Behavioral change in response to a statewide tobacco tax increase and differences across socioeconomic status

Abstract

Background Tobacco use is a leading behavioral risk factor for morbidity and mortality, and the tobacco epidemic disproportionately affects low-socioeconomic status (SES) populations. Taxation is effective for reducing cigarette use, and it is an effective population-based policy for reducing SES-related tobacco disparities. However, progress in implementing cigarette excise taxes has stalled across the United States, and there is a dearth of research on the full spectrum of behavioral shifts that result from taxes, particularly among low-SES populations. This project documents the impact of Minnesota’s $1.75 cigarette tax increase implemented in 2013. Methods Data come from the 2014 Minnesota Adult Tobacco Survey. Descriptive analyses and Latent Class Analysis (LCA) were used to provide a typology of the tax impact. Results From the LCA, six classes were identified, and 42% of respondents were classified as reporting action-oriented behavioral change related to the tax—8% reported sustained smoking abstinence. We found differential behavior change across levels of SES. Low-SES and medium/high-SES individuals were equally likely to report complete tobacco cessation, but the prevalence of daily smokers who reported action-oriented behavior without sustained cessation was nearly double for low-SES individuals. Conclusions Smokers report a range of behavioral changes in response to cigarette taxes, with differences across SES. The majority of smokers, and particularly low-SES smokers, report behavioral steps toward quitting or achieving sustained tobacco cessation in response to cigarette taxes. Complementary population-based programs geared toward assisting individuals, especially low-SES individuals, to achieve continuous tobacco cessation could increase the reach and effectiveness of cigarette taxes.

Impact of cigarette taxes on smoking prevalence from 2001-2015: A report using the Behavioral and Risk Factor Surveillance Survey (BRFSS)

“…Recent data from the Minnesota Adult Tobacco Survey found that socially disadvantaged smokers were most likely to respond to tax increases by adopting price-minimization behaviors (i.e. rolling their own cigarettes, buying cheaper brands, or buying from cheaper places) without sustained cessation, which is one potential explanation for the apparently modest effect of tax increases on smoking prevalence in the low-SES population [ 19 , 20 ]. It’s also likely that low-income individuals who attempt to quit may not have access to therapeutic options to help them with smoking cessation, such as nicotine-replacement products (patch, gum, lozenges, inhalers, or nasal sprays).…”

Impact of population tobacco control interventions on socioeconomic inequalities in smoking: a systematic review and appraisal of future research directions

“…Of these, 19 664 were excluded following initial title/abstract screening. A further 114 were judged ineligible through the detailed abstract review and 52 through the full-text review, with most excluded because they focused on young people not adults (43), because the policy was unclear or not evaluated (31), or because the study examined cessation support but did not assess population reach (27). The remaining 64 references were combined with 4 identified through hand-searching to give 68 papers for inclusion.…”

Population‐level predictors of changes in success rates of smoking quit attempts in England: a time series analysis

“…This is likely to be partially attributable to reduced uptake in younger age groups, and highlights the lack of progress that has been made in reducing social inequalities. Socio-economic status is a strong predictor of quitting activity [31,32]. Although smokers in more deprived socio-economic groups are just as likely as those in more advantaged groups to try to stop, those in the most deprived group are half as likely to succeed [33,34].…”