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.
Bibliographical noteFunding Information:
This research was funded by ClearWay Minnesota, an independent nonprofit organization, the Statewide Health Improvement Program (SHIP), and State Core Tobacco Control funding from the Centers for Disease Control and Prevention CDC-RFA-DP15-1509 (1U58DP006005-01). SHIP and the Centers for Disease Control and Prevention had no role in the study design, data collection, analysis, interpretation of the data, writing of the manuscript, or decision to submit for publication.
- Cigarette excise taxes
- Health equity
- Stages-of-change perspective
- Statewide tobacco taxation
- Tobacco-related disparities