Cigarette Prices, Smoking, and the Poor: Implications of Recent Trends

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Abstract
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.

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