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A novel approach to estimating the prevalence of untaxed cigarettes in the USA: findings from the 2009 and 2010 international tobacco control surveys
  1. Brian V Fix1,
  2. Andrew Hyland1,
  3. Richard J O'Connor1,
  4. K Michael Cummings2,
  5. Geoffrey T Fong3,4,
  6. Frank J Chaloupka5,
  7. Andrea S Licht1,6
  1. 1Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, New York, USA
  2. 2Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
  3. 3Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
  4. 4Ontario Institute for Cancer Research, Toronto, Ontario, Canada
  5. 5Department of Economics, Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois, USA
  6. 6Department of Social and Preventive Medicine, State University of New York at Buffalo, Buffalo, New York, USA
  1. Correspondence to Brian V Fix, Department of Health Behavior, Roswell Park Cancer Institute, Elm and Carlton Street, Buffalo, NY 14263, USA; brian.fix{at}


Background Increases in tobacco taxes are effective in reducing tobacco consumption, but because of the addictive nature of cigarettes, smokers often seek out less expensive sources of cigarettes. The objective of this study is to estimate the prevalence of cigarette packs that are untaxed by the state in which the participant resides in a sample of US smokers at two time points.

Methods Data for this study were taken from the 2009 and 2010 waves of the International Tobacco Control United States Survey. Members of this nationally representative cohort of smokers were invited to send us an unopened pack of their usual brand of cigarettes.

Results In 2009, 318 packs were received from 401 eligible participants (79%). In 2010, 366 packs were received from 491 eligible participants (75%). In total, 20% of the packs in 2009 and 21% in 2010 were classified as untaxed by the participant's state of residence. The prevalence of untaxed cigarettes was higher in states with higher-excise taxes. Smokers who do not have a plan to quit were significantly more likely to have sent back a pack that was classified as untaxed by the participant's state of residence.

Conclusions One in five packs were untaxed with rates higher in states with higher-excise taxes. It is unclear whether these estimates differ from the actual prevalence of cigarettes that are untaxed by a smoker's state of residence. Harmonisation of excise tax rates across all 50 US states might be one method of reducing or eliminating the incentive to avoid or evade these taxes.

  • Taxation
  • Economics
  • Price

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