The Texas Legislature is considering new taxes, including a proposed $1 per pack tax on cigarettes. In the past, various issues have been raised in debates on this topic.^1,2 Proponents cite evidence that increased taxes deter young people from using tobacco^3–5 and argue that additional revenues can be used to provide health care services for children and to support smoking prevention programmes.^6,7 Opponents argue that higher tobacco taxes place an unfair burden on smokers in low income groups.^8,9,10

To gain insight into how Texans view new cigarette taxes, data from a statewide telephone survey (random digit dialling of working residential numbers) of 6345 adults were analysed. The survey was conducted between October and December 2004. Participants were asked whether they support a $1 per pack increase in cigarettes taxes. They were also asked about the use of these taxes to provide funds for children’s health care and programmes to prevent tobacco use among young people. To learn how views differed between those who use tobacco and those who do not, as well as between those in different income groups, participants were also asked about their own tobacco use and their household income.

About 6000 usable responses were available for different analyses. Current smokers made up 17% of the sample, and 35% of smokers reported household incomes below $25 000 per year. Among all respondents, 65% favoured a $1 per pack increase in cigarette taxes. Support for the $1 per pack increase grows when the taxes are to be used partly for preventing young people from smoking (77%) or to help provide health insurance for children in low income families (75%). Smokers and non-smokers differed notably in their opinions, and there were also significant differences between income groups, as shown in fig 1. Confidence intervals are ±2% or less except in the low income group of smokers, where they are approximately ±5% because of the smaller sample size.

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Figure 1

 Support for cigarette tax increase according to proposed use, smoking status, and household income.

Among non-smokers, support for a $1 per pack tax rises significantly when its proposed uses include smoking prevention and children’s health insurance. When the use is not specified, higher income non-smokers are more likely to favour the tax than low income non-smokers (71% v 67%, p < 0.05). When a specified use is smoking prevention, the level of support is 82% among non-smokers in both income groups. However, when a specified use is health insurance for children in low income families, support is weaker among higher income non-smokers than among low income non-smokers (77% v 83%, p < 0.01).

Among smokers, support for the $1 tax was dramatically affected by its proposed use. When the use was not specified, support was low (17% and 23%) among higher and low income groups. However, when smokers considered proposed uses for smoking prevention and children’s health insurance, levels of support among the higher and low income groups, respectively, increased to 48% and 59% with prevention use and to 53% and 67% with child health use. Interestingly, when the proposed uses were for prevention or health insurance for children in low income families, support for a $1 tax was significantly greater among smokers in the low income group than among those in the higher income group (p < 0.01).

SPONSORS/ACKNOWLEDGEMENTS

This research was supported by a grant from the National Cancer Institute (US-NIH). State funds were not used in the preparation of this report. Interpretations of the findings are solely those of the authors.