Social Theory & Health

, Volume 16, Issue 1, pp 20–43 | Cite as

Self-interest and public opinion in health policy: smoking behavior and support for tobacco control

  • Andrew L. Spivak
  • Michael S. Givel
  • Shannon M. Monnat
Original Article


This study examines the influence of self-interest on attitudes about public health policy, specifically the influence of smoking on opposition to tobacco control measures. We analyze the relationships between being a current smoker, former smoker, or nonsmoker and support for cigarette taxes and anti-tobacco health education campaigns in order to reveal the extent to which the direct “pocketbook” self-interest of health-related behaviors, versus general sociotropic values, influence public health policy opinions. Using a sample of 442 adult participants in a statewide survey, binary logistic regression and proportional odds models compare respondents’ support for varying amounts and allocation levels of cigarette taxes, as well as anti-tobacco health education campaigns, controlling for smoking status and demographic variables. Results indicate that the connection between being a current smoker and being less supportive of cigarette taxes (a policy that directly affects self-interest) is not mediated when controlling for attitudes about anti-tobacco education campaigns (a policy that does not as directly affect self-interest). However, while former smokers do not support cigarette taxes as much as do nonsmokers, their support for taxes becomes indistinguishable from that of nonsmokers when their attitudes about anti-tobacco education campaigns are considered. We conclude that both direct self-interest and broader social values influence tobacco control policy attitudes. Smokers appear to consider their pocketbooks, but simultaneously both current and former smokers are ideologically motivated to oppose health initiatives. Thus, public health policymakers should highlight the importance of public education and social norms in garnering support for tobacco control policies.


Tobacco Smoking Tobacco taxes Self-interest 



The authors thank Mary Outwater and the University of Oklahoma Public Opinion Learning Laboratory (OUPOLL) for their assistance in conducting the survey.


Research contributing to this study was funded in part by American Heart Association Grant 0335002 N. Dr. Monnat acknowledges grant funding from the Robert Wood Johnson Foundation New Connections program and research support from the Population Research Institute at Penn State University, which receives funding from the Eunice Kennedy Shriver National Institute of Child Heath and Human Development (P2CHD041025).


  1. Allison, Paul D. 2002. Missing Data. Series: Quantitative Applications in the Social Sciences. Thousand Oaks: Sage Publications.CrossRefGoogle Scholar
  2. Baslevent, Cem, and Hasan Kirmanoglu. 2010. Discerning Self-Interested Behavior in Attitudes Towards Welfare State Responsibilities Across Europe. International Journal of Social Welfare (forthcoming: early view online).Google Scholar
  3. Beccaria, Cesare. 1775/1963. On Crime and Punishments. Translated with an introduction by Henry Paolucci. New York: McMillan Publishing Co.Google Scholar
  4. Bentham, Jeremy. 1789/1970. An Introduction to the Principles of Morals and Legislation. London: The Athlone Press.Google Scholar
  5. Biener, Lois, Robert H. Aseltine, Bruce Cohen, and Marlene Anderka. 1998. Reactions of Adult and Teenaged Smokers to the Massachusetts Tobacco Tax. American Journal of Public Health 88 (9): 1389–1391.CrossRefGoogle Scholar
  6. Brandt, Alan M. 2007. The Cigarette Century: The Rise, Fall, and Deadly persistence of the Product That Defined America. New York: Perseus- Basic Books.Google Scholar
  7. Brennan, Geoffrey, and James M. Buchanan. 1988. Is Public Choice Immoral? The Case for the ‘Nobel’ Lie. Virginia Law Review 74 (2): 179–189.CrossRefGoogle Scholar
  8. Cataldo, Everett F., and John D. Holm. 1983. Voting on School Finances: A Test of Competing Theories. Western Political Quarterly 38: 619–631.Google Scholar
  9. Centers for Disease Control and Prevention (CDC). 2003a. Cigarette Smoking Among Adults—United States, 2001. Morbidity and Mortality Weekly Report 52 (40): 953–956.Google Scholar
  10. Centers for Disease Control and Prevention (CDC). 2003b. “Percentage of Adults Who Were Current, Former, or Never Smokers, +Overall and by Sex, Race, Hispanic Origin, Age, and Education, National Health Interview Surveys, Selected Years—United States, 1965-2000.” Tobacco Information and Prevention (TIPS). ( Accessed 20 April 2004.
  11. Chassin, Laurie, Clark C. Presson, Jennifer Rose, Steven J. Sherman, and Justin Prost. 2002. Parental Smoking Cessation and Adolescent Smoking. Journal of Pediatric Psychology 27 (6): 485–496.CrossRefGoogle Scholar
  12. Colombotos, John, and Corine Kirchner. 1986. Physicians and Social Change. New York: Oxford University Press.Google Scholar
  13. Chong, Dennis, Jack Citrin, and Patricia Conley. 2001. When Self-Interest Matters. Political Psychology 22 (3): 541–570.CrossRefGoogle Scholar
  14. Darke, Peter R., and Shelly Chaiken. 2005. The Pursuit of Self-Interest: Self-Interest Bias in Attitude Judgment and Persuasion. Journal of Personality and Social Psychology 89 (6): 864–883.CrossRefGoogle Scholar
  15. Dewey, John. 1939. The Economic Basis of the New Society. pp. 416–38. In Intelligence in the Modern World, edited by Joseph Ratner. New York: Modern Library.Google Scholar
  16. Dixon, Richard D., Roger C. Lowery, Diane E. Levy, and Kenneth F. Ferraro. 1991. Self-Interest and Public Opinion Toward Smoking Policies: A Replication and Extension. Public Opinion Quarterly 55: 241–254.CrossRefGoogle Scholar
  17. Doucet, Jennifer M., Wayne F. Velicer, and Robert G. Laforge. 2007. Demographic Difference in Support for Smoking Policy Interventions. Addictive Behaviors 32: 148–157.CrossRefGoogle Scholar
  18. Downs, Anthony. 1957. An Economic Theory of Democracy. New York: Harper and Row.Google Scholar
  19. Frank, Thomas. 2005. What’s the Matter with Kansas. New York: Henry Hold and Company LLC.Google Scholar
  20. Godbout, Jean-Francois, and Eric Belanger. 2007. Economic Voting and Political Sophistication in the United States. Political Research Quarterly 60 (3): 541–554.CrossRefGoogle Scholar
  21. Gomez, Brad T., and J. Matthew Wilson. 2001. Political Sophistication and Economic Voting in the American Electorate: A Theory of Heterogeneous Attribution. American Journal of Political Science 45: 899–914.CrossRefGoogle Scholar
  22. Grafstein, Robert. 2009. The Puzzle of Weak Pocketbook Voting. Journal of Theoretical Politics 21 (4): 451–482.CrossRefGoogle Scholar
  23. Green, Donald Philip, and Elizabeth Gerken. 1989. Self-Interest and Public Opinion Toward Smoking Restrictions and Cigarette Taxes. Public Opinion Quarterly 53: 1–16.CrossRefGoogle Scholar
  24. Hamilton, William L., Lois Biener, and Christopher N. Rodger. 2005. Who Supports Tobacco Excise Taxes? Factors Associated with Towns’ and Individuals’ Support in Massachusetts. Journal of Public Health Management Practice 11 (4): 333–340.CrossRefGoogle Scholar
  25. Hunt, Corrie, V., Anita Kim, Eugene Borgida, and Shelly Chaiken. 2010. Journal of Experimental Social Psychology (forthcoming; online first).Google Scholar
  26. Funk, Carolyn. 2000. The Dual Influence of Self-Interest and Societal Interest in Public Opinion. Political Research Quarterly 53 (1): 37–62.CrossRefGoogle Scholar
  27. Hobbes, Thomas. 1651/1947. Leviathan. London: J.M. Dent and Sons.Google Scholar
  28. Jencks, Christopher. 1979. The Social Basis of Unselfishness. In On the Making of Americans: Essays in Honor of David Riesman, ed. Herbert J. Gans, Nathan Glazer, Joseph Gusfield, and Christopher Jencks. Philadelphia: University of Pennsylvania Press.Google Scholar
  29. Kawachi, Ichiro, S.V. Subramanian, and Daniel Kim (eds.). 2008. Social Capital and Health. New York: Springer.Google Scholar
  30. Kalberg, Stephen. 1980. Max Weber’s Types of Rationality: Cornerstones for the Analysis of Rationalization Processes in History. American Journal of Sociology 85 (5): 1145–1179.CrossRefGoogle Scholar
  31. Kelman, Steven. 1987. Making Public Policy: A Hopeful View of American Government. New York: Basic Books.Google Scholar
  32. Kiewiet, D.Roderick. 1983. Macroeconomics and Micropolitics. Chicago, IL: University of Chicago Press.Google Scholar
  33. Kinder, Donald R., and D. Roderick Kiewiet. 1981. Sociotropic Politics: The American Case. British Journal of Political Science 11 (2): 129–161.CrossRefGoogle Scholar
  34. King, Gary, Robyn Mallett, Lynn T. Kozlowski, and Robert B. Bendel. 2003. African American’s Attitudes Toward Cigarette Excise Taxes. American Journal of Public Health 93 (5): 828–834.CrossRefGoogle Scholar
  35. Langer, Gary, and Jon Cohn. 2005. Voters and Values in the 2004 Election. Public Opinion Quarterly 69 (5): 744–759.CrossRefGoogle Scholar
  36. Lau, Richard R., and David O. Sears. 1981. Cognitive Links Between Economic Grievances and Political Responses. Political Behavior 3: 279–302.CrossRefGoogle Scholar
  37. Levi-Strauss, Claude. 1974. Structural Anthropology. New York: Basic Books.Google Scholar
  38. Lewis-Beck, Michael S., and Mary Stegmaier. 2000. Economic Determinants of Electoral Outcomes. Annual Review of Political Science 3: 183–219.CrossRefGoogle Scholar
  39. Luttmer, Erzo F.P. 2001. Group Loyalty and the Taste for Redistribution. Journal of Political Economy 109 (3): 500–528.CrossRefGoogle Scholar
  40. Marcus, Stephen E., Seth L. Emont, Ruth D. Corcoran, Gary A. Giovino, John P. Pierce, Michael N. Waller, and Ronald M. Davis. 1994. Public Attitudes About Cigarette Smoking: Results from the 1990 Smoking Activity volunteer Executed Survey. Public Health Reports 109 (1): 125–134.Google Scholar
  41. Mansbridge, Jane J. (ed.) 1990. The Rise and Fall of Self-Interest in the Explanation of Political Life. pp. 3-24. In Beyond Self-Interest, edited by Jane J. Mansbridge. Chicago: University of Chicago Press.Google Scholar
  42. Mutz, Diana C., and Jeffery J. Mondak. 1997. Dimensions of Sociotropic Behavior: Group-Based Judgments of Fairness and Well-Being. American Journal of Political Science 41 (1): 284–308.CrossRefGoogle Scholar
  43. Ospuk, Theresa L., and Delores Acevedo-Garcia. 2010. Support for Smoke-Free Policies: A Nationwide Analysis of Immigrants, US-Born, and Other Demographic Groups, 1995-2002. American Journal of Public Health 100 (1): 171–181.CrossRefGoogle Scholar
  44. Ostrom Elinor, Michael Cox, and Edella Schlager. 2014. An Assessment of the Institutional Analysis and Development Framework and Introduction of Social-Ecological Systems Framework. In Theories of the Policy Process, ed. Sabatier, Paul A. and Christopher M. Weible. Boulder. Colorado: Westview Press.Google Scholar
  45. Pampel, Fred C. 2006. Global Patterns and Determinants of Sex Differences in Smoking. International Journal of Comparative Sociology 47 (6): 466–487.CrossRefGoogle Scholar
  46. Parsons, Talcott. 1937. The Structure of Social Action. New York: McGraw Hill.Google Scholar
  47. Reich, Robert B. (ed.). 1988. The Power of Public Ideas. Cambridge, MA: Ballinger.Google Scholar
  48. Satterthwaite, Shad. 2006. Oklahoma: A Battle of Good Versus Evil. In The Values Vote? The Christian Right in the 2004 Elections, ed. Mark J. Rozell, John C. Green, and Clyde Wilcox, 199–215. Washington, DC: Georgetown University Press.Google Scholar
  49. Sears, David O., and Jack Critin. 1982. Tax Revolt: Something for Nothing in California. Cambridge: Harvard University Press.Google Scholar
  50. Sears, David O., and Carolyn L. Funk. 1990. Self-Interest in Americans’ Political Opinions. In Beyond Self-Interest, ed. Jane J. Mansbridge, 147–170. Chicago: University of Chicago Press.Google Scholar
  51. Sears, David O., and Carolyn L. Funk. 1991. The Role of Self-Interest in Social and Political Attitudes. In Advances in Experimental Social Psychology, vol. 24, ed. Mark P. Zanna, 2–80. San Diego: Academic Press Inc.Google Scholar
  52. Sears, David O., Richard R. Lau, Tom R. Tyler, and Harris M. Allen. 1980. Self-Interest and Symbolic Politics in Policy Attitudes and Presidential Voting. American Political Science Review 74: 670–684.CrossRefGoogle Scholar
  53. Sen, Amartya K. 1977. Rational Fools: A Critique of the Behavioral Foundations of Economic Theory. Philosophy & Public Affairs 6 (4): 317–344.Google Scholar
  54. Smith, Adam. 1759/1976. The Theory of Moral Sentiments. New York: Clarendon Press.Google Scholar
  55. Spivak, Andrew L., and Michael S. Givel. 2005. From Industry Dominance to Legislative Progress: The Political and Public Health Struggle of Tobacco Control in Oklahoma. Norman, OK: University of Oklahoma Department of Political Science (American Heart Association Grant #0335002N).Google Scholar
  56. Stoker, Laura. 1994. Interests and Ethics in Politics. The American Political Science Review 86 (2): 369–380.CrossRefGoogle Scholar
  57. Tullock, Gordon. 1979. “Public Choice in Practice. In Collective Decision Making: Applications from Public Choice Theory, ed. Clifford S. Russell. Baltimore: Johns Hopkins University Press.Google Scholar
  58. Weber, Max 1922/1978. Economy and Society, ed. Roth, Guenther, and Claus Wittich, ed.. Berkeley, CA: University of California Press.Google Scholar
  59. Wilson, James Q., and Edward C. Banfield. 1971. Political Ethos Revisited. American Political Science Review 65 (4): 1048–1062.CrossRefGoogle Scholar
  60. Wilson, James Q., and Peter B. Clark. 1961. Incentive Systems: A Theory of Organization. Administrative Science Quarterly 6 (2): 129–166.CrossRefGoogle Scholar

Copyright information

© Macmillan Publishers Ltd 2017

Authors and Affiliations

  • Andrew L. Spivak
    • 1
  • Michael S. Givel
    • 2
  • Shannon M. Monnat
    • 3
  1. 1.Department of SociologyUniversity of Nevada, Las VegasLas VegasUSA
  2. 2.The University of OklahomaNormanUSA
  3. 3.Syracuse UniversitySyracuseUSA

Personalised recommendations