Abstract
In the USA, little is known about local variation in retail cigarette prices; price variation explained by taxes, bans, and area-level socio-demographics, and whether taxes and hospitality bans have synergistic effects on smoking prevalence. Cigarette prices 2001–2011 from chain supermarkets and drug stores (n = 2973) were linked to state taxes (n = 41), state and county bar/restaurant smoking bans, and census block group socio-demographics. Hierarchical models explored effects of taxes and bans on retail cigarette prices as well as county smoking prevalence (daily, non-daily). There was wide variation in store-level cigarette prices in part due to differences in state excise taxes. Excise taxes were only partially passed onto consumers (after adjustment, $1 tax associated with $0.90 increase in price, p < 0.0001) and the pass-through was slightly higher in areas that had bans but did not differ by area-level socio-demographics. Bans were associated with a slight increase in cigarette price (after adjustment, $0.09 per-pack, p < 0.0001). Taxes and bans were associated with reduction in smoking prevalence and taxes had a stronger association when combined with bans, suggesting a synergistic effect. Given wide variation in store-level prices, and uneven state/county implementation of taxes and bans, more federal policies should be considered.
Highlights
In the U.S, smoking prevalence has declined over time, from approximately 33% in 1980, 26% in1990, 23% in 2010, and 18% in 2013 [1]
We explored ecologic variation in smoking prevalence by state and county and the contribution of store-level cigarette prices, state and federal cigarette taxes, and hospitality bans to smoking prevalence; and tested whether the presence of hospitality bans changes the impact of cigarette taxes on smoking prevalence
The percent of stores in states-counties with hospitality smoking bans rose from 1%
Summary
In the U.S, smoking prevalence has declined over time, from approximately 33% in 1980, 26% in1990, 23% in 2010, and 18% in 2013 [1]. In the U.S, smoking prevalence has declined over time, from approximately 33% in 1980, 26% in. Policies that aim to generate revenue and reduce smoking have likely contributed to the decline [2,3]. Cigarette smoking continues to be a major public health problem in the U.S, resulting in approximately 480,000 deaths each year from smoking-related diseases [3]. Work to date suggests that there is considerable heterogeneity in cigarette tax policies between and within states; and suggests that heterogeneity in pricing may be hampering public health tobacco control efforts. Three U.S studies analyzed store-level price data [4,5,6] but they all focused on short time periods (≤2 year) and two focused on only a single geographic region [4,6]
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