Behavior Genetics

, Volume 46, Issue 1, pp 43–58 | Cite as

The Long-Term Consequences of Vietnam-Era Conscription and Genotype on Smoking Behavior and Health

Original Research


Research is needed to understand the extent to which environmental factors moderate links between genetic risk and the development of smoking behaviors. The Vietnam-era draft lottery offers a unique opportunity to investigate whether genetic susceptibility to smoking is influenced by risky environments in young adulthood. Access to free or reduced-price cigarettes coupled with the stress of military life meant conscripts were exposed to a large, exogenous shock to smoking behavior at a young age. Using data from the Health and Retirement Study (HRS), we interact a genetic risk score for smoking initiation with instrumented veteran status in an instrumental variables (IV) framework to test for genetic moderation (i.e. heterogeneous treatment effects) of veteran status on smoking behavior and smoking-related morbidities. We find evidence that veterans with a high genetic predisposition for smoking were more likely to have been smokers, smoke heavily, and are at a higher risk of being diagnosed with cancer or hypertension at older ages. Smoking behavior was significantly attenuated for high-risk veterans who attended college after the war, indicating post-service schooling gains from veterans’ use of the GI Bill may have reduced tobacco consumption in adulthood.


Gene–environment interactions Smoking behavior Genetic risk scores Vietnam-era draft lottery 



This study was funded by the Russell Sage Foundation (grant number 83-15-29).

Compliance with Ethical Standards

Conflict of Interest

Lauren Schmitz and Dalton Conley declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human participants or animals performed by any of the authors.


  1. Angrist JD (1990) Lifetime earnings and the Vietnam-era draft lottery: evidence from social security administrative records. Am Econ Rev 80:313–336Google Scholar
  2. Angrist JD, Chen SH (2011) Schooling and the Vietnam-era GI bill: evidence from the draft lottery. Am Econ J 3(2):96–118Google Scholar
  3. Angrist JD, Krueger AB (2001) Instrumental variables and the search for identification: from supply and demand to natural experiments. J Econ Perspect 15(4):69–85CrossRefGoogle Scholar
  4. Angrist JD, Pischke JS (2008) Mostly harmless econometrics: an empiricist’s companion. Princeton University Press, PrincetonGoogle Scholar
  5. Angrist JD, Chen SH, Frandsen BR (2010) Did Vietnam veterans get sicker in the 1990s? The complicated effects of military service on self-reported health. J Public Econ 94(11):824–837CrossRefGoogle Scholar
  6. Angrist JD, Chen SH, Song J (2011) Long-term consequences of Vietnam-era conscription: new estimates using Social Security data. Am Econ Rev 101(3):334–338CrossRefGoogle Scholar
  7. Batty GD, Deary IJ, Gottfredson LS (2007) Premorbid (early life) IQ and later mortality risk: systematic review. Ann Epidemiol 17(4):278–288PubMedCrossRefGoogle Scholar
  8. Bedard K, Deschênes O (2006) The long-term impact of military service on health: Evidence from World War II and Korean War veterans. Am Econ Rev 96:176–194CrossRefGoogle Scholar
  9. Belsky DW, Moffitt TE, Baker TB, Biddle AK, Evans JP, Harrington HL, Williams B (2013) Polygenic risk and the developmental progression to heavy, persistent smoking and nicotine dependence: evidence from a 4-decade longitudinal study. JAMA Psychiatry 70(5):534–542PubMedPubMedCentralCrossRefGoogle Scholar
  10. Benetos A, Safar M, Rudnichi A, Smulyan H, Richard JL, Ducimetière P, Guize L (1997) Pulse pressure a predictor of long-term cardiovascular mortality in a French male population. Hypertension 30(6):1410–1415PubMedCrossRefGoogle Scholar
  11. Boardman JD, Saint O, Jarron M, Haberstick BC, Timberlake DS, Hewitt JK (2008) Do schools moderate the genetic determinants of smoking? Behav Genet 38(3):234–246PubMedPubMedCentralCrossRefGoogle Scholar
  12. Bound J, Turner S (2002) Going to war and going to college: did World War II and the GI bill increase educational attainment for returning veterans? J Labor Econ 20(4):784–815CrossRefGoogle Scholar
  13. Card, D., & Lemieux, T. (2001). Going to college to avoid the draft: The unintended legacy of the Vietnam War. American Economic Review, 97-102Google Scholar
  14. Centers for Disease Control & Prevention (1994) Surveillance for selected tobacco-use behaviors–United States, 1900–1994. MMWR Morb Mortal Wkly Rep 43(3):1–43Google Scholar
  15. Centers for Disease Control & Prevention (2003) Prevalence of current cigarette smoking among adults and changes in prevalence of current and some day smoking—United States, 1996–2001. MMWR Morb Mortal Wkly Rep 52(14):303Google Scholar
  16. Centers for Disease Control & Prevention (2008) Smoking-attributable mortality, years of potential life lost, and productivity losses—United States, 2000–2004. MMWR Morb Mortal Wkly Rep 57(45):1226Google Scholar
  17. Chang C.C., Chow C.C., Tellier LCAM, Vattikuti S., Purcell S.M,. Lee J.J. (2015). Second-generation PLINK: rising to the challenge of larger and richer datasets. GigaScience, 4Google Scholar
  18. Conley D (2009) The promise and challenges of incorporating genetic data into longitudinal social science surveys and research. Biodemogr Soc Biol 55(2):238–251CrossRefGoogle Scholar
  19. Conley D, Heerwig JA (2011) The war at home: effects of Vietnam-era military service on postwar household stability. Am Econ Rev 101(3):350–354CrossRefGoogle Scholar
  20. Conley D, Heerwig JA (2012) The long-term effects of military conscription on mortality: estimates from the Vietnam-era draft lottery. Demography 49(3):841–855PubMedCrossRefGoogle Scholar
  21. Daw J, Shanahan M, Harris KM, Smolen A, Haberstick B, Boardman JD (2013) Genetic sensitivity to peer behaviors 5HTTLPR, smoking, and alcohol consumption. J Health Soc Behav 54(1):92–108PubMedCrossRefGoogle Scholar
  22. De Walque D (2007) Does education affect smoking behaviors?: evidence using the Vietnam draft as an instrument for college education. Journal of Health Economics 26(5):877–895PubMedCrossRefGoogle Scholar
  23. De Walque D (2010) Education, information, and smoking decisions evidence from smoking histories in the United States, 1940–2000. J Hum Resour 45(3):682–717Google Scholar
  24. Dobkin C, Shabani R (2009) The health effects of military service: evidence from the Vietnam draft. Econ Inq 47(1):69–80CrossRefGoogle Scholar
  25. Eisenberg D, Rowe B (2009) The effect of smoking in young adulthood on smoking later in life: evidence based on the Vietnam era draft lottery. In: Forum for Health Economics & Policy, 12(2), Health Policy and Planning, BeijingGoogle Scholar
  26. Farrell P, Fuchs VR (1982) Schooling and health: the cigarette connection. J Health Econ 1(3):217–230PubMedCrossRefGoogle Scholar
  27. Faul F, Erdfelder E, Buchner A, Lang AG (2009) Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behav Res Methods 41:1149–1160PubMedCrossRefGoogle Scholar
  28. Fienberg SE (1971) Randomization and social affairs: the 1970 draft lottery. Science 171(3968):255–261PubMedCrossRefGoogle Scholar
  29. Fletcher JM, Conley D (2013) The challenge of causal inference in gene–environment interaction research: leveraging research designs from the social sciences. Am J Public Health 103(S1):S42–S45PubMedPubMedCentralCrossRefGoogle Scholar
  30. Fortmann SP, Rogers T, Vranizan K, Haskell WL, Solomon DS, Farquhar JW (1984) Indirect measures of cigarette use: expired-air carbon monoxide versus plasma thiocyanate. Prev Med 13(1):127–135PubMedCrossRefGoogle Scholar
  31. Fuchs, V. R. (1982). Time preference and health: An exploratory study. Economic Aspects of Health, 93Google Scholar
  32. Furberg H, Kim Y, Dackor J, Boerwinkle E, Franceschini N, Ardissino D, Merlini PA (2010) Genome-wide meta-analyses identify multiple loci associated with smoking behavior. Nat Genet 42(5):441–447CrossRefGoogle Scholar
  33. Gimbel C, Booth A (1996) Who fought in Vietnam? Soc Forces 74(4):1137–1157CrossRefGoogle Scholar
  34. Glassman AH, Helzer JE, Covey LS, Cottler LB, Stetner F, Tipp JE, Johnson J (1990) Smoking, smoking cessation, and major depression. JAMA 264(12):1546–1549PubMedCrossRefGoogle Scholar
  35. Grimard F, Parent D (2007) Education and smoking: were Vietnam war draft avoiders also more likely to avoid smoking? J Health Econ 26(5):896–926PubMedCrossRefGoogle Scholar
  36. Grossman M (1972) On the concept of health capital and the demand for health. J Polit Econ 80(2):223–255CrossRefGoogle Scholar
  37. Grossman M (2006) Education and nonmarket outcomes. Handb Econ Educ 1:577–633CrossRefGoogle Scholar
  38. Hatziandreu EJ, Pierce JP, Fiore MC, Grise V, Novotny TE, Davis RM (1989) The reliability of self-reported cigarette consumption in the United States. Am J Public Health 79(8):1020–1023PubMedPubMedCentralCrossRefGoogle Scholar
  39. Health and Retirement Study (1992–2010 Core Files) public use dataset and (1992–2010 Respondent Date of Birth Files) restricted use dataset (2014) Produced and distributed by the University of Michigan with funding from the National Institute on Aging (grant number NIA U01AG009740), Ann ArborGoogle Scholar
  40. Hearst N, Newman TB, Hulley SB (1986) Delayed effects of the military draft on mortality: a randomized natural experiment. N Eng J Med 314(10):620CrossRefGoogle Scholar
  41. Heckman J (1997) Instrumental variables: a study of implicit behavioral assumptions used in making program evaluations. J Hum Resour 32:41–462CrossRefGoogle Scholar
  42. Heerwig JA, Conley D (2013) The causal effects of Vietnam-era military service on post-war family dynamics. Soc Sci Res 42(2):299–310PubMedCrossRefGoogle Scholar
  43. Helyer AJ, Brehm WT, Perino L (1998) Economic consequences of tobacco use for the Department of Defense, 1995. Mil Med 163(4):217–221PubMedGoogle Scholar
  44. Johnston LD, O’Malley PM, Bachman JG, Schulenberg JE (2005) Monitoring the future: National Survey Results on Drug Use, 1975–2004, volume II, College students and adults ages 19–45, 2004, National Institutes of Health, BethesdaGoogle Scholar
  45. Kandel DB, Logan JA (1984) Patterns of drug use from adolescence to young adulthood: periods of risk for initiation, continued use, and discontinuation. Am J Public Health 74(7):660–666PubMedPubMedCentralCrossRefGoogle Scholar
  46. Kendler KS, Gardner C, Jacobson KC, Neale MC, Prescott CA (2005) Genetic and environmental influences on illicit drug use and tobacco use across birth cohorts. Psychol Med 35(09):1349–1356PubMedCrossRefGoogle Scholar
  47. Le Marchand L, Derby KS, Murphy SE, Hecht SS, Hatsukami D, Carmella SG, Wang H (2008) Smokers with the CHRNA lung cancer–associated variants are exposed to higher levels of nicotine equivalents and a carcinogenic tobacco-specific nitrosamine. Cancer Res 68(22):9137–9140PubMedPubMedCentralCrossRefGoogle Scholar
  48. Liu JZ, Tozzi F, Waterworth DM, Pillai SG, Muglia P, Middleton L, Waeber G (2010) Meta-analysis and imputation refines the association of 15q25 with smoking quantity. Nat Genet 42(5):436–440PubMedPubMedCentralCrossRefGoogle Scholar
  49. Lleras-Muney A (2005) The relationship between education and adult mortality in the United States. Rev Econ Stud 72(1):189–221CrossRefGoogle Scholar
  50. Maes HH, Woodard CE, Murrelle L, Meyer JM, Silberg JL, Hewitt JK, Carbonneau R (1999) Tobacco, alcohol and drug use in eight-to sixteen-year-old twins: the Virginia Twin study of adolescent behavioral development. J Stud Alcohol Drugs 60(3):293CrossRefGoogle Scholar
  51. Merline AC, O’Malley PM, Schulenberg JE, Bachman JG, Johnston LD (2004) Substance use among adults 35 years of age: prevalence, adulthood predictors, and impact of adolescent substance use. Am J Public Health 94(1):96–102PubMedPubMedCentralCrossRefGoogle Scholar
  52. Patrick DL, Cheadle A, Thompson DC, Diehr P, Koepsell T, Kinne S (1994) The validity of self-reported smoking: a review and meta-analysis. Am J Public Health 84(7):1086–1093PubMedPubMedCentralCrossRefGoogle Scholar
  53. Price AL, Patterson NJ, Plenge RM, Weinblatt ME, Shadick NA, Reich D (2006) Principal components analysis corrects for stratification in genome-wide association studies. Nat Genet 38(8):904–909PubMedCrossRefGoogle Scholar
  54. Purcell S, Chang C (2014) PLINK [Computer software].
  55. Rouse B, Sanderson C, Feldmann J (2002) Results from the 2001 National Household Survey on Drug Abuse: Volume I. Summary of National Findings, vol I. Substance Abuse and Mental Health Services Administration, Office of Applied Studies, RockvilleGoogle Scholar
  56. Slomkowski C, Rende R, Novak S, Lloyd-Richardson E, Niaura R (2005) Sibling effects on smoking in adolescence: evidence for social influence from a genetically informative design. Addiction 100(4):430–438PubMedCrossRefGoogle Scholar
  57. Spitz MR, Amos CI, Dong Q, Lin J, Wu X (2008) The CHRNA5-A3 region on chromosome 15q24-25.1 is a risk factor both for nicotine dependence and for lung cancer. J Natl Cancer Inst 100(21):1552–1556PubMedPubMedCentralCrossRefGoogle Scholar
  58. Stanley M (2003) College education and the midcentury GI Bills. Q J Econ 118(2):671–708CrossRefGoogle Scholar
  59. StataCorp (2013) Stata statistical software: release 13. StataCorp LP, College StationGoogle Scholar
  60. Thorgeirsson TE, Geller F, Sulem P, Rafnar T, Wiste A, Magnusson KP, Oskarsson H (2008) A variant associated with nicotine dependence, lung cancer and peripheral arterial disease. Nature 452(7187):638–642PubMedPubMedCentralCrossRefGoogle Scholar
  61. Thorgeirsson TE, Gudbjartsson DF, Surakka I, Vink JM, Amin N, Geller F, Walter S (2010) Sequence variants at CHRNB3-CHRNA6 and CYP2A6 affect smoking behavior. Nat Genet 42(5):448–453PubMedPubMedCentralCrossRefGoogle Scholar
  62. Timberlake DS, Rhee SH, Haberstick BC, Hopfer C, Ehringer M, Lessem JM, Hewitt JK (2006) The moderating effects of religiosity on the genetic and environmental determinants of smoking initiation. Nicot Tob Res 8(1):123–133CrossRefGoogle Scholar
  63. U.S. Department of Health and Human Services (1989) Reducing the health consequences of smoking: 25 years of progress. A report of the surgeon general. U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control, Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. DHHS Publication No. (CDC) 89-8411Google Scholar
  64. U.S. Department of Health and Human Services (1990) A report of the surgeon general: the health benefits of smoking cessation, Washington, DCGoogle Scholar
  65. U.S. Department of Veteran Affairs (2015) Vietnam Veterans.
  66. U.S. Selective Service System (2015) Induction statistics.
  67. Wedge R, Bondurant S (eds) (2009) Combating tobacco use in military and veteran populations. National Academies Press, Washington, DCGoogle Scholar
  68. Winefield HR, Winefield AH, Tiggemann M, Goldney RD (1989) Psychological concomitants of tobacco and alcohol use in young Australian adults. Br J Addict 84(9):1067–1073PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Population Studies CenterUniversity of MichiganAnn ArborUSA
  2. 2.Departments of Sociology, Public Policy, and MedicineNew York UniversityNew YorkUSA

Personalised recommendations