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Cigarette prices, smoking, and the poor: implications of recent trends.

Franks P, Jerant AF, Leigh JP, Lee D, Chiem A, Lewis I, Lee S

Center for Health Services Research in Primary Care, School of Medicine, University of California, Davis, Sacramento, CA 95817, USA. pfranks@ucdavis.edu

OBJECTIVE: We examined the relationship between smoking participation and cigarette pack price by income group and time period to determine role of cigarette prices in income-related disparities in smoking in the United States. METHODS: We used data from the 1984-2004 Behavioral Risk Factor Surveillance System surveys linked to information on cigarette prices to examine the adjusted prevalence of smoking participation and smoking participation-cigarette pack price elasticity (change in percentage of persons smoking relative to a 1% change in cigarette price) by income group (lowest income quartile [lower] vs all other quartiles [higher]) and time period (before vs after the Master Settlement Agreement [MSA]). RESULTS: Increased real cigarette-pack price over time was associated with a marked decline in smoking among higher-income but not among lower-income persons. Although the pre-MSA association between cigarette pack price and smoking revealed a larger elasticity in the lower- versus higher-income persons (-0.45 vs -0.22), the post-MSA association was not statistically significant (P>.2) for either income group. CONCLUSIONS: Despite cigarette price increases after the MSA, income-related smoking disparities have increased. Increasing cigarette prices may no longer be an effective policy tool and may impose a disproportionate burden on poor smokers.

Published 26 September 2007 in Am J Public Health, 97(10): 1873-7.
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