The effect of West German television on smoking and health: A natural experiment from German reunification
利用德国统一后东德地区西德电视信号的可获得性差异，研究发现电视暴露使女性吸烟概率增加9.5个百分点、消费量上升68%，但对男性无影响，且该行为变化持续并导致健康恶化。
This paper examines the long-term impact of West German television exposure on smoking behavior in East Germany, with a focus on gender-specific responses. Using data from 1989 and 2002 and leveraging quasi-random variation in West German TV signal availability across East German regions, we find that TV exposure led to a substantial increase in smoking among women - by 9.5 percentage points in smoking probability and 68% in cigarette consumption - while having no measurable effect on men. This asymmetric effect reflects divergent pre-reunification norms: under socialism, female smoking was heavily stigmatized, and exposure to Western media relaxed these social constraints. The behavioral shift persisted over time, with exposed women reporting worse physical and mental health and higher healthcare utilization in 2002. Back-of-the-envelope calculations suggest a sizable increase in smoking-related mortality and healthcare costs. Our findings highlight how cultural integration through media can alter health behaviors and generate significant public health externalities in transitional societies.