Does every US smoker bear the same cigarette tax?

Aims: To evaluate state cigarette excise tax pass-through rates for selected price-minimizing strategies.

Design: Multivariate regression analysis of current smokers from a stratified, national, dual-frame telephone survey.

Setting: United States.

Participants: A total of 16 542 adult current smokers aged 18 years or older.

Measurements: Cigarette per pack prices paid with and without coupons were obtained for pack versus carton purchase, use of generic brands versus premium brands, and purchase from Indian reservations versus outside Indian reservations.

Findings: The average per pack prices paid differed substantially by price-minimizing strategy. Smokers who used any type of price-minimizing strategies paid substantially less than those who did not use these strategies (P < 0.05). Premium brand users who purchased by pack in places outside Indian reservations paid the entire amount of the excise tax, together with an additional premium of 7-10 cents per pack for every $1 increase in excise tax (pass-through rate of 1.07-1.10, P < 0.05). In contrast, carton purchasers, generic brand users or those who were likely to make their purchases on Indian reservations paid only 30-83 cents per pack for every $1 tax increase (pass-through rate of 0.30-0.83, P < 0.05).

Conclusions: Many smokers in the United States are able to avoid the full impact of state excise tax on cost of smoking by buying cartons, using generic brands and buying from Indian reservations.