Cigarette Prices, Smoking, and the Poor: Implications of Recent Trends

• Published in: American journal of public health (1971) 2007-10, Vol.97 (10), p.1873-1877
• Main Authors: Franks, Peter, Jerant, Anthony F, Leigh, J. Paul, Lee, Dennis, Chiem, Alan, Lewis, Ilene, Lee, Sandy
• Format: Article
• Language: English
• Subjects: Adult; Age; Behavior; Biological and medical sciences; Black markets; Cigarettes; Consumer Price Index; Data collection; Disease control; Drama; Economic models; Excise taxes; Fixed incomes; Health surveillance; Hispanic people; Humans; Logistic Models; Low income groups; Medical sciences; Miscellaneous; Personal health; Physicists; Population Surveillance - methods; Poverty; Price elasticity; Price increases; Prices; Public health; Public health. Hygiene; Public health. Hygiene-occupational medicine; Regression analysis; Research and Practice; Risk factors; Smoking; Smoking - economics; Smoking - epidemiology; Smoking - trends; Studies; Surveillance; Tax evasion; Taxes - economics; Taxes - trends; Time Factors; Tobacco; Tobacco, tobacco smoking; Toxicology; United States - epidemiology
• ISSN: 0090-0036; 1541-0048
• DOI: 10.2105/AJPH.2006.090134

We examined the relationship between smoking participation and cigarette pack price by income group and time period to determine role of cigarette prices in income-related disparities in smoking in the United States. We used data from the 1984-2004 Behavioral Risk Factor Surveillance System surveys linked to information on cigarette prices to examine the adjusted prevalence of smoking participation and smoking participation-cigarette pack price elasticity (change in percentage of persons smoking relative to a 1% change in cigarette price) by income group (lowest income quartile [lower] vs all other quartiles [higher]) and time period (before vs after the Master Settlement Agreement [MSA]). Increased real cigarette-pack price over time was associated with a marked decline in smoking among higher-income but not among lower-income persons. Although the pre-MSA association between cigarette pack price and smoking revealed a larger elasticity in the lower- versus higher-income persons (-0.45 vs -0.22), the post-MSA association was not statistically significant (P>.2) for either income group. Despite cigarette price increases after the MSA, income-related smoking disparities have increased. Increasing cigarette prices may no longer be an effective policy tool and may impose a disproportionate burden on poor smokers.