Household smoking restrictions and adolescent smoking

PURPOSE: To examine the association between household smoking restrictions and adolescent smoking, controlling for parental smoking, peer smoking, and tobacco marketing. DESIGN: Cross-sectional analysis of 1999 data from the Growing Up Today Study, a longitudinal cohort of adolescents. SETTING: Self-report questionnaire. SUBJECTS: 10,593 adolescents aged 12 to 18 years. MEASURES: The dependent variable was established smoking (smoking > or = 100 cigarettes). Variables of interest were household smoking restrictions, parental smoking, peer smoking, and tobacco promotional item (TPI) possession. RESULTS: Four percent of participants reported that their households permitted smoking. Parental smoking, peer smoking, and TPI possession were significantly associated with established smoking In logistic regression models adjusted for age, gender, peer smoking, and TPI possession, adolescent smoking was inversely related to the presence of a restrictive household policy (odds ratio [OR] = 0.67, 95% confidence interval [CI] = 0.48-0.93); however, when parental smoking was added to this model, the association was attenuated (OR = 0.94, CI = 0.65-1.35). When only one parent in the household smoked, smoking restrictions were more common when this parent was the father. CONCLUSIONS: Although household smoking restrictions offer health benefits, they do not appear to be associated with adolescent smoking after accounting for other factors. Prior studies did not include parental smoking, peer smoking, and marketing influences. This analytic difference may explain apparent contradictions in the literature.     

Letter: Effects of tobacco excise taxes on the use of smokeless tobacco products in the USA

Data from the September 1985 Current Population Survey are used to estimate the effects of tobacco excise taxes and state laws restricting smoking in public places on the likelihood of current use of cigarettes or smokeless tobacco (ST) products (moist snuff or chewing tobacco) among males in the USA. The results indicate that higher ST excise tax rates are associated with a reduced probability of ST use, whereas higher cigarette excise tax rates are associated with an increased probability of ST use, holding other factors constant. State laws restricting smoking have no apparent effect on ST use. © 1997 John Wiley & Sons, Ltd.     

State cigarette excise taxes - United States, 2010-2011

Increasing the price of cigarettes reduces the demand for cigarettes, thereby reducing youth smoking initiation and cigarette consumption and decreasing the prevalence of cigarette use in the United States overall, particularly among youths and young adults. The most common way governments have increased the price of cigarettes is by increasing cigarette excise taxes, which currently are imposed by all states and the District of Columbia. To update data on state cigarette excise taxes in 2009, CDC conducted a survey of changes in state cigarette excise taxes during 2010-2011. During that period, eight states increased their cigarette excise taxes, and one state decreased its tax; as a result, the mean state tax increased from $1.34 in 2009 to $1.46 in 2011. Previous evidence indicates that further increases in cigarette excise taxes would be expected to result in further reductions in demand for cigarettes, decreasing smoking and associated morbidity and mortality.     

The impact of tobacco control policies on disparities in children's secondhand smoke exposure: a comparison of methods

To examine the impact of cigarette excise taxes and smoke-free legislation on tobacco use among households with school-age children and adolescents as well as disparities in children's secondhand smoke exposure. We compare the results from models using causal inference techniques to those from cross-sectional models. We linked families of 6-17-year-olds from the 2003 (N = 67,607) and 2007 (N = 62,768) contacts of the National Survey of Children's Health with state-level cigarette excise taxes and smoke-free legislation total score (0 [none]-32 [very strong]) in 2001 and 2005. Parents reported whether anyone in the household used tobacco products. In adjusted causal inference models every $1.00 increase in cigarette excise tax between 2001 and 2005 was associated with a 4 percentage point decrease in household tobacco use between 2003 and 2007 (p = 0.008); however, there was no effect of smoke-free legislation on household tobacco use. Significant interactions revealed that cigarette tax increases were only associated with reductions in household tobacco use for parents of white children and, separately, lower income households. In contrast, in adjusted cross-sectional models, a higher smoke-free legislation total score was associated with a lower prevalence of household tobacco use. Stronger cigarette excise taxes decrease tobacco use among households with school-age children and adolescents, but smoke-free legislation at the state level does not change parental smoking. Since cross-sectional models cannot assess the direction of causality, evaluations should employ causal inference methods to help inform policy decisions to reduce disparities in adult smoking and, ultimately, protect children from secondhand smoke.     

Higher cigarette taxes--healthier people, wealthier state: the Hungarian experience

OBJECTIVE: To prove that higher cigarette taxes eventually decrease smoking and do also increase state incomes from tobacco taxes by using Hungarian figures. METHOD: Collection and analysis of available data on tobacco use, levels of excise and value added taxes on tobacco products and state incomes originating from the tobacco sector. CONCLUSIONS: In Hungary, regular tobacco tax increases resulted in decreased cigarette consumption and its lower prevalence figures in some population groups. State incomes have increased in spite of regular cigarette tax raises. Therefore, there is on conflict of interest between the health and finance portfolios in supporting further tobacco tax increases. Hungary should use regular, above the inflation tobacco tax raises as means for improving population health. Tobacco control advocates should prevent tobacco companies' attempts aimed at deterring decision makers from supporting such tax policies.     

Economic and Political Influence on Tobacco Tax Rates: A Nationwide Analysis of 31 Years of State Data

Objectives. We evaluated state-level characteristics associated with cigarette excise taxes before and after the Master Settlement Agreement (MSA).Methods. We gathered annual cigarette excise tax rates for all US states and the District of Columbia, between 1981 and 2011, and matched each state–year tax rate with economic, political, attitudinal, and demographic characteristics, creating a data set of 1581 observations. We used panel data regression techniques to assess relationships between key characteristics and state cigarette excise tax levels.Results. Cigarette excise tax rates grew at more than 6 times the rate of inflation between 1981 and 2011; growth varied by time period and region. We found strong negative associations between Republican Party control of state legislatures and governors’ offices and state cigarette tax rates. Tobacco production, citizens’ attitudes toward taxes and tobacco control, and cigarette tax rates in neighboring states were significantly associated with cigarette tax rates. We found no association between unemployment and tax rates.Conclusions. Future excise tax growth rate may depend more on the political leanings of state legislators, and the attitudes of the people they represent, than on economic circumstances.Smoking prevalence has declined in the past few decades, but recently, progress has stalled.1,2 In 1997, nearly 1 in 4 adults, and more than 1 in 3 youths, smoked at least 1 cigarette in the previous month. Although by 2007 rates for both groups had dropped to about 20%, no declines have been observed since.2,3 Without further progress, Healthy People 2020 goals for smoking among adults (12%) and youths (16%) will not be met.4Cigarette excise taxes are considered one of the most effective strategies for reducing smoking.5,6 Higher cigarette prices are associated with decreased consumption,7–9 and taxes are an effective tool for raising product price.10 Furthermore, in almost half of all states, some portion of excise tax revenues fund tobacco control programs.11Although all states levy cigarette taxes, rates vary extensively.12 In 2011, New York’s $4.35 tax rate was more than 25 times higher than Missouri’s $0.17 rate.13 Geographic variation in taxes may promote regional disparities in smoking prevalence and encourage cross-border smuggling or online tobacco sales, limiting the public health impact and revenue generation capabilities of high taxes.13–15 In 2007, the Institute of Medicine recommended that states with excise taxes below those in the top quintile raise their rates to match those in high-tax states.6Yet raising cigarette taxes, especially in low-tax states, has proven difficult. Between 2007 and 2011, only 43% of states in the bottom 4 quintiles raised taxes, whereas 91% of the highest-tax states increased their rates.12 Little is known about what motivates recent changes in state excise tax levels. Tobacco control advocates have suggested that economic contractions may drive states to raise cigarette taxes to generate revenue, noting high numbers of tax hikes following national recessions.16Political scientists, however, argue that political factors and regional pressures may also be important policy predictors.17–19 Nonelection years and neighboring tax initiatives, in addition to poor fiscal health, have been associated with diffusion of gasoline and income taxes.18 Public support of tobacco control, as well as actions of local and neighboring governments, influence the uptake of indoor air and tobacco sales restriction policies.20,21 The extent to which economic circumstances, state politics, constituency beliefs, or regional pressures influence state cigarette excise tax rates, however, remains unclear.Moreover, the key determinants of cigarette taxes can change over time, as public opinion evolves. The 1998 Master Settlement Agreement (MSA) with tobacco manufacturers generated new allocations of tobacco control revenue, some of which was used to fund social marketing campaigns about smoking and the tobacco industry (e.g., the “truth” campaign). One study did document some economic and political correlates of state cigarette tax rates, but relied on data through 2000, just as the impact of the MSA began.22 In the years since the MSA, the public has increasingly identified smoking as hazardous, and the majority now supports some form of tobacco control legislation.23 If these public sentiments influence beliefs about cigarette taxes, the political landscape in which tax decisions are made could be changing.Better understanding of which factors most strongly predict cigarette taxes could help tobacco control professionals target their advocacy. We used annual data from all 50 states between 1981 and 2011 to explore the magnitude of the associations between key economic, political, and regional characteristics and state cigarette excise tax levels, both before and after the MSA.     

The Impact of Tobacco Control Policies on Disparities in Children’s Secondhand Smoke Exposure: A Comparison of Methods

To examine the impact of cigarette excise taxes and smoke-free legislation on tobacco use among households with school-age children and adolescents as well as disparities in children’s secondhand smoke exposure. We compare the results from models using causal inference techniques to those from cross-sectional models. We linked families of 6–17-year-olds from the 2003 (N = 67,607) and 2007 (N = 62,768) contacts of the National Survey of Children’s Health with state-level cigarette excise taxes and smoke-free legislation total score (0 [none]–32 [very strong]) in 2001 and 2005. Parents reported whether anyone in the household used tobacco products. In adjusted causal inference models every $1.00 increase in cigarette excise tax between 2001 and 2005 was associated with a 4 percentage point decrease in household tobacco use between 2003 and 2007 (p = 0.008); however, there was no effect of smoke-free legislation on household tobacco use. Significant interactions revealed that cigarette tax increases were only associated with reductions in household tobacco use for parents of white children and, separately, lower income households. In contrast, in adjusted cross-sectional models, a higher smoke-free legislation total score was associated with a lower prevalence of household tobacco use. Stronger cigarette excise taxes decrease tobacco use among households with school-age children and adolescents, but smoke-free legislation at the state level does not change parental smoking. Since cross-sectional models cannot assess the direction of causality, evaluations should employ causal inference methods to help inform policy decisions to reduce disparities in adult smoking and, ultimately, protect children from secondhand smoke.     

State Cigarette Excise Tax,Secondhand Smoke Exposure,and Periodontitis in US Nonsmokers

Objectives. We assessed the relationship of state cigarette excise tax with cigarette sales, secondhand smoke (SHS) exposure, and periodontitis among US lifetime nonsmokers.Methods. Cigarette excise tax and per capita sales data from 1983 to 1998 were obtained for 50 states and the District of Columbia. Periodontal data were analyzed for 3137 adults in 28 states from 3 National Health and Nutrition Examination Survey cycles (1999–2004). Measures of periodontal pocket depth and attachment level were used to classify people with moderate or severe periodontitis. SHS exposure was classified according to gender- or race/ethnicity–specific thresholds of serum cotinine concentration. Statistical analysis adjusted for the complex survey design.Results. For each additional $0.10 in excise tax, predicted sales decreased by 0.74 packs per person per month and adjusted odds of moderate or severe periodontitis decreased 22% (odds ratio [OR] = 0.78; 95% confidence interval [CI] = 0.62, 0.97). For each pack sold per person per month, adjusted odds of SHS exposure increased 28% (95% CI = 1.17, 1.40) and adjusted odds of periodontitis increased 15% (95% CI = 1.03, 1.29). Odds of periodontitis for those exposed to SHS were elevated 2-fold relative to those who were unexposed (OR = 2.03; 95% CI = 1.30, 3.20).Conclusions. Cigarette excise tax may protect nonsmokers against periodontitis.Unlike many countries whose regulation of tobacco products occurs primarily at the national level, the 50 states and District of Columbia (DC) of the United States have considerable autonomy over tobacco regulation in their jurisdictions. This produces marked variation in tobacco control expenditures,1 smoke-free air laws,2 access for minors,3 advertising restrictions,4 and cigarette excise taxes5 throughout the country. For instance, in 2009, 25 states and DC had comprehensive laws to prohibit indoor smoking in private-sector worksites, restaurants, and bars,6 yet none of the tobacco-growing states of Indiana, Kentucky, Mississippi, South Carolina, Texas, West Virginia, and Wyoming prohibited smoking in all 3 of these venues.6 Because these laws were implemented relatively recently, only their short-term effect on economic activity has been reported,7,8 and investigation of the public health effects has been confined to single states9,10 or smaller jurisdictions.11–13By contrast, state cigarette excise taxes were first implemented in 1921 in Iowa.14 By 1969, all 50 states and Washington, DC, imposed a cigarette excise tax that is passed on to the consumer in the price of cigarettes. Furthermore, there has been a history of marked state variation in the amount of excise tax. For example, in 1983 it ranged from $0.02 in North Carolina to $0.25 in Wisconsin; by 2004, the range was $0.025 in Virginia to $2.50 in New Jersey. Such marked interstate variation provides a unique opportunity to compare the impact of differing tobacco control policies on smoking rates, per capita sales, secondhand smoke (SHS) exposure, and public health within a single population.Two features of the state cigarette excise tax suggested it might influence public health. First, despite the addictive nature of nicotine, cigarette price increases resulted in a reduction in the prevalence of smoking and the number of cigarettes smoked per person.15–20 Price elasticity of demand estimates revealed that a 10% increase in price led to a 3% to 5% reduction in cigarette consumption.21 Secondly, although states raised cigarette excise taxes in absolute terms over 40 years, the relative ranking of states by their level of tax had long-term stability. Hence, states that currently impose a high tax have been consistently high taxing relative to other states.22 Similarly, historically low-taxing states maintained a relatively low tax on cigarettes.22 Meanwhile, the federal cigarette excise tax is applied uniformly in every state; currently, this tax is $1.01 per pack of 20 cigarettes.Despite good evidence for an inverse relation between cigarette price and sales, few studies have investigated the impact of cigarette prices on health. Moreover, no study has investigated whether state cigarette excise tax is associated with health in nonsmokers. In 2004, the US Surgeon General added periodontal disease to the list of conditions causally linked to cigarette smoking,23 and several epidemiological studies found SHS exposure to be associated with periodontal disease among nonsmokers.24,25 In the United States, 42% of periodontitis was attributed to current smoking and 11% to former smoking.26 This study sought to investigate the relationship of state cigarette excise tax with periodontitis among lifetime nonsmokers. We hypothesized that (1) states with historically high cigarette excise taxes had lower per capita cigarette sales, and (2) nonsmokers in those states had less SHS exposure and lower odds of periodontitis than did nonsmokers in states with historically low tax levels.     

The potential for using excise taxes to reduce smoking

We examine the potential for reducing cigarette smoking through increases in cigarette excise taxes by estimating the price elasticity of demand for cigarettes. Using information on individual smoking behavior from the 1976 Health Interview Survey, we estimate the adult price elasticity of demand for cigarettes to be -0.42. We find that price has its greatest effect on the smoking behavior of young males and that it operates primarily on the decision to smoke rather than via adjustments in the quantity of cigarettes smoked. An excise tax increase would discourage smoking by successive cohorts of young adults, and those reduced smoking levels would be reflected in aggregate smoking as these cohorts mature.     

Cigarette Taxes and Smoking During Pregnancy

OBJECTIVES: This study sought to estimate how changes in state cigarette excise taxes affect the smoking behavior of pregnant women. METHODS: Detailed information about mothers and their pregnancy was used to examine the impact of taxes on the propensity of pregnant women to smoke. The 1989 to 1995 Natality Detail Files were used in conducting analyses to assess the impact of taxes on smoking among different subpopulations. RESULTS: Higher cigarette excise taxes reduced smoking rates among pregnant women. A tax hike of $0.55 per pack would reduce maternal smoking by about 22%. Overall, a 10% increase in price would reduce smoking rates by 7%. Estimates for subpopulations suggested that nearly all would be very responsive to tax changes, including the subpopulations with the highest smoking rates. CONCLUSIONS: Smoking rates among pregnant women are responsive to tax hikes.     

The influence of electronic cigarette age purchasing restrictions on adolescent tobacco and marijuana use

ObjectiveIn the United States, many states have established minimum legal purchase ages for electronic nicotine delivery systems (ENDS) to ban adolescent purchases, but these policies may also affect other related substance use. We explore whether ENDS are substitutes or complements for cigarettes, cigars, smokeless tobacco, and marijuana among adolescents by using variation in state-level implementation of ENDS age purchasing restrictions.MethodsWe linked data on ENDS age purchasing restrictions to state- and year-specific rates of adolescent tobacco and marijuana use in 2007–2013 from the Youth Risk Behavior Surveillance System. This data provides a nationally representative sample of adolescents who attend public and private schools. We performed a fixed effect regression analysis exploring the influence of ENDS age purchasing restrictions on outcomes of tobacco use and marijuana use, controlling for state and year fixed characteristics, age-race cohorts, cigarette excise taxes, and cigarette indoor use restrictions.ResultsFor cigarette use, we separate our results into cigarette use frequency. We found causal evidence that ENDS age purchasing restrictions increased adolescent regular cigarette use by 0.8 percentage points. ENDS age purchasing restrictions were not associated with cigar use, smokeless tobacco use, or marijuana use.ConclusionsWe document a concerning trend of cigarette smoking among adolescents increasing when ENDS become more difficult to purchase.     

Peers, schools, and adolescent cigarette smoking.

PURPOSE: To investigate the effects of popularity, best friend smoking, and cigarette smoking within the peer networks on current smoking of seventh- through 12th-grade students. These factors were examined for adolescents attending schools with varying rates of student cigarette smoking. METHODS: This study used data from the saturated school sample of National Longitudinal Study of Adolescent Health (Add Health), a nationally representative school-based sample. The sample for the present study was 2525 adolescents in Grades 7-12 who completed an in-school questionnaire and an in-home interview. Information from the in-school questionnaire was used to construct measures of school smoking prevalence and popularity. Using peer nominations from the in-home interview, best friend smoking, and peer network smoking exposure were constructed using the peers' own reports of their cigarette smoking. Multiple regression techniques were used to estimate the risk of current cigarette smoking as a function of popularity, best friend smoking, peer network smoking, and school smoking prevalence, and all first-order interactions between measures of peer and school smoking prevalence. RESULTS: Adjusting for age, gender, race/ethnicity, parent education, school, and availability of cigarettes in the home, the risk of current smoking was significantly associated with peer networks in which at least half of the members smoked [odds ratio (OR) = 1.91], one or two best friends smoked (OR = 2.00), and with increasing rates of school smoking prevalence (OR = 1.73). In addition, there was a significant interaction of popularity and school smoking prevalence such that risk of current smoking was somewhat greater among popular students in schools with high smoking prevalence than among popular students in schools with low smoking prevalence. CONCLUSION: Findings suggest that school environments are important contexts for understanding peer group influences on adolescent cigarette smoking.     

State laws on tobacco control--United States, 1998.

PROBLEM/CONDITION: State laws addressing tobacco use, the leading preventable cause of death in the United States, are summarized. Laws address smoke-free indoor air, minors' access to tobacco products, advertising of tobacco products, and excise taxes on tobacco products. REPORTING PERIOD COVERED: Legislation effective through December 31, 1998. DESCRIPTION OF SYSTEM: CDC identified laws addressing tobacco control by using an on-line legal research database. CDC's findings were verified with the National Cancer Institute's State Cancer Legislative Database. RESULTS: Since a previous surveillance summary on state tobacco-control laws published in November 1995 (covering legislation effective through June 30, 1995), several states have enacted new restrictions or strengthened existing legislation that addresses smoke-free indoor air, minors' access to tobacco, tobacco advertising, and tobacco taxes. Five states strengthened their smoke-free indoor air legislation. All states and Washington, D.C., continued to prohibit the sale and distribution of tobacco products to minors; however, 21 states expanded minors' access laws by designating enforcement authorities, adding license suspension or revocation for sale to minors, or requiring signage. Since the 1995 report, eight additional states (a total of 19 states and Washington, D.C.) now ban vending machines from areas accessible to minors. Thirteen states restrict advertising of tobacco products, an increase of four states since the 1995 report. Although the number of states that tax cigarettes and smokeless tobacco did not change, 13 states increased excise taxes on cigarettes, and five states increased excise taxes on smokeless tobacco products. The average state excise tax on cigarettes is 38.9 cents per pack, an increase of 7.4 cents compared with the average tax in the 1995 report. INTERPRETATION: State laws addressing tobacco control vary in relation to restrictiveness, enforcement and penalties, preemptions, and exceptions. ACTIONS TAKEN: The data summarizing state tobacco-control laws are available through CDC's State Tobacco Activities Tracking and Evaluation (STATE) System; the laws are collected and updated every quarter. The STATE System also contains state-specific data on the prevalence of tobacco use, tobacco-related deaths, and the costs of tobacco use. Information from the STATE System is available for use by policy makers at the state and local levels to plan and implement initiatives to prevent and reduce tobacco use. In addition, CDC is using this information to assess the ongoing impact of tobacco-control programs and policies on tobacco use.     

Does cigarette price influence adolescent experimentation?

The economics literature generally agrees that state and federal excise taxes can play an important role in deterring adolescent smoking. Teens' apparent responsiveness to cigarette prices is puzzling, since the majority of adolescent smokers do not buy their cigarettes. Teens typically do not begin to purchase cigarettes until they have developed an established pattern of smoking. Previous studies have not had adequate measures of smoking experience to explore whether adolescents' price responsiveness may vary by smoking experience. This paper uses data from a 1993 national survey of youth smoking to explore this hypothesis.     

The effect of cigarette taxes on cigarette consumption, 1955 through 1994.

OBJECTIVES: This study examines the effectiveness of state and federal taxes in reducing the consumption of cigarettes, estimates the impact of government health warnings, and shows how warnings and taxes interact. METHODS: By means of a pooled time-series analysis from 1955 through 1994 with the 50 states as units of analysis, the impact of excise taxes on cigarette consumption for several different models and econometric techniques is assessed. RESULTS: From 1955 through 1994, increases in state taxes were effective in reducing cigarette use. Federal tax increases, however, appear to have been more effective. This difference is partly the result of the "bootlegging" of cigarettes across state lines and the size of the increases in the federal tax. Cigarette consumption also declined when health warning labels were added. CONCLUSIONS: Increases of taxes on cigarettes are associated with declines in the consumption of tobacco. Because of inflation, increased health concerns, and the declining percentage of smokers, however, large reductions in consumption require large tax increases.     

Increasing excise taxes on cigarettes in California: a dynamic simulation of health and economic impacts

BACKGROUND: California raised cigarette excise taxes in 1999, and may generate additional health and economic benefits by raising them further. METHODS: A dynamic computer simulation model follows births, deaths, migration, aging, and changes in smoking status for the entire population of California over 75 years to estimate the cumulative health and economic outcomes of these changes under several excise tax rate conditions (up to 100% price increase). RESULTS: A 20% tax-induced cigarette price increase would reduce smoking prevalence from 17% to 11.6% with large gains in cumulative life years (14 million) and QALY's (16 million) over 75 years. Total spending on cigarettes by consumers would increase by 270 million dollars in that span (all going to tax revenue), and those who reduce the number of years spent as a smoker would spend 12.5 billion dollars less on cigarettes. Total smoking-related medical costs would drop by 188 billion dollars. These benefits increase greatly with larger tax increases, with which tax revenues continue to rise even as smoking prevalence falls. CONCLUSIONS: Even considering benefits from the 1999 increase, California has not yet maximized the potential of excise taxes to lessen the negative impacts of smoking. Additional tax increases would provide added health benefits and revenue to the state.     

Heterogeneity in Smokers' Responses to Tobacco Control Policies

This paper uses unconditional quantile regression to estimate whether smokers' responses to tobacco control policies change across the distribution of smoking levels. I measure smoking behavior with the number of cigarettes smoked per day and also with serum cotinine levels, a continuous biomarker of nicotine exposure, using individual‐level repeated cross‐section data from the National Health and Nutrition Examination Surveys. I find that the cigarette taxes lead to reductions in both the number of cigarettes smoked per day and in smokers' cotinine levels. These reductions are most pronounced in the middle quantiles of both distributions in terms of marginal effects, but most pronounced in the lower quantiles in terms of tax elasticities. I do not find that higher cigarette taxes lead to statistically significant changes in the amount of nicotine smokers ingest from each cigarette. Copyright © 2015 John Wiley & Sons, Ltd.     

Cigarette taxes and youth smoking: new evidence from national, state, and local Youth Risk Behavior Surveys

Several studies have examined the effects of state cigarette tax increases on youth substance use over the 1990s, with most--but not all--finding that higher taxes reduce youth consumption of tobacco. We advance the literature by using data from the 1991 to 2005 waves of the national Youth Risk Behavior Surveys (YRBS), providing information on over 100,000 high school age youths. We also are the first to make use of hundreds of independently fielded state and local versions of the YRBS, reflecting data from over 750,000 youths. Importantly, these data are to our knowledge the only sources of relevant information on youth smoking that were explicitly designed to be representative of the sampled state or locality. We estimate two-way fixed effects models of the effect of state cigarette taxes on youth smoking, controlling for survey demographics and area and year fixed effects. Our most consistent finding is that--contrary to some recent research--the large state tobacco tax increases of the past 15 years were associated with significant reductions in smoking participation and frequent smoking by youths. Our price elasticity estimates for smoking participation by high school youths are generally smaller than previous cross-sectional approaches but are similar to recent quasi-experimental estimates.     

The effect of cigarette taxes on cigarette consumption.

OBJECTIVES: This paper reexamines the work of Meier and Licari in a previous issue of the Journal. METHODS: The impact of excise taxes on cigarette consumption and sales was measured via standard regression analysis. RESULTS: The 1983 federal tax increase is shown to have an anomalous effect on the regression results. When those data are excluded, there is no significant difference between state and federal tax increases. Further investigation suggests that firms raised cigarette prices substantially in the years surrounding the 1983 federal tax increase, which accounts for the relatively large decrease in consumption during this period. CONCLUSIONS: Federal excise taxes per se do not appear to be more effective than state excise taxes in terms of reducing cigarette consumption. The reaction of cigarette firms to government policies appears to be an important determinant of the success of antismoking initiatives.     

Smoking initiation among youth: the role of cigarette excise taxes and prices by race/ethnicity and gender

Existing evidence for the role of cigarette excise taxes and prices as significant determinants of youth smoking initiation is mixed. A few studies have considered the possibility that the impact of cigarette taxes and prices might differ by gender or race/ethnicity. In this paper, we address the role of cigarette taxes and prices on youth smoking initiation using the National Longitudinal Survey of Youth 1997 cohort and discrete-time survival methods. We present results overall and by gender, race/ethnicity, and gender by race/ethnicity. We examine initiation over the age range during which youth are most at risk of initiation and over a period in which substantial changes have occurred in tax and price. The result for cigarette excise taxes is small and mixed across alternative specifications, with the effect strongest for black youth. Cigarette prices are more consistently a significant determinant of youth smoking initiation, especially for black youth.