cohort study in Iceland. BMJ Open 2(5): (2012). doi: 10.1136/bmjopen-2012-001386
  9. 9.
    Ragnarsdóttir, B.H., Bernburg, J.G., Ólafsdóttir, S.: The global financial crisis and individual distress: the role of subjective comparisons after the collapse of the Icelandic economy. Sociology (2012). doi: 10.1177/0038038512453790 Google Scholar
  10. 10.
    Ásgeirsdóttir, T.L., Corman, H., Noonan, K., Ólafsdóttir, T., Reichman, N.E.: Was the economic crisis of 2008 good for Icelanders? Impact Health Behav. Econ. Human Biol. (2013). doi: 10.1016/j.ehb.2013.03.005
  11. 11.
    International Monetary Fund: Iceland: Financial System Stability Assessment-Update. December, p. 12 (2008)Google Scholar
  12. 12.
    Prime Minister’s Office: Address to the Nation by H.E. Geir H. Haarde, Prime Minister of Iceland, October 6th 2008. (2008). Accessed 15 Oct 2013
  13. 13.
    Statistics Iceland: Activity rate, unemployment and labour force by quarters.,-income-and-labour-market/Labour-market (2013). Accessed 15 Oct 2013
  14. 14.
    Gerdtham, U.G., Johannesson, M.: A note on the effect of unemployment on mortality. J. Health Econ. 22(3), 505–518 (2003). doi: 10.1016/S0167-6296(03)00004-3 PubMedCrossRefGoogle Scholar
  15. 15.
    Stuckler, D., Meissner, C.M., King, L.P.: Can a bank crisis break your heart? Global. Health 4 (2008). doi: 10.1186/1744-8603-4-1
  16. 16.
    Svensson, M.: Do not go breaking your heart: do economic upturns really increase heart attack mortality? Soc. Sci. Med. 65(4), 833–841 (2007). doi: 10.1016/j.socscimed.2007.04.015 PubMedCrossRefGoogle Scholar
  17. 17.
    Economou, A., Nikolaou, A., Theodossiou, I.: Are recessions harmful to health after all? Evidence from the European Union. J. Econ. Stud. 35(5), 368–384 (2008)CrossRefGoogle Scholar
  18. 18.
    Gerdtham, U.G., Ruhm, C.J.: Deaths rise in good economic times: evidence from the OECD. Econ. Hum. Biol. 4(3), 298–316 (2006). doi: 10.1016/j.ehb.2006.04.001 PubMedCrossRefGoogle Scholar
  19. 19.
    Martikainen, P.T., Valkonen, T.: Excess mortality of unemployed men and women during a period of rapidly increasing unemployment. Lancet 348(9032), 909–912 (1996)PubMedCrossRefGoogle Scholar
  20. 20.
    Lewis, G., Sloggett, A.: Suicide, deprivation, and unemployment: record linkage study. Brit. Med. J. 317(7168), 1283–1286 (1998)PubMedCentralPubMedCrossRefGoogle Scholar
  21. 21.
    Charles, K.K., DeCicca, P.: Local labor market fluctuations and health: is there a connection and for whom? J. Health Econ. 27(6), 1532–1550 (2008). doi: 10.1016/j.jhealeco.2008.06.004 PubMedCrossRefGoogle Scholar
  22. 22.
    Ruhm, C.J.: Good times make you sick. J. Health Econ. 22(4), 637–658 (2003)PubMedCrossRefGoogle Scholar
  23. 23.
    Ruhm, C.J.: Healthy living in hard times. J. Health Econ. 24(2), 341–363 (2005). doi: 10.1016/j.jhealeco.2004.09.007 PubMedCrossRefGoogle Scholar
  24. 24.
    Barnes, M.G., Smith, T.G.: Tobacco use as response to economic insecurity: evidence from the national longitudinal survey of youth. Be J. Econ. Anal. Poli. 9(1), 47 (2009)Google Scholar
  25. 25.
    Brenner, M.H.: Unemployment, economic-growth, and mortality. Lancet 1(8117), 672 (1979)PubMedCrossRefGoogle Scholar
  26. 26.
    Brenner, M.H.: Trends in alcohol consumption and associated illnesses—some effects of economic changes. Am. J. Public Health 65(12), 1279–1292 (1975)PubMedCentralPubMedCrossRefGoogle Scholar
  27. 27.
    Saffer, H., Dave, D.: Mental illness and the demand for alcohol, cocaine, and cigarettes. Econ. Inq. 43(2), 229–246 (2005). doi: 10.1093/Ei/Cbi016 CrossRefGoogle Scholar
  28. 28.
    Dave, D.M., Kelly, I.R.: How does the business cycle affect eating habits? Soc. Sci. Med. 74(2), 254–262 (2011)PubMedCrossRefGoogle Scholar
  29. 29.
    Colman, G.J., Dave, D.M.: Exercise, physical activity, and exertion over the business cycle. In: National Bureau of Economic Research Working Paper No. 1740, (2011)Google Scholar
  30. 30.
    Chaloupka, F.J., Warner, K.E.: The economics of smoking. In: Culyer, A.J., Newhouse, J.P. (eds.) Handbook of Health Economics, pp. 1539–1627. Elsevier, Amsterdam (2000)Google Scholar
  31. 31.
    Dee, T.S.: Alcohol abuse and economic conditions: evidence from repeated cross-sections of individual-level data. Health Econ. 10(3), 257–270 (2001)PubMedCrossRefGoogle Scholar
  32. 32.
    Ruhm, C.J., Black, W.E.: Does drinking really decrease in bad times? J. Health Econ. 21(4), 659–678 (2002)PubMedCrossRefGoogle Scholar
  33. 33.
    Jónsson, S.H., Guðlaugsson, J.O., Gylfason, H.F., Guðmundsdóttir, D.G.: Heilsa og líðan Íslendinga 2007: Framkvæmdaskýrsla. In: The Public Institute of Iceland. Reykjavík (2011). Accessed 15 Oct 2013
  34. 34.
  35. 35.
    Baron, R.M., Kenny, D.A.: The moderator mediator variable distinction in social psychological-research—conceptual, strategic, and statistical considerations. J. Pers. Soc. Psychol. 51(6), 1173–1182 (1986). doi: 10.1037/0022-3514.51.6.1173 PubMedCrossRefGoogle Scholar
  36. 36.
    Ministry of Industry and Innovation: Skýrsla eftirlitsnefndar til efnahags-og viðskiptaráðherra,samkvæmt lögum nr. 107/2009, um aðgerðir í þágu einstaklinga, heimila og fyrirtækja vegna banka-og gjaldeyrishrunsins. (2011). Accessed 15 Nov 2013
  37. 37.
    Prime Minister’s Office: Skýrsla sérfræðingahóps um skuldavanda heimilanna. (2010). Accessed 15 Nov 2013
  38. 38.
    Directorate of Health. (2013). Accessed 20 Dec 2013
  39. 39.
    The Central Bank of Iceland. (2013). Accessed 20 Dec 2013
  40. 40.
    The Icelandic Cabinet: Code of Regulations (i. Reglugerðasafn) n.d. (2007). Accessed 10 Jan 2014
  41. 41.
  42. 42.
  43. 43.
    Joossens, L., Raw, M.: The Tobacco Control Scale: a new scale to measure country activity. Tob. Control. 15(3), 247–253 (2006). doi: 10.1136/tc.2005.015347 PubMedCentralPubMedCrossRefGoogle Scholar
  44. 44.
    Joossens, L., Raw, M.: The Tobacco Control Scale 2010. In: A Report of the Association of European Cancer Leagues. (2010). Accessed 20 Dec 2013
  45. 45.
    Yurekli, A.A., Zhang, P.: The impact of clean indoor-air laws and cigarette smuggling on demand for cigarettes: an empirical model. Health Econ. 9(2), 159–170 (2000)PubMedCrossRefGoogle Scholar
  46. 46.
    Tauras, J.A.: Smoke-free air laws, cigarette prices, and adult cigarette demand. Econ. Inq. 44(2), 333–342 (2006). doi: 10.1093/Ei/Cbj028 CrossRefGoogle Scholar
  47. 47.
    Adda, J., Cornaglia, F.: The effect of bans and taxes on passive smoking. Am. Econ. J. Appl. Econ. 2(1), 1–32 (2010). doi: 10.1257/App.2.1.1 CrossRefGoogle Scholar
  48. 48.
    Anger, S., Kvasnicka, M., Siedler, T.: One last puff? Public smoking bans and smoking behavior. J. Health Econ. 30(3), 591–601 (2011). doi: 10.1016/j.jhealeco.2011.03.003 PubMedCrossRefGoogle Scholar
  49. 49.
    Callinan, J.E., Clarke, A., Doherty, K., Kelleher, C.: Legislative smoking bans for reducing secondhand smoke exposure, smoking prevalence and tobacco consumption. Cochrane Db Syst. Rev. 4 (2010). doi: 10.1002/14651858.Cd005992.Pub2
  50. 50.
    Hargreaves, K., Amos, A., Highet, G., Martin, C., Platt, S., Ritchie, D., White, M.: The social context of change in tobacco consumption following the introduction of ‘smokefree’ England legislation: a qualitative, longitudinal study. Soc. Sci. Med. 71(3), 459–466 (2010). doi: 10.1016/j.socscimed.2010.04.025 PubMedCrossRefGoogle Scholar
  51. 51.
    Asgeirsdottir, T.L., Olafsdottir, T., Ragnarsdottir, D.O.: Business cycles, hypertension and cardiovascular disease: evidence from the Icelandic economic collapse. Blood Pressure Early Online, 1–9 (2013). doi: 10.3109/08037051.2013.862913
  52. 52.
    Freeman, R.B.: Longitudinal analyses of the effects of trade-unions. J. Labor Econ. 2(1), 1–26 (1984). doi: 10.1086/298021 CrossRefGoogle Scholar
  53. 53.
    Carpenter, C., Cook, P.J.: Cigarette taxes and youth smoking: new evidence from national, state, and local Youth Risk Behavior Surveys. J. Health Econ. 27(2), 287–299 (2008). doi: 10.1016/j.jhealeco.2007.05.008 PubMedCrossRefGoogle Scholar
  54. 54.
    Directorate of Health. (2013). Accessed 15 Feb 2014
  55. 55.
    Fitzgerald, J., Gottschalk, P., Moffitt, R.: An analysis of sample attrition in panel data—the Michigan Panel Study of Income Dynamic. J. Human Resour. 33(2), 251–299 (1998). doi: 10.2307/146433 CrossRefGoogle Scholar
  56. 56.
    Fernandez, E., Gallus, S., Schiaffino, A., Lopez-Nicolas, A., La Vecchia, C., Barros, H., Townsend, J.: Price and consumption of tobacco in Spain over the period 1965–2000. Eur. J. Cancer Prev. 13(3), 207–211 (2004). doi: 10.1097/01.cej.0000130018.93310.92 PubMedCrossRefGoogle Scholar
  57. 57.
    Dedobbeleer, N., Beland, F., Contandriopoulos, A.P., Adrian, M.: Gender and the social context of smoking behaviour. Soc. Sci. Med. 58(1), 1–12 (2004). doi: 10.1016/S0277-9536(03)00139-4 PubMedCrossRefGoogle Scholar
  58. 58.
    Lewit, E.M., Coate, D.: The potential for using excise taxes to reduce smoking. J. Health Econ. 1, 121–145 (1982)CrossRefGoogle Scholar
  59. 59.
    Chaloupka, F.J., Pacula, R.L.: Sex and race differences in young people’s responsiveness to price and tobacco control policies. Tob. Control. 8(4), 373–377 (1999)PubMedCentralPubMedCrossRefGoogle Scholar
  60. 60.
    Townsend, J., Roderick, P., Cooper, J.: Cigarette-smoking by socioeconomic group, sex, and age—effects of price, income, and health publicity. Brit. Med. J. 309(6959), 923–927 (1994)PubMedCentralPubMedCrossRefGoogle Scholar
  61. 61.
    Johnston, L.D., O’Malley, P.M., Bachman, J.G.: Smoking, drinking, and illicit drug use among American secondary school students, college students, and young adults, 1975–1991. Volume II: College Students and Young Adults. In: National Institute on Drug Policy. NIH. Publication No. 93-3481 (1993)Google Scholar
  62. 62.
    Zhao, X.S., Lynch, J.G., Chen, Q.M.: Reconsidering Baron and Kenny: myths and truths about mediation analysis. J. Consum. Res. 37(2), 197–206 (2010). doi: 10.1086/651257 CrossRefGoogle Scholar
  63. 63.
    Green, D.P., Ha, S.E., Bullock, J.G.: Enough already about “black box” experiments: studying mediation is more difficult than most scholars suppose. Ann. Am. Acad. Polit. Soc. Sci. 628, 200–208 (2010). doi: 10.1177/0002716209351526 CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Thorhildur Ólafsdóttir
    • 1
    Email author
  • Birgir Hrafnkelsson
    • 2
  • Tinna Laufey Ásgeirsdóttir
    • 1
  1. 1.Faculty of EconomicsUniversity of IcelandReykjavíkIceland
  2. 2.Department of Mathematics, Faculty of Physical SciencesUniversity of IcelandReykjavíkIceland

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