Tobacco price and use following California Proposition 56 tobacco tax increase

Abstract

Background California Proposition 56 increased cigarette excise tax by $2 per pack with equivalent increases on non-cigarette tobacco products. We estimated the changes in cigarette price, cigarette use, and non-cigarette use following the implementation of Proposition 56 in California in 2017. Methods Seven waves of Tobacco Use Supplements to the Current Population Survey (TUS-CPS) 2011–2019 data were used to obtain state-level aggregate self-reported outcomes, including cigarette price per pack, current and daily cigarette use, cigarette consumption per day, and current and daily use of non-cigarette tobacco products (hookah, pipe, cigar, and smokeless tobacco). A modified version of a synthetic control method was used to create a “synthetic” California that best resembled pre-policy sociodemographic characteristics and outcome trends in California while correcting time-invariant pre-policy differences. Various sensitivity analyses were also conducted. Results The implementation of Proposition 56 was associated with an increase in self-reported cigarette price per pack in California ($1.844, 95%CI: $0.153, $3.534; p = 0.032). No evidence suggested that Proposition 56 was associated with the changes in the prevalence of current or daily cigarette use, cigarette consumption per day, or the prevalence of current or daily use of non-cigarette tobacco products. Conclusion Most of the cigarette tax increase following Proposition 56 in California was passed on to consumers. There is a lack of evidence that the implementation of Proposition 56 was associated with the changes in the use of cigarettes and other tobacco products such as hookah, pipe, cigar, and smokeless tobacco.

Evaluation of Cancer Deaths Attributable to Tobacco in California, 2014-2019

“…In November 2016, a $2 tobacco tax was passed by California voters that also helps support the activities of the California Tobacco Control Program, although there is a lack of evidence from survey estimates that smoking behavior in the general population continued to decrease significantly. 23 However, the overall quit ratio in our study (69.6%) is a little higher than that for the general population in California (65.9%), 8 and there was an increase in this ratio over the 2 periods, which reflects the periods before and after the implementation of the state tax. Additionally, the increasing proportion of never users over the 2 periods may reflect the growing proportion of never users since the California Tobacco Control Program started in 1989.…”

“…Our analyses of changes over the 2 time periods suggest promising trends in tobacco behavior among California patients with newly diagnosed cancer, which could be related to California’s ongoing tobacco control efforts. In November 2016, a $2 tobacco tax was passed by California voters that also helps support the activities of the California Tobacco Control Program, although there is a lack of evidence from survey estimates that smoking behavior in the general population continued to decrease significantly . However, the overall quit ratio in our study (69.6%) is a little higher than that for the general population in California (65.9%), and there was an increase in this ratio over the 2 periods, which reflects the periods before and after the implementation of the state tax.…”

Impacts of Tax and Flavor Tobacco Policies on San Francisco Bay Area Tobacco Prices

“…Together with these findings, our study, which had a longer follow-up to observe the effect of the tax policy over time, can indicate a common tobacco industry strategy of absorbing a part of the tax increase through reduced profits initially, but gradually moving to price increases that would eventually exceed the increase in taxation (Ross et al, 2012). On the other hand, these variations in the magnitude of price change and the direction of tax shifting may be related to differences in the definition of the outcome variable (e.g., price paid for the last pack of cigarettes in Gunadi et al (2021) vs. a focus on popular brands, rather than discount brands, in the study by Henriksen et al (2019), and the cheapest cigarette pack in our study) and/or the nature of data sources. Similar to Henriksen et al (2019), we obtained information on tobacco prices through direct retail audits and found over-shifting, whereas other studies that found under-shifting used selfreported cigarette pricing data from a population survey (Gunadi et al, 2021) or calculated cigarette prices as a retail revenue-to-sales ratio (Boettiger & White, 2020).…”

“…The present study compared changes in retail prices of tobacco products stratified by two San Francisco Bay Area counties before and after the implementation of the state excise tax increase, accounting for socio-demographic characteristics by city. Past studies focused on Proposition 56 impacts on pricing were limited to cigarettes only (Boettiger & White, 2020; Gunadi et al, 2021; Henriksen et al, 2019). We expand on previous research by also analyzing price changes for non-cigarette products, including flavored e-cigarettes.…”

Can additional funding improve mental health outcomes? Evidence from a synthetic control analysis of California’s millionaire tax

“…Differences between California and the synthetic control are construed as an intervention-driven treatment effect. Abadie and Gardeazabal [ 17 ] developed the method and applied it to terrorism’s economic impact, while others have used it to evaluate a variety of public health policies, including expanded contraceptive availability [ 18 ] and soda and tobacco taxes [ 19 , 20 ].…”