Exhibit 4. Tobacco Surcharge Effects on Health Insurance Coverage and Smoking Cessation.

	Percentage Point Change Over the Zero-Surcharge Effect (CI)
	Low Surcharge (0 < Surcharge <10%)	Medium Surcharge (10% ≤ Surcharge <30%)	High Surcharge (30% ≤ Surcharge)
Model I: Health Insurance
Full Sample (N=206,952)	-2.2 (-10.1, 5.7)	-4.3 (-9.4, 0.8)*	-11.6 (-21.0, -2.3)**
Age < 40	-7.4 (-21.5, 6.7)	-11.9 (-19.3, -4.5)***	-19.9 (-28.4, -11.3)***
Age ≥ 40	-0.1 (-6.8, 6.6)	-0.7 (-5.1, 3.6)	-8.2 (-18.4, 2.1)
Model I: Smoking Cessation
Full Sample (N=48.942)	-5.6 (-10.9, -0.3)**	-1.6 (-6.8, 3.7)	0.0 (-6.8, 6.8)
Age < 40	-5.4 (-16.7, 5.9)	0.2 (-10.6, 11.0)	-1.2 (-12.2, 9.8)
Age ≥ 40	-5.2 (-8.1, -2.4)***	-2.6 (-5.5, 0.4)*	-0.2 (-6.5, 6.0)

SOURCE Authors' analysis of data from the 2011-2014 BRFSS surveys, with respondents matched to newly collected information on tobacco surcharges in the 2014 state health insurance marketplaces. NOTES Analyses are sample-weighted linear probability models specified as triple-differences for health insurance and difference-in-differences for smoking cessation, with additional controls for age, sex, race, education, income, and cell phone interview indicators, as well as state cigarette taxes and unemployment rates, and state, quarter, and year fixed effects. Effects given above are the differential percentage point increases in health insurance coverage (Model I) and smoking cessation (Model II) exhibited by smokers facing each of the above surcharge levels, relative to the response of smokers in the zero surcharge group. Both samples are limited to Medicaid ineligible 25 to 64 year olds not living in Massachusetts, with incomes between 138 and 400 percent of the federal poverty level (FPL) and no children in the household. The smoking cessation sample is further restricted to those who smoked at least once in the 6 months prior to interview. Surcharge levels are based on median surcharges for a given respondent's age and state, calculated as a percent increases over the corresponding no-tobacco premium. 95 percent confidence intervals are in parentheses. Output from the full models is available in Exhibits A2 and A3 of the Technical Appendix.¹⁹ ***[**](*) denotes statistical significance at the 1% [5%] (10%) levels.