Cigarette Tax Increase Research Articles

Association between current cigarette prices and cessation behaviors among male adult smokers: findings from 2018 to 2020 ITC Vietnam surveys

BackgroundThis study evaluated the impact of the tax increase in January 2019 on changes in intention to quit and the effect of cigarette prices on quit attempts and successful quitting among male cigarette smokers in Vietnam.MethodsData were derived from the ITC project in Vietnam, which included 1585 adult smokers at baseline (Wave 1, Aug-Oct 2018) followed up to waves 2 (Sep-Nov 2019) and 3 (Sep-Dec 2020). Generalized estimating equations regression was performed to estimate changes in the intention to quit. Multiple logistic regression analysis was used to evaluate the cigarette price of a cigarette pack in relation to quit attempts and successful quitting.ResultsThe increase in cigarette tax in 2019 did not significantly increase the likelihood of the intention to quit. After the tax increase, 63.6% of participants who smoked made a quit attempt, and 27.6% successfully quit smoking in the follow-up waves. However, the price of a cigarette pack was not significantly associated with quit attempts and successful quitting. The study did not observe a significant impact of cigarette prices on quit attempts and successful quitting in all subgroups of household income. Factors associated with quit attempts included the number of cigarettes smoked and the intention to quit, while those associated with successful quitting included age, dual use of cigarettes and other tobacco products, and the intention to quit.ConclusionCurrent cigarette prices were not associated with cessation behaviors even within the lowest household income group. Therefore, a sharp rise in cigarette tax is required to incentivize smokers to quit smoking.

Tobacco industry pricing strategies during recent tax adjustments in Mexico: evidence from sales data

IntroductionPrevious studies have identified pricing strategies that the tobacco industry employs to try to minimise the impact of tobacco taxation, but these studies are mostly about high-income countries. This research...

Beer taxes associate with lower alcohol and cigarette use; cigarette taxes associate with lower cigarette but higher alcohol use

ABSTRACT Background: There is a yet unmet opportunity to utilize data on taxes and individual behaviors to yield insight for analyzing studies involving alcohol and cigarette use. Objectives: To inform the direction and strength of their mutual associations by leveraging the fact that taxation can affect individual consumption, but individual consumption cannot affect taxation. Methods: We linked state-level data on cigarette and beer taxes in 2009–2020 with individual-level data on self-reported current cigarette and alcohol use from the Behavioral Risk Factor Surveillance System, a telephone survey by the Centers for Disease Control and Prevention that is representative of the population of each state in the United States. We constructed linear and logistic models to examine associations between a $1 increase in cigarette taxes per pack and a $1 increase in beer taxes per gallon and self-reported cigarette use and alcohol consumption (assessed as any current intake, average drinks/day, heavy drinking, and binge drinking), adjusting for survey year and individual characteristics. Results: Among 2,968,839,352 respondents (49% male), a $1 increase in beer taxes was associated with .003 (95% confidence interval [CI] −.013, .008) fewer drinks/day and lower odds of any drinking (odds ratio [OR] = .81 95%CI .80, .83), heavy drinking (OR = .96 95%CI .93, .99), binge drinking (OR = .82 95%CI .80, .83), and smoking (OR = .98 95%CI .96, 1.00). In contrast, a $1 increase in cigarette taxes was associated with lower odds of smoking (OR = .94 95%CI .94, .95) but .007 (95%CI .005, .010) more drinks/day, and higher odds of any drinking (OR = 1.10 95%CI 1.10, 1.11), heavy drinking (OR = 1.02 95%CI 1.01, 1.02), and binge drinking (OR = .82 95%CI .80, .83). Conclusion: Higher beer taxes were associated with lower odds of drinking and smoking, but higher cigarette taxes were associated with lower odds of smoking and higher alcohol consumption. These results suggest that alcohol intake may be a determinant of cigarette use rather than cigarette use as a determinant of alcohol intake.

The association between excise taxes and smoking and vaping transitions–Findings from the 2016–2020 ITC United States surveys

BackgroundWhile a growing number of studies examined the effect of e-cigarette (EC) excise taxes on tobacco use behaviors using cross-sectional surveys or sales data, there are currently no studies that evaluate the impact of EC taxes on smoking and vaping transitions. MethodsUsing data from the US arm of the 2016–2020 International Tobacco Control Four Country Smoking and Vaping Survey (ITC 4CV), we employed a multinomial logit model with two-way fixed effects to simultaneously estimate the impacts of cigarette/EC taxes on the change in smoking and vaping frequencies. ResultsOur benchmark model suggests that a 10 % increase in cigarette taxes led to an 11 % reduction in smoking frequencies (p < 0.01), while EC taxes did not have a significant effect on smoking frequencies. ConclusionOur findings suggest that increasing cigarette taxes may serve as an effective means of encouraging people who smoke to cut back on smoking or quit smoking. The impact of increasing EC taxes on smoking transitions is less certain at this time.

Exposure to anti- and pro-smoking messages among adults in China: Results from the Global Adult Tobacco Survey, 2018.

For decades, tobacco advertisements and promotions have been common in mass media and public places in China. In 2015, China amended the Advertising Law to prohibit the distribution of tobacco advertising, while also initiating waves of tobacco control media campaigns. This study investigates the associations between exposure to anti- and pro-smoking messages, smoking status, and people's smoking-related beliefs and willingness to support tobacco control policies. A secondary data analysis was performed with the 2018 Global Adult Tobacco Survey of 19,376 adults aged ≥15 years in China. Anti- and pro-smoking message exposures were measured as the sum of sources (media or places) where respondents have seen the messages. Multivariable logistic regression analyses were conducted to examine the relationships among smoking status, message exposure, and the outcome variables (health harm beliefs, support for increasing tax on cigarettes, support for using part of the increased tax on tobacco control) controlling for smoking status and demographic differences. Overall, 63.3% of the respondents reported being exposed to anti-smoking messages from at least 1 source, while 18.1% were exposed to pro-smoking messages from at least 1 source. Adults who currently, formerly, and never smoked differed in their beliefs about smoking and willingness to support tobacco control policies. Greater reported exposure to anti-smoking messages was positively associated with belief that smoking is harmful, support for increased cigarette tax, and support for using increased tax revenue for tobacco control measures. Meanwhile, greater reported exposure to pro-smoking messages was negatively related to willingness to support cigarette tax increases. While national and local tobacco control campaigns in China have reached a large proportion of the adult population, there is still room for improvement. China might consider expanding anti-tobacco campaigns, as reported exposure to these messages is associated with increased public awareness of the health hazards of smoking and support for increasing cigarette taxes.

Association of cigarette excise taxes and clean indoor air laws with change in smoking behavior in the United States: a Markov modeling analysis.

The rates of cigarette smoking in the United States have declined over the past few decades in parallel with increases in cigarette taxes and introduction of more stringent clean indoor air laws. Few longitudinal studies have examined association of taxes and clean indoor air policies with change in smoking nationally. This study examined the association of state and local cigarette taxes and clean indoor laws with change in smoking status of 18,499 adult participants of the longitudinal 2010-2011 Tobacco Use Supplement of the Current Population Survey over a period of 1 year. Every $1 increase in cigarette excise taxes was associated with 36% higher likelihood of stopping smoking among regular smokers. We found no association between clean indoor air laws and smoking cessation nor between taxes and clean indoor air laws with lower risk of smoking initiation. Cigarette taxes appear to be effective anti-smoking policies. Some state and local governments do not take full advantage of this effective policy measure.

Tax incidence for menthol cigarettes by race: Evidence from Nielsen Homescan data

We use Nielsen Homescan data to examine whether the incidence of cigarette taxes on menthol products varies with race. We find that taxes are shifted at significantly lower rates to Black smokers of menthol cigarettes than any other smokers. One possible explanation is that the industry targets price promotions to Black menthol smokers because they tend to be more responsive to cigarette prices relative to other smokers. We find evidence that Black smokers receive significantly more price discounts for menthol products than white menthol smokers. Our findings indicate that increasing cigarette taxes would effectively reduce menthol smoking among Black Americans because tax pass-through rate for Black menthol smokers is still substantially above zero.

Real-world, anti-tobacco environmental impact upon price-induced smoking reduction among urban Chinese men: Evidence from China's 2015 cigarette tax increase.

Raising the price of cigarettes via taxation has been promoted by the World Health Organization as an important tobacco control strategy. Price elasticity of cigarettes is not uniform and is dependent upon individual and environmental determinants. Many studies have examined the determinants of price-induced smoking, taking into account sociodemographic characteristics and consumption patterns. Little research has been conducted on the association between anti-smoking environments and price-induced smoking behavior. This study addresses the deficit within the Chinese context. Participants were 2852 male smokers identified through a multi-stage survey sampling process encompassing 6 cities in China between July and December 2016. A standardized questionnaire tapped price-induced smoking reduction and related information. Both unadjusted and adjusted logistic regression methods were applied in the analyses. In all, 25.5% (95% CI: 22.5-27.9) of smokers in this study decreased their smoking expenditures following the 2015 excise tax increase. The adjusted logistic regression analysis showed that increased exposures to an anti-smoking information environment (AOR=1.39; 95% CI: 1.10-1.79), restricted smoking in their home (AOR=1.67; 95% CI: 1.32-2.08) and workplace (AOR=1.43; 95% CI: 1.09-1.85) were more likely to report diminished cigarette smoking following the tax increases. This study adds to understanding price-induced smoking behavior among urban male Chinese smokers. Strengthening of excise tax policies needs to intensify environmental smoking restrictions and public education campaigns to increase the sensitivity of cigarette price changes among smokers.

Summaries of Articles

Summaries of Articles

Price Isn’t Everything: Behavioral Response Around Changes In Sin Taxes

In traditional economic models, taxes change behavior by changing prices. In empirical analyses, factors other than price are thought to be relevant, but any nonprice factors are usually assumed to be held constant as taxes vary. We contend that violations of this assumption are expected when laws are passed changing sin taxes. In support of this claim, we document that state-level cigarette tax increases are concomitant with increases in antismoking appropriations, media coverage on smoking, lobbying efforts, and place-based smoking restrictions. The influence of these nonprice factors is easily confused with price effects, and we find evidence suggesting that controlling for them substantially reduces the estimated demand responsivity to the tax itself.

Illuminating a Path Forward for Tobacco Nation: Projected Impacts of Recommended Policies on Geographic Disparities.

This study quantifies the impacts of strengthening 2 tobacco control policies in "Tobacco Nation," a region of the United States (U.S.) with persistently higher smoking rates and weaker tobacco control policies than the rest of the US, despite high levels of support for tobacco control policies. We used a microsimulation model, ModelHealthTM:Tobacco, to project smoking-attributable (SA) outcomes in Tobacco Nation states and the U.S. from 2022 to 2041 under 2 scenarios: (1) no policy change and (2) a simultaneous increase in cigarette taxes by $1.50 and in tobacco control expenditures to the CDC-recommended level for each state. The simulation uses state-specific data to simulate changes in cigarette smoking as individuals age and the health and economic consequences of current or former smoking. We simulated 500 000 individuals for each Tobacco Nation state and the U.S. overall, representative of each population. Over the next 20years, without policy changes, disparities in cigarette smoking will persist between Tobacco Nation and other U.S. states. However, compared to a scenario with no policy change, the simulated policies would lead to a 3.5% greater reduction in adult smoking prevalence, 2361 fewer SA deaths per million persons, and $334M saved in healthcare expenditures per million persons in Tobacco Nation. State-level findings demonstrate similar impacts. The simulations indicate that the simulated policies could substantially reduce cigarette smoking disparities between Tobacco Nation and other U.S. states. These findings can inform tobacco control advocacy and policy efforts to advance policies that align with evidence and Tobacco Nation residents' wishes.

Cigarette, electronic cigarette, and marijuana use among young adults under policy changes in California

IntroductionSince 2016, California has implemented a series of policies, including prohibiting the sale of tobacco products and electronic cigarettes (e-cigarettes) to persons under 21, cigarette tax increase, and recreational marijuana legalization. The study aims to examine the use of cigarettes, e-cigarettes, and marijuana among young adults (ages 18–25) and their associations with other factors in the context of these policy changes. MethodsWe used the data from the California Health Interview Survey (CHIS) 2017–2018 to compare the rates of using cigarettes, e-cigarettes, and marijuana separately or any use of the three. Using CHIS 2018 data, weighted logistic regression models were used to examine associations of using cigarettes, e-cigarettes, and marijuana separately or any use of these products/substance with demo-socioeconomic factors, psychological distress, and use of each product/substances. ResultsCigarette smoking remained flat while the use of e-cigarettes and marijuana escalated among young adults from 2017 to 2018. Using tobacco products increased the use of marijuana or vice versa among young adults. Severe psychological distress was significantly associated with cigarette use (adjusted odds ratio [AOR] = 4.06; 95% CI = 1.32, 12.55), marijuana use (AOR = 2.32; 95% CI = 1.10, 4.48), and any use (AOR = 4.11; 95% CI = 1.93, 8.77). Moderate psychological distress was also significantly associated with the use of these products/substance. Underage (ages 18–20) young adults had lower odds of using cigarettes than other young adults (ages 21–25). ConclusionsOur findings highlight the importance of addressing the use of cigarettes, e-cigarettes, and marijuana simultaneously through policies to curtail tobacco and marijuana use among young adults.

A 114% Cigarette Tax Hike and Drinking Behavior: Results From Nationally Representative Longitudinal Panel Data in Korea.

This study investigated whether or not drinking behavior changed among Korean adult smokers after a 114% cigarette tax hike in 2015. Data were drawn from waves 9 to 12 (collected yearly from 2014 to 2017) of the nationally representative longitudinal study, the Korean Welfare Panel Study. Korean adults who were ≥19 years comprised the analysis sample (N = 10 875). We applied a difference-in-differences approach to compare drinking behavior before and after the tax increase among three groups (i.e., quitters, continued smokers, and nonsmokers). We found that alcohol drinking significantly decreased among those who quit smoking after the tax increase, compared with nonsmokers (P = .022). Our findings support that a cigarette tax increase may have the beneficial spillover influence of reduction in drinking as well as smoking if the tax increase can induce smokers to quit, but such positive spillover influence may be short-term or null for continued smokers.

The association between smoking behaviors and prices and taxes per cigarette pack in the United States from 2000 through 2019

ObjectiveThe conclusions on how tax and price increases affect smoking behaviors are mixed. This work is devoted to re-evaluating the relationship between cigarette prices and taxes and smoking behaviors.MethodsUsing 2000–2019 Behavioral Risk Factor Surveillance System data, we employed linear mixed-effect models to re-examine the impact of cigarette prices and taxes on smoking prevalence and the proportion of current smokers having tried to quit smoking in the past 12 months. All the analyses were conducted for the general population, then by age group, gender, race/ethnicity, and income level.ResultsThe results indicate that higher cigarette prices and taxes were associated with a decrease in smoking prevalence and an increased likelihood of quitting smoking. Cigarette tax and price increases produced the most powerful impact on the smoking prevalence of 18- to 24-year-olds. The estimates also show that males tended to be more price-sensitive than females. Raising cigarette prices and taxes was estimated to be more effective in reducing the smoking prevalence among non-Hispanic Blacks and Hispanics when compared to non-Hispanic whites. Cigarette price and tax changes were likely to have a smaller effect on individuals with annual income under $25,000 relative to individuals with higher income levels.ConclusionsIncreases in cigarette prices and taxes are significantly associated with a reduction in smoking prevalence and an increased likelihood of quitting smoking among adults across different demographic and socioeconomic groups. However, as cigarette price and tax changes disproportionately affect low-income individuals, raising cigarette prices and taxes may deepen income disparities.

Trends and Determinants of Cigarette Tax Increases in Japan: The Role of Revenue Targeting.

Cigarette prices in Japan are lower than those in most other high-income countries. A more striking fact is that cigarette tax revenues have been kept almost flat at just over two trillion JPY (Japanese yen; 18.2 billion US dollars) over more than three decades, despite steadily declining cigarette sales and seemingly weakening pressure from stakeholders with a vested interest in the tobacco industry. We attempted to examine trends and determinants of cigarette tax increases in Japan. In particular, we hypothesized that the Japanese finance ministry adjusts cigarette taxes to meet a revenue target. Under this hypothesis, we searched for the most plausible amount of the minimum target of tax revenue that corresponds to cigarette tax increases over the past 37 years (1985–2021) using public data on cigarette sales and taxes. The results revealed that two trillion JPY was the minimal revenue target that could plausibly explain the increase in cigarette tax. In addition, the timing and magnitude of cigarette tax increases have been successfully set to maintain stable tax revenues. A key determinant of cigarette tax increases in Japan has been hard revenue targets, rather than public health concerns.

Cigarette taxation and neonatal and infant mortality: A longitudinal analysis of 159 countries.

Previous studies on the associations between cigarette taxes and infant survival have all been in high-income countries and did not examine the relative benefits of different taxation levels and structures. We evaluated longitudinal associations of cigarette taxes with neonatal and infant mortality globally. We applied country-level panel regressions using 2008-2018 annual mortality and biennial WHO tobacco taxation data. Complete data was available for 159 countries. Outcomes were neonatal and infant mortality. We conducted analyses by type of taxes (i.e. specific cigarette taxes, ad valorem taxes, and other taxes, import duties and VAT) and the income group classification of countries. Covariates included scores for other WHO recommended tobacco control policies, socioeconomic, health-care, and air quality measures. Secondary analyses investigated the associations between cigarette tax and cigarette consumption. We found that a 10 percentage-point increase in total cigarette tax as a percentage of the retail price was associated with a 2.6% (95% Confidence Interval [CI]: 1.9% to 3.2%) decrease in neonatal mortality and a 1.9% (95% CI: 1.3% to 2.6%) decrease in infant mortality globally. Estimates were similar for both excise and ad valorem taxes. We estimated that 231,220 (95% CI: 152,658 to 307,655) infant deaths could have been averted in 2018 if all countries had total cigarette tax at least 75%. 99.2% of these averted deaths would have been in low- and middle-income countries (LMICs). The secondary analysis supported causal interpretation of results by finding that a 10 percentage-point increase in taxes was associated with a reduction of 94.6 (95% CI: 32.7 to 156.5) in annual cigarette consumption per capita. Although causal inference is precarious due to the quasi-experimental design, we used a robust analytical approach and focused on within-country changes. Limitations include an inability to include data on roll-your-own tobacco, other forms of tobacco use, and reliance on taxation data only for the cigarette brands most sold in each country. In line with limited existing evidence conducted in HICs, we found that raising taxes on tobacco was associated with a reduction in neonatal and infant mortality globally. Implementing recommended levels of taxation in LMICs should be a priority since this is where the lowest levels of taxation and the largest potential infant mortality benefits exist.

Trends in Use of Conventional Cigarettes, E-cigarettes, and Marijuana in Pregnancy and Impact of Health Policy.

The substance use policy context continues to evolve. As tobacco control policies have become more restrictive, marijuana legalization has increased access to marijuana. Data suggest that prenatal conventional cigarette use is declining, while e-cigarette and marijuana use are increasing among persons preconception, prenatally, and postpartum. Policy evaluations have found that increasing cigarette taxes reduces prenatal smoking and improves birth outcomes; however, there have been few studies of e-cigarette policies or marijuana legalization on prenatal use or birth outcomes. It is important for clinicians to screen for prenatal substance use, as recommended by American College of Obstetricians and Gynecologists (ACOG), and understand how policies influence use among their patients.

Cigarette Taxes, Smoking, and Health in the Long Run

Medical experts have argued forcefully that using cigarettes harms health, prompting the adoption of myriad anti-smoking policies. The association between smoking and mortality may, however, be driven by unobserved factors, making it difficult to discern the underlying long-term causal relationship. In this study, we explore the effects of cigarette taxes experienced as a teenager, which are arguably exogenous, on adult smoking participation and mortality. A one-dollar increase in teenage cigarette taxes is associated with an 8 percent reduction in adult smoking participation and a 6 percent reduction in mortality. Mortality effects are most pronounced for heart disease and lung cancer.

Tobacco price and use following California Proposition 56 tobacco tax increase.

BackgroundCalifornia Proposition 56 increased cigarette excise tax by $2 per pack with equivalent increases on non-cigarette tobacco products. We estimated the changes in cigarette price, cigarette use, and non-cigarette use following the implementation of Proposition 56 in California in 2017.MethodsSeven waves of Tobacco Use Supplements to the Current Population Survey (TUS-CPS) 2011–2019 data were used to obtain state-level aggregate self-reported outcomes, including cigarette price per pack, current and daily cigarette use, cigarette consumption per day, and current and daily use of non-cigarette tobacco products (hookah, pipe, cigar, and smokeless tobacco). A modified version of a synthetic control method was used to create a “synthetic” California that best resembled pre-policy sociodemographic characteristics and outcome trends in California while correcting time-invariant pre-policy differences. Various sensitivity analyses were also conducted.ResultsThe implementation of Proposition 56 was associated with an increase in self-reported cigarette price per pack in California ($1.844, 95%CI: $0.153, $3.534; p = 0.032). No evidence suggested that Proposition 56 was associated with the changes in the prevalence of current or daily cigarette use, cigarette consumption per day, or the prevalence of current or daily use of non-cigarette tobacco products.ConclusionMost of the cigarette tax increase following Proposition 56 in California was passed on to consumers. There is a lack of evidence that the implementation of Proposition 56 was associated with the changes in the use of cigarettes and other tobacco products such as hookah, pipe, cigar, and smokeless tobacco.

Tobacco taxes for improving welfare and distributional outcomes: the case of Georgia.

Georgia has one of the highest smoking prevalence and tobacco-related morbidity and mortality rates in Europe and Central Asia. Nonetheless, tax increases on tobacco products are often opposed due to concerns of regressive fiscal effects. This article provides evidence on the long-term welfare and distributional impacts of increasing cigarette taxes in Georgia. An Extended Cost-Benefit Analysis is used to simulate the distributional effect of raising taxes on cigarettes. It weighs short-term losses due to higher tobacco prices with long-term benefits related to reduced medical expenses and additional earnings associated with extended life expectancy. Household expenditure data are used to estimate decile-specific price elasticities of demand for cigarettes, accounting for heterogeneous behavioral responses by income-group. Consistent with previous literature, cigarettes price elasticity decreases with income. A simulated 50% cigarette price increase would yield positive net gains for the lowest three deciles; increase the available income of the poorest 10% of the population by an average of 1% and, as a result, lift up to 7000 people out-of-poverty in 2017. The effects would be highly progressive. As lower-income households tend to be more responsive to price changes on cigarettes, they stand to benefit most from the health and economic consequences of taxing tobacco. This article shows that in addition to boosting fiscal revenues, increasing cigarette prices would lead to progressive and positive net gains for the poorest households in Georgia.