Taxation reduces smoking but may not reduce smoking disparities in youth

Nancy L. Fleischer, J. Travis Donahoe, M. Chandler McLeod, James F. Thrasher, David T. Levy, Michael R. Elliott, Rafael Meza, Megan E. Patrick

    Research output: Contribution to journalArticlepeer-review

    3 Scopus citations


    Objective This study examines the extent to which cigarette taxes affect smoking behaviour and disparities in smoking among adolescents by gender, socioeconomic status (SES) and race/ethnicity. Methods We used US nationally representative, repeated cross-sectional data from the 2005 to 2016 Monitoring the Future study to evaluate the relationship between state cigarette taxes and past 30-day current smoking, smoking intensity, and first cigarette and daily smoking initiation using modified Poisson and linear regression models, stratified by grade. We tested for interactions between tax and gender, SES and race/ethnicity on the additive scale using average marginal effects. Results We found that higher taxes were associated with lower smoking outcomes, with variation by grade. Across nearly all of our specifications, there were no statistically significant interactions between tax and gender, SES or race/ethnicity for any grades/outcomes. One exception is that among 12th graders, there was a statistically significant interaction between tax and college plans, with taxes being associated with a lower probability of 30-day smoking among students who definitely planned to attend college compared with those who did not. Conclusion We conclude that higher taxes were associated with reduced smoking among adolescents, with little difference by gender, SES and racial/ethnicity groups. While effective at reducing adolescent smoking, taxes appear unlikely to reduce smoking disparities among youth.

    Original languageEnglish (US)
    Pages (from-to)264-272
    Number of pages9
    JournalTobacco control
    Issue number3
    StatePublished - May 1 2021

    Bibliographical note

    Funding Information:
    Funding Research reported in this publication was supported by the National Cancer Institute of the National Institutes of Health (grant number R37CA214787). Data were collected with support from the National Institute on Drug Abuse of the National Institutes of Health (grant number R01DA001411). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

    Publisher Copyright:
    © Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.


    • disparities
    • price
    • priority/special populations
    • taxation

    PubMed: MeSH publication types

    • Journal Article
    • Research Support, N.I.H., Extramural
    • Research Support, Non-U.S. Gov't


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