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Cumulative cigarette discount coupon exposure and trajectories of cigarette smoking: a longitudinal analysis in US adults
  1. Kristen R Hamilton-Moseley1,
  2. Timothy S McNeel2,
  3. Kelvin Choi1
  1. 1 Division of Intramural Research, Social and Behavioral Sciences Branch, National Institute on Minority Health and Health Disparities, Bethesda, Maryland, USA
  2. 2 Information Management Services, Rockville, Maryland, USA
  1. Correspondence to Dr Kristen R Hamilton-Moseley; kristen.moseley{at}nih.gov

Abstract

Introduction Exposure to cigarette discount coupons is associated with short-term increase in cigarette smoking; however, long-term impact is unclear. This study examined associations of cumulative exposure to cigarette coupons with trajectories of cigarette smoking in US adults.

Methods Data were from the US Population Assessment of Tobacco and Health Study Adult Surveys (n=19 824; waves 2–5). We examined the number of waves participants received cigarette discount coupons/promotions during waves 2–4 and smoking behaviours at wave 5. Weighted logistic multivariable regression models were used, adjusting for wave 2 demographics and stratified by wave 2 smoking status.

Results Among wave 2 adults who never smoked, each increment wave of exposure to cigarette discount coupons was associated with greater odds of wave 5 current smoking (adjusted OR (aOR)=2.09, 95% CI 1.24–3.52). Among wave 2 adults who smoked daily, each wave of coupon exposure was associated with lower odds of quitting smoking at wave 5 (aOR=0.67, 95% CI 0.62—0.73). Among wave 2 adults who had quit smoking, each increment wave of exposure was associated with greater odds of wave 5 current smoking (aOR=1.61, 95% CI 1.41—1.85). Additionally, women (vs men) and adults with lower socioeconomic status (SES) (vs higher SES) were more frequently exposed to cigarette coupons for a higher number of waves (p<0.05).

Discussion Exposure to cigarette coupons exhibited a dose–response relationship with changes in cigarette smoking behaviours over time, promoting smoking progression and hindering smoking cessation especially among women and people with lower SES. Prohibiting these coupons can be an important tobacco control strategy.

  • addiction
  • disparities
  • nicotine

Data availability statement

Data are available in a public, open access repository.

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Data availability statement

Data are available in a public, open access repository.

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Footnotes

  • Contributors KRH-M was responsible for planning, conceptualising and drafting the manuscript. TSM was responsible for conducting statistical analysis and reviewing the manuscript. KC was responsible for planning, conceptualisation, supervising and reviewing the manuscript, and is responsible for the overall content as guarantor. All authors provided critical revision of the manuscript for important intellectual content and approved the final version of the manuscript to be published.

  • Funding This research was supported by the Division of Intramural Research, National Institute on Minority Health and Health Disparities.

  • Disclaimer The comments and opinions expressed belong to the authors and do not necessarily represent those of the U.S. Government, Department of Health and Human Services, National Institutes of Health, and National Institute on Minority Health and Health Disparities.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.