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Taxation reduces smoking but may not reduce smoking disparities in youth
  1. Nancy L Fleischer1,
  2. J Travis Donahoe2,
  3. M Chandler McLeod3,
  4. James F Thrasher4,5,
  5. David T Levy6,
  6. Michael R Elliott7,8,
  7. Rafael Meza1,
  8. Megan E Patrick9
  1. 1Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
  2. 2Graduate School of Arts & Sciences, Harvard University, Cambridge, Massachusetts, USA
  3. 3Biostatistics Core, Rogel Cancer Center, University of Michigan, Ann Arbor, Michigan, USA
  4. 4Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
  5. 5Tobacco Research, Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
  6. 6Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
  7. 7Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
  8. 8Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
  9. 9Institute of Child Development and Institute for Translational Research in Children’s Mental Health, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
  1. Correspondence to Dr Nancy L Fleischer, Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA; nancyfl{at}umich.edu

Abstract

Objective This study examines the extent to which cigarette taxes affect smoking behaviour and disparities in smoking among adolescents by gender, socioeconomic status (SES) and race/ethnicity.

Methods We used US nationally representative, repeated cross-sectional data from the 2005 to 2016 Monitoring the Future study to evaluate the relationship between state cigarette taxes and past 30-day current smoking, smoking intensity, and first cigarette and daily smoking initiation using modified Poisson and linear regression models, stratified by grade. We tested for interactions between tax and gender, SES and race/ethnicity on the additive scale using average marginal effects.

Results We found that higher taxes were associated with lower smoking outcomes, with variation by grade. Across nearly all of our specifications, there were no statistically significant interactions between tax and gender, SES or race/ethnicity for any grades/outcomes. One exception is that among 12th graders, there was a statistically significant interaction between tax and college plans, with taxes being associated with a lower probability of 30-day smoking among students who definitely planned to attend college compared with those who did not.

Conclusion We conclude that higher taxes were associated with reduced smoking among adolescents, with little difference by gender, SES and racial/ethnicity groups. While effective at reducing adolescent smoking, taxes appear unlikely to reduce smoking disparities among youth.

  • taxation
  • disparities
  • price
  • priority/special populations
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Footnotes

  • Contributors NLF designed the study, supervised the analyses, and drafted and revised the manuscript. JTD contributed to the study design, conducted analyses, and drafted and revised the manuscript. MCM conducted analyses and drafted and revised the manuscript. JFT, DTL, MRE and RM contributed to study design and interpretation of data, and critically reviewed the article for important intellectual content. MEP aided in the data acquisition, contributed to study design and interpretation of data, and critically reviewed the article for important intellectual content. All authors approved the final version.

  • Funding Research reported in this publication was supported by the National Cancer Institute of the National Institutes of Health (grant number R37CA214787). Data were collected with support from the National Institute on Drug Abuse of the National Institutes of Health (grant number R01DA001411). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Due to the use of deidentified data, the University of Michigan Institutional Review Board deemed this research exempt.

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

  • Data availability statement Data are available from the Monitoring the Future Study.

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