If it were totally up to me, I would raise the cigarette tax so high the revenues from it would go to zero.
– Michael Bloomberg (New York mayor)
Significant gains have been made in reducing the prevalence of smoking for the general population in North America and other high-income countries. However, smoking rates remain high for some subpopulations. Responses to tobacco control interventions and pathways to change in smoking behavior can vary substantially among subgroups of smokers. Even for those who benefit from these measures, they do not gain equally and major disparities exist.
Tobacco taxation, passed on to consumers in the form of higher cigarette prices, has been recognized as one of the most effective population-based strategies for decreasing smoking and its adverse health consequences [1
]. On average, a price increase of 10% on a pack of cigarettes would reduce demand for cigarettes by about 4% for the general adult population in high income countries [4
]. Tobacco taxes can benefit smokers who quit, reduce the overall consumption of tobacco, and put smoking cessation on the radar of those who continue to smoke. Increased taxes also have a positive impact on non-smokers by reducing their exposure to second-hand smoke. However, much less is known about the impact of taxation on specific subgroups. Are they influenced to the same extent as the general population? Do they need additional measures and initiatives to reduce smoking?
Using a better practices approach to knowledge synthesis, this study illustrates the value of using two complementary approaches (systematic review of literature and expert opinion) in an area of high importance but with varying degrees of empirical studies across subpopulations. The Better Practices Model, developed by the Canadian Tobacco Control Research Initiative [5
], provides a structure for integrating variable, but complementary, sources of information which can lead to enhanced understanding of chronic diseases. Integral to this approach is the belief that “good solutions to complex problems draw upon both science and experience.” Broad sources of information (e.g., peer-reviewed studies, grey literature, expert opinion) are synthesized to increase knowledge of a particular topic.
We systematically reviewed and synthesized evidence regarding the effects of tobacco taxation and pricing (tobacco taxation and pricing hereafter referred to as “price”) on smoking behavior in six high-risk subpopulations. They were selected based on continued high rates of smoking (Table 1
) and greater risk for the health consequences of smoking (note: these are not always distinct categories and there may be considerable overlap with some of these subpopulations. For example, heavy and long-term smoking is characteristic of smokers with dual diagnoses; low socioeconomic status is more common among Aboriginals, dual diagnosis individuals, and heavy smokers).
1.1. Youth (<19 years)
Youth (<19 years) are a critical focus for tobacco control policy. Because most adult smokers report smoking onset before the age of 20 years [6
], if one can reach adulthood without smoking, then the probability of smoking onset is greatly reduced. Although youth continue to smoke, O’Loughlin and colleagues [9
] found that 70% of teens express a desire to quit. However, only 19% making a quit attempt remained smoke-free for 12 months or more by the end of the five-year study. Because cessation strategies have not been very effective for youth populations, the research suggests that more needs to be done in terms of legislation, programming and taxation [10
1.2. Young Adults (18–24 years)
Young Adults (18–24 years) continue to smoke at high rates, despite strong public awareness of the health hazards [11
]. This developmental period is a time of risk for both initiation of smoking and progression to higher levels [12
]. Moreover, smoking among young adults is predictive of smoking in later adulthood. While smoking rates have decreased over the past twenty years for both adults and teens, rates for young adults aged 18 to 24 years have not substantially changed in most high-income countries.
1.3. Low Socio-Economic Status (SES)
Smoking is strongly linked to social and economic status and is a significant contributor to inequalities in health. Smoking rates in high income countries are highest among those who have had the least education and are in the lowest socioeconomic groups [13
1.4. Dual Diagnosis
Smokers who are diagnosed with mental health and/or non-nicotine substance abuse disorders are disproportionately affected by tobacco dependence. In North America, five to 10 percent of the population has a diagnosable mental illness [15
]. Yet, they carry almost half the burden of Canadian and US tobacco consumption, smoking approximately 40% of all cigarettes consumed [15
1.5. Heavy and/or Long-Term Smokers
Heavy and/or Long-term smokers are at greater risk for the health consequences of smoking. Both intensity and duration of smoking from onset to cessation have a strong positive association with morbidity and mortality [19
]. There is not a consistent definition of either “heavy smokers” or “long-term smokers” in the literature. Generally, studies describe heavy smokers as those who smoke more than 15 cigarettes per day [20
], although some define “heavy” by 25 cigarettes per day [21
]. A measure of “long-term” smokers was not found in the literature we reviewed.
1.6. Aboriginal People
Aboriginal people in North America have substantially higher rates of smoking than the general population (Table 1
). These rates have changed very little in the past 25 years. Availability of inexpensive cigarettes (in North America, access to inexpensive cigarettes is due to tax-exemption) has been cited as a major contributing factor, exacerbated by relative poor socioeconomic status, lack of access to quality health care, poor physical infrastructure and environmental factors [23
The aim of this study was to determine the differential effects of tobacco taxation and price on six subpopulations compared to the general population, primarily in high income countries.
Main Effects: Do subpopulations respond differently than the general population to changes in tobacco taxation and pricing?
Synergistic Effects: What are the interactive effects between taxation and other tobacco control policies among the subpopulations under review?
Inadvertent Effects: Do subpopulations adopt price minimization strategies (e.g., switching to discount brands, smoking more of a cigarette, contraband) in response to increased cigarette prices?
This article focuses primarily on high-income countries. We present an overview of the main findings and key recommendations. A detailed description of the methods and results is presented in the background report [27
2.1. Systematic Review
An extensive search was conducted to identify relevant studies, both published and unpublished, on the impact of price on smoking behavior of the six subpopulations. We used the following sources published from 1975 to November 2010: electronic bibliographic databases (all EBM Reviews, EconLit, Embase, Medline, OTRULIB, PAIS Intl, PolicyFile, PsychInfo, Scopus, Web of Science), key journals in tobacco control and health economics, reference lists from retrieved articles, electronic mailing lists, and economic working papers and other unpublished works recommended by the authors, expert panel members, and colleagues in the field. Members of the expert panel reviewed the final reference list for completeness.
Study Selection and Inclusion Criteria
Two independent reviewers assessed titles and abstracts for relevance and inclusion. Disagreements were resolved through discussion. Included studies had a primary focus on the impact of price on smoking initiation, cessation, prevalence, or consumption. Some studies were included because they provided pertinent information regarding the impact of price on the general population or contained important background on the subpopulations.
Data Extraction and Quality Assessment
Citations were screened using the above criteria and full texts of all citations considered relevant to the study were obtained. To provide consistent coding of responses, data were extracted using forms adapted from Bader et al
], which included information on: population subgroup, study design/methods, outcome measures, results, conclusions and recommendations. A notes section for a descriptive summary and limitations of the study was also included. A systematic approach to citation management (Excel) was used to manage the review.
Each study was rated by one reviewer, and checked by the other, to assess the strength of evidence. Quality was assessed using a checklist adapted from Bader et al
] and the Effective Public Health Practice Project Quality Assessment Tool [33
]. Studies were rated as Strong, Moderate,
by summing across the individual responses coded as Strong (2), Moderate (1)
(0) in the Quality Assessment Form and computing a total score (maximum = 2 times # items). A study was rated Strong if it achieved a score of at least 75% of the maximum score, Moderate with 50–75%, and Weak with 50% or less.
Data Analysis and Synthesis
Results were analyzed focusing on the question: Are “specific subpopulation” more responsive to price of cigarettes than the general population? For Youth and Young Adults, studies were analyzed according to an additional question: Are there differential responses to price of cigarettes according to various dimensions of smoking behavior—that is, by initiation, cessation, participation, consumption, or transitions to different stages of smoking uptake? For Low SES, studies were analyzed according to an additional question, If low socioeconomic populations are more price-responsive, are they sufficiently more price-responsive to counter any adverse effects of increased taxation? (If populations of low socioeconomic status cut their consumption more than the general population in response to higher prices, do they do so enough to offset their price-minimizing behaviors, such as switching to cheaper or contraband cigarettes, or smoking each cigarette more completely).
2.2. Expert Panel
An integral component of this Knowledge Synthesis was a comprehensive evaluation of evidence that included expert knowledge and advice. Experts were identified by a search of the literature for their publications, key note speakers on tobacco taxation at conferences, and recommendations of the authors and other colleagues. The 12 selected experts from Canada, the US, and Australia included: health economists, researchers, epidemiologists, a policy analyst, a psychiatrist and an addiction medicine physician (see Full Report, [27
]). The Expert Panel met twice:
Initial Phase: to obtain feedback on the study plan;
Analysis Phase: to discuss findings, develop policy recommendations, and identify priorities for future research based on gaps in literature.
3.1. Main Effects
The majority of studies (67) focused on the impact of increased price on youth. In comparison, 19 studies were identified for young adults, 25 for persons with low socio-economic status, three for persons with a dual diagnosis, one for heavy and/or long-term smokers and two for Aboriginal people (7 studies examined both youth and young adults, 1 both youth and low SES, for a total of 108 discrete studies).
There was strong evidence that raising cigarette prices through increased taxes is a more effective tobacco control policy measure for reducing smoking behavior among youth, young adults, and persons of low socioeconomic status, compared to the general population. In contrast, there was a lack of evidence about the impact of price on smoking behavior in persons with a dual diagnosis, heavy and/or long-term smokers, and Aboriginal people.
Sixty-seven studies (57 published; 10 unpublished) met our selection criteria. Quality ratings for all studies were strong or moderate. Most studies were conducted in the US, six were Canadian, and eight were international (Australia, France, Ireland, Spain, Sweden, UK). Because youth smoking is mainly a function of initiation and transitions to higher levels of smoking uptake, and to a lesser extent of cessation, it is essential to understand how increased cigarette prices specifically affect youth smoking behavior. Do higher cigarette prices encourage existing youth smokers to quit? Do higher prices deter nonsmokers from starting? A few studies also posed the question, ‘Do higher cigarette prices deter youth smokers from transitioning from lower to higher stages of smoking uptake’? Twenty-one studies examined the impact of increased cigarette prices on initiation [34
], seven on initiation and cessation [42
], three on cessation alone [38
], five on progression to different stages of smoking uptake [37
], and 31 on participation and/or consumption [55
]. Table 2
summarizes the results (some studies may appear more than once if they include findings for different dimensions). Studies examining the effects of increased price on youth generally found that they are two to three times more price-responsive than the general population, although price elasticity estimates vary across studies. The consensus is that increased prices decrease both smoking participation and consumption of cigarettes.
However, the impact of increased price on smoking initiation is less clear. Of 22 studies on the role of price in preventing smoking initiation, seven found that increased price prevents smoking onset [35
], nine found that it does not [38
], and six found that price prevents initiation in some cases [34
Many studies recognize that youth are not a homogeneous population. The effects of price on smoking behavior depend on age, gender, income, peer and family influences, school status (high school student vs.
dropout), and broader context (e.g., state sentiment). Twelve studies found differential responses to price by age—that is, younger teens (more likely to be experimental smokers) are not price-responsive, while older teens (more regular smokers) are responsive to price [44
]. Explanations include the differing levels of addiction between experimental and regular smoking as well as sources from which youth acquire cigarettes—younger teens at lower levels of smoking intensity “borrowing” versus
older teens at higher levels purchasing cigarettes. Eleven studies that observed gender differences had mixed results [35
]. Only six studies included peer and/or family influences in their analysis [34
Nineteen studies (16 published; three unpublished) focused on the impact of price on young adults. Quality ratings were strong or moderate. Sixteen studies were conducted in the US, one in Canada, and the other a meta-analysis of international studies. Table 3
summarizes the results (some studies may appear more than once if they include findings for different dimensions).
Eleven studies estimated elasticities for price-responsiveness for participation and/or consumption [7
], eight studies attempted to discern whether decreases in smoking prevalence are due to smoking initiation or smoking cessation [38
], and one investigated the impact of price on progression to different intensities of smoking behavior [98
]. While most studies found that increased prices result in reductions in smoking behavior, the magnitude of the effect tends to be smaller than for youth. The majority of studies found that price is inversely related to both smoking participation and consumption. Price has an impact on encouraging cessation, but as with youth, the impact of price on smoking initiation is less clear. One study that explored transitions to higher levels of smoking uptake [98
] found that all three transitions (from no daily smoking to 1/2–1+ packs/day) were responsive to price changes.
The majority of studies (rated strong or moderate) reported significant smoking participation and consumption effects for low income, low education populations. Twenty-four studies (22 published; two unpublished) met selection criteria. Nineteen published and two unpublished studies were rated as strong or moderate. Studies were conducted in Canada, the US, the UK, other European countries, New Zealand, China/Russia and Mexico. Twelve studies found that persons of low socioeconomic status are more responsive to price than the general population [19
]. Five indicated that low SES groups have the same responsiveness to price as the general population, that is, increased price appears to benefit all socioeconomic groups equally in terms of reducing both smoking participation and consumption [13
A central concern regarding the impact of increased taxes of cigarettes on low socioeconomic status groups is whether or not such a tax is equitable. It has been argued that cigarette taxes are a regressive tax on the poor. A tax is regressive if lower incomes are taxed proportionally more than higher incomes. Therefore, tobacco taxes are regressive in percentage terms, as lower income individuals devote a higher percentage of their income to paying the tobacco tax than do higher income individuals. In addition, because people of lower socioeconomic status (SES) have higher smoking rates, they pay more tobacco tax per capita than those with higher incomes [114
However, some argue that increasing cigarette taxes is not regressive if it results in differential smoking behavior change—i.e.
, quitting smoking or reducing consumption of cigarettes at higher rates than the general population. Some propose that increasing tobacco taxes is actually progressive at the population level because of the potentially greater accrued health benefits of reduced smoking [115
]. This point of view is still contentious among economists, however, and some estimate that for most intents and purposes, tobacco tax increases
are also regressive even at the population level [101
While there are numerous studies that support the effectiveness of increasing prices, most declare that equity implications need to be paramount. Even studies that support increased taxes underscore the need to implement policies or measures to assist those who continue to smoke, especially for those smokers who do not quit or reduce smoking in response to increased taxes and who, as a result, may suffer from financial hardship [116
]. In other words, increased prices need to be accompanied by strategies to mitigate any adverse consequences of such taxes to low SES populations.
Three studies examined the impact of price on populations with a dual diagnosis. Ong et al
] found that increased price had a significant effect on smoking participation for smokers with drug or mental disorders, but not for those with alcohol dependence. Saffer and Dave [17
] found both smokers with mental disorders and those without were similarly price-responsive. Tekin et al
], who examined adolescents (grades 7–12), found that adolescent smokers with emotional or behavioral problems were at least as responsive to price as those without such problems.
Heavy and/or Long-Term Smokers
Only one study specifically examined the effects of price on the likelihood of quitting smoking for individuals with different smoking intensities, including heavy smokers [119
]. Of three tobacco policies investigated (taxation, clean air restrictions, and media/comprehensive campaigns), higher prices had the greatest association with making a quit attempt in the past year, but price was not related to the likelihood of remaining abstinent for three or more months. This study did not look at the impact of this policy on duration of smoking.
Only two studies examined the impact of price on smoking behavior. A Canadian study by Wardman and Khan [24
] is a commentary on the high smoking prevalence among Registered Indians, rather than an empirical study. It mentions two reserves that implemented a seven percent tax on tobacco products but found no significant decreases in smoking behavior. Another recent unpublished paper by Matheson [26
] analyzes the effect of price on adult smoking behavior in Canada’s Aboriginal communities, distinguishing between direct (individual response to price increase) and indirect effects (the influence of price on an individual through changes in community smoking behavior). Findings indicate that price alone is not effective in reducing smoking (a 10% price increase decreases overall smoking by 0.73%) in the aboriginal communities examined. However, the indirect effect doubles the price elasticity over the direct effect alone.
3.2. Synergistic Effects
Although some studies examined the independent effects of tobacco control policies in addition to price, few looked at the synergistic effects or interactions between these policies. Clearly, it can be complicated to separate the effects of various policies when several are in place at the same time. However, it is critical to understand their main and interactive effects for designing interventions that will improve the effectiveness of tobacco control programs.
Only one study examined the interactions among tobacco control policies for youth [87
], although 22 (of 67 studies) (Table 7a in [27
]) incorporated one or more other tobacco control policies in their analysis. The two most commonly reviewed policies were: Clean Indoor Air laws (restrictions on smoking in public places, private worksites, and high schools) and Youth Access laws (e.g., limits on availability of tobacco products to youth, warning signs at point of sale, and bans on vending machine sales).
While many studies on Young Adults (10 of 18) examined the impact of various tobacco control policies in addition to price, findings related to synergistic effects among policies were quite general. For example, several studies recommended that price increases should be combined with a comprehensive tobacco control program for maximum effectiveness, but did not provide evidence regarding specific contributions from individual policies or combinations of policies.
Only three studies investigated the synergistic effects of different tobacco control policies on low SES populations [13
]. No data were found on the effects of taxation policies and other tobacco control policies on populations with dual diagnosis, heavy and/or long-term smokers, and Aboriginal smokers.
3.3. Inadvertent Effects
Few studies in this review evaluated the potential unintended consequences of increased cigarette taxation, such as compensatory smoking behavior or greater use of contraband cigarettes. Indeed, it is crucial to understand the extent to which compensatory smoking behavior or use of contraband cigarettes may alter the intended impact of public health policies so that interventions can be designed with greater effectiveness.
Inadvertent effects of price increases were discussed in only one of the Youth studies [56
] and not in any Young Adult studies. Two studies found that increased price resulted in greater demand for smuggled cigarettes among low SES smokers [107
]. Similarly, Taylor et al
] found that heavy smokers are particularly likely to purchase contraband cigarettes. One study found relatively high rates of illicit cigarette consumption in three psychiatric populations in Toronto [122
]. Commonly cited inadvertent effects of tax-free tobacco products in Aboriginal communities included the increase of smuggling activities and “down the road” sales of on-reserve products—i.e.
, tobacco products purchased in tax-free communities and sold to residents of communities with taxes [23
Assessing the Main Effects of population strategies, such as tobacco taxation and pricing, on high-risk subpopulations is important for understanding the reach and effectiveness of such strategies. Increased tobacco taxes, passed on to consumers in the form of higher cigarette prices, provide an economic disincentive to those who smoke or may be contemplating smoking. Indeed, evidence from this knowledge synthesis strongly supports increasing cigarette prices through tobacco taxation as a powerful strategy for achieving major reductions in smoking among some, but not all, high-risk populations. This is a highly effective policy tool for reducing smoking participation and consumption among youth, young adults and persons of low socioeconomic status. In contrast, major gaps exist in our knowledge about the impact of price on persons diagnosed with mental health or non-nicotine substance abuse disorders, heavy and/or long-term smokers, and Aboriginal people.
Raising cigarette prices is an effective tobacco control policy in reducing smoking among youth. While most studies of young adults found that increased prices also result in reductions in smoking behavior, the magnitude tends to be smaller than for youth. Chaloupka and Pacula [64
] argue that because tobacco is an addictive substance, response to increased prices will occur more slowly than for non-addictive goods; therefore long-term gains may be larger than short-term gains. The impact of increased price on smoking initiation among youth and young adults is less clear. Also, differential responses to price by youth and young adults were associated with other determinants, including age (younger vs
. older teens), gender, income, school status, and peer and family influences.
The majority of studies found that persons of low socioeconomic status are more responsive to price than the general population. This indicates that increased price has the potential to benefitdisadvantaged groups and thereby contribute to reducing health inequalities. The issue of whether or not cigarette taxes are a regressive tax on the poor remains contentious. However, many studies strongly agree on the importance of addressing poverty and social disparities for those who continue to smoke. In other words, increased price needs to be accompanied by strategies to mitigate adverse consequences of such taxes to low SES populations.
The question remains unanswered about whether smokers with a dual diagnosis, heavy and/or long-term smokers, and Aboriginal smokers respond differently than the general population to changes in price. Since these subpopulations have especially high rates of smoking, there is a pressing need for research on effective policy measures to reduce their smoking.
Although some studies examined the independent effects of tobacco control policies in addition to price, few looked at the synergistic effects or interactions between these policies. It is complicated to separate the effects of policies when several are in place at the same time. However, it is critical to understand their main and interactive effects in order to design interventions that will improve the effectiveness of tobacco control programs. Which specific policy measures work best and in which contexts? Which combinations of policies are most effective in influencing smoking behavior in the six subpopulations examined in this study? The answers to these questions underscore the need for further research.
Few studies evaluated inadvertent effects and potential unintended consequences of increased price, such as compensatory smoking behavior or greater use of contraband cigarettes. Indeed, it is crucial to understand the extent to which compensatory smoking behavior or use of contraband cigarettes may alter the intended impact of public health policies so that interventions can be designed with greater effectiveness.
4.1. Limitations of Study
There are limitations in the evidence base of some of the subpopulations. The lack of data makes it difficult to assess the impact of taxation on certain groups or to evaluate trends across the six subpopulations. The majority of studies on youth smoking rely on data from school-based surveys. These surveys do not capture smoking rates of high school dropouts, street and homeless youth. While prevalence rates in this group are often difficult to ascertain, they are thought to be substantially higher than those of the general youth population.
Most studies reviewed are cross-sectional and do not have the methodological rigor of longitudinal research. Also, studies generally have used large datasets that are not built to address specific questions regarding taxation. Since smoking behavior is determined by a number of factors and their interactions, it is a challenge to elucidate the specific impact of price.
The following recommendations address policy and research needs for reducing the disproportionate burden of tobacco use among the six subpopulations (Table 4
gives further details):
Increase price of cigarettes through higher cigarette taxes, or by using other similar or complementary means, such as minimum prices.
Implement “smart tax” policies: Maximize the benefits of tobacco taxation by:
Conduct a meta-analysis of studies reviewed in this report:
Study the effects of large tax increases:
Establish a centralized repository of data:
Examine synergies between taxation and other tobacco control policies:
♦ to determine whether there are important synergies between tobacco taxation and other tobacco control policies that may either enhance or moderate effects. Multivariate analyses (e.g., hierarchical linear modeling; path analyses; structural equation modeling) can help elucidate the differential and combined effects of various policies.
Study the unintended consequences of increased taxation on cigarettes:
Incorporate gender stratification routinely in study designs and analyses:
Expedite research on dual diagnosis, heavy/long-term smokers and Aboriginals:
Significant strides have been made in reducing smoking over the past three decades, particularly in high-income countries. Nevertheless, the health toll of smoking remains a compelling global health challenge. Concerted efforts are needed to reach a higher summit in tobacco control, especially with subpopulations at most risk.
The economic literature has made unique and important contributions to our understanding of the effectiveness of tobacco taxation on ameliorating the health consequences of smoking. Increased tobacco taxes, passed on to consumers in the form of higher cigarette prices, provide an economic disincentive to those who smoke or may be contemplating smoking. Indeed, the evidence from this knowledge synthesis strongly supports increasing cigarette prices through tobacco taxation as a powerful strategy for achieving major reductions in smoking behavior among some, but not all, high-risk populations.
For instance, increasing the price of cigarettes is a very effective policy tool for reducing smoking participation and consumption among youth, young adults and persons of low socioeconomic status. In contrast, major gaps exist in our knowledge about the impact of price on persons diagnosed with mental health or non-nicotine substance abuse disorders, heavy and long-term smokers, and Aboriginal people. Given their high prevalence of smoking, urgent attention is needed to develop effective tobacco control policies for these subpopulations. A related issue is whether or not increased prices have an effect on reducing smoking initiation among youth and young adults.
The findings from this study should be of particular value to policy-makers and researchers in their efforts to design and improve the effectiveness of tobacco control measures. Although further work is needed, tobacco taxation is a key policy measure for driving success.
Benjamin Franklin once said, “In this world, nothing can be said to be certain, except death and taxes.” Yet we have a tax that could prevent hundreds of millions of premature deaths. It is time to use it more effectively
We are grateful to the following 12 Expert Panel members, whose expertise contributed greatly to the quality and findings of this study: Chaloupka, F., Collishaw, N., DeCicca, P., Garcia, J., Gnam, W., Hyland, A., Stabile, M., Stephens, T., Tauras, J., Thompson, F., Wakefield, M., Wardman, D. This study was funded by the Canadian Tobacco Control Research Initiative. The funding source had no role in the writing of the paper.
Pearl Bader (Principal Author) took the lead in the study design, implementation, and analysis, and was responsible for writing the manuscript. David Boisclair (Co-Author) helped with the study design, implementation, analysis and edit of the manuscript. Roberta Ferrence (Senior Responsible Author) was responsible for the conception, funding and oversight of the study and contributed to the study design and edit of the manuscript. All authors declare that they have no conflicting interests.
- World Health Organization, WHO Report on the Global Tobacco Epidemic; World Health Organization; Geneva, Switzerland, 2008.
- Office of the Surgeon General, Public Health Service, Centers for Disease Control, Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Reducing Tobacco Use: A Report of the Surgeon General; Office of the Surgeon General, Public Health Service: Atlanta, GA, USA, 2000.
- Tobacco Control in Developing Countries; Jha, P.; Chaloupka, F.J. (Eds.) Oxford University Press: Oxford, UK, 2000.
- Jha, P.; Chaloupka, F.J. Curbing the Epidemic: Governments and the Economics of Tobacco Control; World Bank Publications: Washington, DC, USA, 1999. [Google Scholar]
- Moyer, C.; Maule, C.; Cameron, R.; Manske, S.; Garcia, J. Better Solutions for Complex Problems: Description of a Model to Support Better Practices for Health, Version 04.07.27; Canadian Tobacco Control Research Initiative: Toronto, ON, Canada, 2004. [Google Scholar]
- Office of the Surgeon General, Public Health Service, Centers for Disease Control, Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion. Reducing Tobacco Use: A Report of the Surgeon General; Office of the Surgeon General, Public Health Service: Atlanta, GA, USA, 2004. Available online: http://www.surgeongeneral.gov/library/secondhandsmoke/report/ accessed on 10 December 2008.
- Chaloupka, F.J.; Wechsler, H. Price, tobacco control policies and smoking among young adults. J. Health Econ. 1997, 16, 359–373. [Google Scholar]
- Breslau, N.; Peterson, E.L. Smoking cessation in young adults: Age at initiation of cigarette smoking and other suspected influences. Am. J. Public Health 1996, 86, 214–220. [Google Scholar]
- O’Loughlin, J.; Gervais, A.; Dugas, E.; Meshefedjian, G. Milestones in the process of cessation among novice adolescent smokers. Am. J. Public Health 2008. [Google Scholar] [CrossRef]
- Cunningham, R. Convincing teens to quit smoking, not prevention, is top priority. The Globe and Mail 2008. [Google Scholar]
- Bader, P.; Travis, H.E.; Skinner, H.A. Knowledge synthesis of smoking cessation among employed and unemployed young adults. Am. J. Public Health 2007, 97, 1434–1443. [Google Scholar]
- Tercyak, K.P.; Rodriguez, D.; Audrain-McGovern, J. High school seniors’ smoking initiation and progression 1 year after graduation. Am. J. Public Health 2007, 97, 1397–1398. [Google Scholar]
- Dinno, A.; Glantz, S. Tobacco control policies are egalitarian: A vulnerabilities perspective on clean indoor air laws, cigarette prices, and tobacco use disparities. Soc. Sci. Med. 2009, 68, 1439–1447. [Google Scholar]
- Chapman, S. Falling prevalence of smoking: How low can we go? Tob. Control 2007, 16, 145–147. [Google Scholar]
- Picard, A. We can’t sacrifice the body in treating mental illnesses. The Globe and Mail 2007. [Google Scholar]
- Ong, M.K.; Zhou, Q.; Sung, H.Y. Sensitivity to cigarette prices among individuals with alcohol, drug or mental disorders. Am. J. Public Health 2010, 100, 1243–1245. [Google Scholar]
- Saffer, H.; Dave, D. Mental Illness and the Demand for Alcohol, Cocaine and Cigarettes; Working Paper No. 8699; National Bureau of Economic Research: Cambridge, MA, USA, 2002. [Google Scholar]
- Lasser, K.; Boyd, J.W.; Woolhandler, S.; Himmelstein, D.U.; McCormick, D.; Bor, D.H. Smoking and mental illness: A population-based prevalence study. JAMA 2000, 284, 2606–2610. [Google Scholar]
- Siahpush, M.; Heller, G.; Singh, G. Lower levels of occupation, income and education are strongly associated with a longer smoking duration: Multivariate results from the 2001 Australian National Drug Strategy survey. Public Health 2005, 119, 1105–1110. [Google Scholar]
- Godtfredsen, N.S.; Prescott, E.; Osler, M. Effect of smoking reduction on lung cancer risk. JAMA 2005, 294, 1505–1510. [Google Scholar]
- Levy, D.T.; Romano, E.; Mumford, E. The relationship of smoking cessation to sociodemographic characteristics, smoking intensity, and tobacco control policies. Nicotine Tob. Res. 2005, 7, 387–396. [Google Scholar]
- Thompson, B.; Thompson, L.A.; Thompson, J.; Fredickson, C.; Bishop, S. Heavy smokers: A qualitative analysis of attitudes and beliefs concerning cessation and continued smoking. Nicotine Tob. Res. 2003, 5, 923–933. [Google Scholar]
- Samji, H.; Wardman, A.E.D. First Nations communities and tobacco taxation: A commentary. American Indian and Alaska Native Mental Health Research 2009, 6, 1–10. [Google Scholar]
- Wardman, A.E.D.; Khan, N.A. Registered Indians and tobacco taxation: A culturally-appropriate strategy? Can. J. Public Health 2005, 96, 451–453. [Google Scholar]
- Van Wynsberghe, R. Paper on First Nations Tobacco Tax Strategy; First Nations and Inuit Peoples of Canada and Tobacco Taxation: Vancouver, BC, Canada, 2005. Available online: http://www.gatheringplacefirstnationscanews.ca/Governance/0500608_04.htm accessed on 24 August 2008.
- Matheson, J. Estimating Price Elasticity for Tobacco in Canada’s Aboriginal Communities. Job Market Paper. 2010. Available online: http://works.bepress.com/cgi/viewcontent.cgi?article=1003&context=matheson accessed on 31 January 2011.
- Bader, P.; Boisclair, D.; Cohen, J.; Prabhat, J.; Luk, R.; Perley, M.; Ferrence, R. Effects of Tobacco Taxation and Pricing on Smoking Behavior in High Risk Populations: A Knowledge Synthesis; Prepared for Canadian Tobacco Control Research Initiative, 1 January 2009; The Ontario Tobacco Research Unit: Toronoto, ON, Canada, 2008; (available on request from corresponding author). [Google Scholar]
- Statistics Canada. Census Family Status (6), Age Groups (20) and Sex (3) for the Population in Private Households of Canada, Provinces, Territories, Census Metropolitan Areas and Census Agglomerations, 2006 Census—20% Sample Data; Statistics Canada: Ottawa, ON, Canada, 2006. Available online: http://www12.statcan.gc.ca/english/census06/data/topics/RetrieveProductTable.cfm?TPL=RETR&ALEVEL=3&APATH=3&CATNO=97-553-XCB2006014&DETAIL=0&DIM=&DS=99&FL=0&FREE=0&GAL=0&GC=99&GK=NA&GRP=1&IPS=97-553-XCB2006014&METH=0&ORDER=1&PID=89024&PTYPE=88971,97154&RL=0&S=1&ShowAll=No&StartRow=1&SUB=0&Temporal=2006&Theme=68&VID=0&VNAMEE=&VNAMEF= accessed on 1 December 2008.
- US Census Bureau. We the People: American Indians and Alaskan Natives in the US, Census 2000 Special Reports; US Census Bureau: Washington, DC, USA, 2006. Available online: http://www.census.gov/prod/2006pubs/censr-28.pdf accessed on 11 December 2008.
- Report on the State of Public Health in Canada, 2008; The Public Health Agency of Canada: Ottawa, ON, Canada, 2008. Available online: http://ww.sportmatters.ca/Groups/SMG%20Resources/Health/2008-cpho-report-eng.pdf accessed on 10 December 2008.
- U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics. Health, United States, 2007; Centers for Disease Control and Prevention: Atlanta, GA, USA, 2007. Available online: http://www.cdc.gov/nchs/data/hus/hus07.pdf#063 accessed on 10 December 2008.
- Centers for Disease Control and Prevention. Adult Cigarette Smoking in the United States: Current Estimates (updated November 2007); Centers for Disease Control and Prevention: Atlanta, GA, USA, 2007. Available online: http://www.cdc.gov/tobacco/data_statistics/fact_sheets/adult_data/adult_cig_smoking.htm accessed on 8 December 2008.
- Effective Public Health Practice Project Quality Assessment Tool, Effective Public Health Practice Project, Canada 2003; Public Health Services: Hamilton, ON, Canada, 2003. Available online: http://www.city.hamilton.on.ca/phcs/EPHPP/ accessed on 15 July 2008.
- Auld, M.C. Causal effect of early initiation on adolescent smoking patterns. Can. J. Econ. 2005, 38, 709–734. [Google Scholar]
- Boudarbat, B.; Malhotra, N. The hazard of starting the smoking habit among the Canadian population. Int. J. Econ. Perspect. 2009, 3, 93–106. [Google Scholar]
- Cawley, J.; Markowitz, S.; Tauras, J.A. Body weight, cigarette prices, youth access laws and adolescent smoking initiation. E. Econ. J. 2006, 32, 149–170. [Google Scholar]
- Cawley, J.; Markowitz, S.; Tauras, J.A. Lighting up and slimming down: The effects of body weight and cigarette prices on adolescent smoking initiation. J. Health Econ. 2004, 23, 293–311. [Google Scholar]
- DeCicca, P.; Kenkel, D.S.; Mathios, A.D. Cigarette taxes and the transition from youth to adult smoking: Smoking initiation, cessation, and participation. J. Health Econ. 2008, 27, 904–917. [Google Scholar]
- DeCicca, P.; Kenkel, D.; Mathios, A.; Shin, Y.J.; Lim, J.Y. Youth smoking, cigarette prices, and anti-smoking sentiment. Health Econ. 2007. [Google Scholar] [CrossRef]
- DeCicca, P.; Kenkel, D.S.; Mathios, A.D. Putting out the fires: Will higher taxes reduce the onset of youth smoking? J. Polit. Econ. 2002, 110, 144–169. [Google Scholar]
- Dee, T.S.; Evans, W.N. A comment on DeCicca, Kendel, and Mathios. 1998, unpublished data. [Google Scholar]
- Douglas, S.; Hariharan, G. The hazard of starting smoking: Estimates from a split population duration model. J. Health Econ. 1994, 13, 213–230. [Google Scholar]
- Forster, M.; Jones, A. The role of tobacco taxes in starting and quitting smoking: Duration analysis of British data. J. Roy Stat. Soc. A 2001, 164, 1–31. [Google Scholar]
- Glied, S. Is smoking delayed smoking averted? Am. J. Public Health 2003, 93, 412–416. [Google Scholar]
- Glied, S. Youth tobacco control: Reconciling theory and empirical evidence. J. Health Econ. 2002, 21, 117–135. [Google Scholar]
- Grignon, M.; Pierrard, B. Youth tobacco initiation and the impact of tobacco price: Evidence from France. Journal d’Economie Médicale 2004, 22, 119–130. [Google Scholar]
- Hammar, H.; Martinsson, P. The Effect of Cigarette Prices and Antismoking Policies on the Age of Smoking Initiation; Working Papers in Economics No. 62; Department of Economics, Goteborg University: Goteborg, Sweden, 2001. [Google Scholar]
- Kidd, M.P.; Hopkins, S. The hazards of starting and quitting smoking: Some Australian evidence. Econ. Rec. 2004, 80, 177–192. [Google Scholar]
- Liu, F. Cutting through the smoke: Separating the effect of price on smoking initiation, relapse and cessation. Appl. Econ. 2010, 42, 2921–2939. [Google Scholar]
- López Nicolás, A. How important are tobacco prices in the propensity to start and quit smoking? An analysis of smoking histories from the Spanish Health Survey. Health Econ. 2002, 11, 521–535. [Google Scholar]
- Peretti-Watel, P. Pricing policy and some other predictors of smoking behaviours: An analysis of French retrospective data. Int. J. Drug Pol. 2004, 16, 19–26. [Google Scholar]
- Madden, D. Tobacco taxes and starting and quitting smoking: Does the effect differ by education? Appl. Econ. 2007, 39, 613–627. [Google Scholar]
- Tauras, J.A.; O’Malley, P.; Johnston, L. Effects of Price and Access Laws on Teenage Smoking Initiation: A National Longitudinal Analysis; NBER Working Paper 8331; National Bureau of Economic Research: Cambridge, MA, USA, 2001. [Google Scholar]
- Sen, A.; Wirjanto, T. Estimating the impacts of cigarette taxes on youth smoking participation, initiation, and persistence: Empirical evidence from Canada. Health Econ. 2010, 19, 1264–1280. [Google Scholar]
- Harris, J.E.; Chan, S.W. The continuum of addiction: Cigarette smoking in relation to price among Americans aged 15–29. Health Econ. 1999, 8, 81–86. [Google Scholar]
- Ross, H.; Powell, L.M.; Tauras, J.A.; Chaloupka, F.J. New evidence on youth smoking behavior based on experimental price increases. Contemp. Econ. Pol. 2005, 23, 195–210. [Google Scholar]
- Emery, S.; White, M.M.; Pierce, J.P. Does cigarette price influence adolescent experimentation? J. Health Econ. 2001, 20, 261–270. [Google Scholar]
- Liang, L.; Chaloupka, F.J. Differential effect of cigarette price on youth smoking intensity. Nicotine Tob. Res. 2002, 4, 109–114. [Google Scholar]
- Ross, H.; Chaloupka, F.; Wakefield, M. Youth smoking uptake progress: Price and public policy effect. E. Econ. J. 2006, 32, 355–367. [Google Scholar]
- Ahmad, S.; Billimek, J. Limiting youth access to tobacco: Comparing the long-term health impacts of increasing cigarette excise taxes and raising the legal smoking age to 21 in the United States. Health Pol. 2007, 80, 378–391. [Google Scholar]
- Biener, L.; Aseltine, R.H.; Cohen, B.; Anderka, M. Reactions of adult and teenaged smokers to the Massachusetts Tobacco Tax. Am. J. Public Health 1998, 88, 1389–1391. [Google Scholar]
- Carpenter, C.; Cook, P.J. Cigarette taxes and youth smoking: New evidence from national, state, and local youth risk behavior surveys. J. Health Econ. 2008, 27, 287–299. [Google Scholar]
- Chaloupka, F.J.; Grossman, M. Price, Tobacco Control Policies and Youth Smoking; Working Paper 5740; National Bureau of Economic Research: Cambridge, MA, USA, 1996. [Google Scholar]
- Chaloupka, F.J.; Pacula, R.L. The impact of price on youth tobacco use. In Changing Adolescent Smoking Prevalence—Where It Is and Why, Smoking and Tobacco Control Monograph No. 14; Burns, D.M., Ed.; National Cancer Institute: Rockville, MA, USA, 2001; pp. 93–99. [Google Scholar]
- Chaloupka, F.J.; Pacula, R.L. Sex and race differences in young people’s responsiveness to price and tobacco control policies. Tob. Control 1999, 8, 373–377. [Google Scholar]
- Chaloupka, F.J.; Pacula, R.L.; Farrelly, M.C.; Johnston, L.D.; O’Malley, P.M. Do higher Cigarette Prices Encourage Youth to Use Marijuana? Working Paper No. 6939. National Bureau of Economic Research: Cambridge, MA, USA, 1999. Available online: http://www.nber.org/papers/w6939.pdf accessed on 15 November 2008.
- Coppejans, M.; Gilleskie, D.; Sieg, H.; Strumpf, K. Consumer demand under price uncertainty: Empirical evidence from the market for cigarettes. Rev. Econ. Stat. 2007, 89, 510–521. [Google Scholar]
- Dee, T.S. The complementarity of teen smoking and drinking. J. Health Econ. 1999, 18, 769–793. [Google Scholar]
- Evans, W.N.; Huang, L.X. Cigarette Taxes and Teen Smoking: New Evidence from Panels of Repeated Cross-Sections; Working paper; Department of Economics, University of Maryland: College Park, MD, USA, 1998. [Google Scholar]
- Ferrence, R.G.; Garcia, J.M.; Sykora, K.; Collishaw, N.E.; Farinon, L. Effects of Pricing on Cigarette Use among Teenagers and Adults in Canada 1980–1989; Addiction Research Foundation: Toronto, ON, Canada, 1991. [Google Scholar]
- Gallet, C.A.; List, J.A. Cigarette demand: A meta-analysis of elasticities. Health Econ. 2003, 12, 821–835. [Google Scholar]
- Gilleskie, D.B.; Strumpf, K.S. The behavioral dynamics of youth smoking. J. Hum. Res. 2005, 40, 822–866. [Google Scholar]
- Gruber, J.; Zinman, J. Youth Smoking in the US: Evidence and Implications; Working Paper No. 7780; National Bureau of Economic Research: Cambridge, MA, USA, 2001. [Google Scholar]
- Gruber, J. Youth Smoking in the U.S.: Prices and Policies; NBER Working Paper No. 7506; National Bureau of Economic Research: Cambridge, MA, USA, 2000. [Google Scholar]
- Katzman, B.; Markowitz, S.; McGeary, K.A. An empirical investigation of the social market for cigarettes. Health Econ. 2007, 16, 1025–1039. [Google Scholar]
- Katzman, B.; Markowitz, S.; McGeary, K.A. The Impact of Lending Borrowing, and Anti-Smoking Policies on Cigarette Consumption by Teens; Working Paper No. 8844; National Bureau of Economic Research: Cambridge, MA, USA, 2002. [Google Scholar]
- Lewit, E.M.; Hyland, A.; Kerrebrock, N.; Cummings, K.M. Price, public policy, and smoking in young people. Tob. Control 1997, 6 Suppl 2, S17–S24. [Google Scholar]
- Lewit, E.M.; Coate, D.; Grossman, M. The effects of government regulation on teenage smoking. J. Law Econ. 1981, 24, 545–569. [Google Scholar]
- Liang, L.; Chaloupka, F.J.; Nichter, M.; Clayton, R. Prices, policies and youth smoking, May 2001. Addiction 2003, 98 Suppl 1, 105–122. [Google Scholar]
- National Cancer Institute, The Impact of Cigarette Excise Taxes on Smoking among Children and Adults: Summary Report of a National Cancer Institute Expert Panel; National Cancer Institute, Division of Cancer Prevention and Control, Cancer Control Science Program, 1993: Bethesda, MD, USA, 1993.
- Powell, L.; Chaloupka, F. Parents, public policy, and youth smoking. J. Pol. Anal. Manag. 2005, 24, 93–112. [Google Scholar]
- Ross, H.; Chaloupka, F.J. The effect of public policies and prices on youth smoking. South. Econ. J. 2004, 70, 796–815. [Google Scholar]
- Ross, H.; Chaloupka, F.J. The effect of cigarette prices on youth smoking. Health Econ. 2003, 12, 217–223. [Google Scholar]
- Sen, A.; Ariizumi, H. Cigarette Taxes, Youth Smoking, and Drugs: Evidence from Canada. 2008 Canadian Health Economics Study Group meeting, Fredericton, NB, Canada, 15–16 May 2008.
- Tauras, J.A.; Chaloupka, F.J.; Farrelly, M.C.; Giovino, G.A.; Wakefield, M.; Johnston, L.D.; O’Malley, P.M.; Kloska, D.D.; Pechacek, T.F. State tobacco control spending and youth smoking. Am. J. Public Health 2005, 95, 338–344. [Google Scholar]
- Thomson, C.C.; Fisher, L.B.; Winickoff, J.P. State tobacco excise taxes and adolescent smoking behaviors in the United States. J. Public Health Manag. Pract. 2004, 10, 490–496. [Google Scholar]
- Wakefield, M.; Chaloupka, F. Effectiveness of comprehensive tobacco control programmes in reducing teenage smoking in the USA. Tob. Control 2000, 9, 177–186. [Google Scholar]
- Waller, B.; Cohen, J.E.; Ashley, M.J. Youth attitudes towards tobacco control: A preliminary assessment. Chron. Dis. Can. 2004, 25, 97–100. [Google Scholar]
- Wasserman, J.; Manning, W.G.; Newhouse, J.P.; Winkler, J.D. The effects of excise taxes and regulations on cigarette smoking. J. Health Econ. 1991, 10, 43–64. [Google Scholar]
- Emery, S.; Gilpin, E.A.; White, M.M.; Pierce, J.P. How adolescents get their cigarettes: Implications for policies on access and price. J. Natl. Cancer Inst. 1999, 91, 184–186. [Google Scholar]
- Powell, L.; Tauras, J.; Ross, H. The importance of peer effects, cigarette prices, and tobacco control policies for youth smoking behavior. J. Health Econ. 2005, 24, 950–968. [Google Scholar]
- Czart, C.; Pacula, R.L.; Chaloupka, F.J.; Wechsler, H. The impact of prices and control policies on cigarette smoking among college students. Contemp. Econ. Pol. 2001, 19, 135–149. [Google Scholar]
- Sloan, F.A.; Trogdon, J.F. The impact of the master settlement agreement on cigarette consumption. J. Pol. Anal. Manag. 2004, 3, 843–855. [Google Scholar]
- Tauras, J.A.; Markowitz, S.; Cawley, J. Tobacco control policies and youth smoking: Evidence from a new era. In Advances in Health Economics and Health Services Research Volume 16– Substance Use: Individual Behavior, Social Interactions, Markets and Politics; Lingren, B., Grossman, M., Eds.; Elsevier: Amsterdam, The Netherlands, 2005. [Google Scholar]
- Tauras, J.A.; Chaloupka, F.J. Price, Clean Indoor Air Laws, and Cigarette Smoking: Evidence from Longitudinal Data for Young Adults; Working Paper No. 6937; National Bureau of Economic Research: Cambridge, MA, USA, 1999. [Google Scholar]
- U.S. Office of Smoking and Health. Responses to increases in cigarette prices by race/ethnicity, income and age groups—US, 1976–1993. MMWR 1998, 47, 605–609.
- DeCicca, P.; Kenkel, D.S.; Donald, S.; Mathios, A. The fires aren’t out yet: Higher taxes and young adult smoking. In Advances in Health Economics and Health Services Research; Lindgren, B., Grossman, M., Eds.; Emerald Group Publishing Limited: Bingley, UK, 2005; pp. 293–312. [Google Scholar]
- Tauras, J.A. Can public policy deter smoking escalation among young adults? J. Pol. Anal. Manag. 2005, 24, 771–784. [Google Scholar]
- Tauras, J.A.; Chaloupka, F.J. Determinants of smoking cessation: An analysis of young adult men and women. In The Economics of Substance Use and Abuse: The Experience of Developed Countries and Lessons for Developing Countries; Grossman, M., Hsieh, C.-R., Eds.; Edward Elgar Publishing Limited: Cheltenham, UK, 2001; pp. 337–364. [Google Scholar]
- Zhang, B.; Cohen, J.; Ferrence, R.; Rehm, J. The impact of tobacco tax cuts on smoking initiation among Canadian young adults. Am. J. Prev. Med. 2006, 30, 474–479. [Google Scholar]
- Colman, G.J.; Remler, D.K. Vertical equity consequences of very high cigarette tax increases: If the poor are the ones smoking, how could cigarette tax increases be progressive? J. Pol. Anal. Manag. 2008, 27, 376–400. [Google Scholar]
- Emery, S.; Ake, C.F.; Navarro, A.M.; Kaplan, R.M. Simulated effect of tobacco tax variation on Latino health in California. Am. J. Prev. Med. 2001, 21, 278–283. [Google Scholar]
- Farrelly, M.C.; Bray, J.W.; Pechacek, T.; Woollery, T. Response by adults to increases in cigarette prices by sociodemographic characteristics. South. Econ. J. 2001, 68, 156–165. [Google Scholar]
- Gruber, J.; Sen, A.; Stabile, M. Estimating price elasticities when there is smuggling: The sensitivity of smoking to price in Canada. J. Health Econ. 2003, 22, 821–842. [Google Scholar]
- Jha, P.; Musgrove, P.; Chaloupka, F.J.; Yach, D. Story on smoking and poor people is incomplete. BMJ 2001, 323, 1070. [Google Scholar]
- Levy, D.T.; Mumford, E.A.; Compton, C. Tobacco control policies and smoking in a population of low education women, 1992–2002. J. Epidemiol. Community Health 2006, 60 Suppl 2, 20–26. [Google Scholar]
- Thomas, S.; Fayter, D.; Misso, K.; Ogilvie, D.; Petticrew, M.; Sowden, A.; Whitehead, M.; Worthy, G. Population tobacco control interventions and their effects on social inequalities in smoking: systematic review. Tob. Control 2008. [Google Scholar] [CrossRef]
- Townsend, J.; Roderick, P.; Cooper, J. Cigarette smoking by socioeconomic group, sex, and age: Effects of price, income, and health publicity. BMJ 1994, 309, 923–927. [Google Scholar]
- Townsend, J.L. Cigarette tax, economic welfare and social class patterns of smoking. Appl. Econ. 1987, 19, 355–365. [Google Scholar]
- Franks, P.; Jerant, A.F.; Leigh, J.P.; Lee, D.; Chiem, A.; Lewis, I.; Lee, S. Cigarette prices, smoking, and the poor: Implications of recent trends. Am. J. Public Health 2007, 97, 1873–1877. [Google Scholar]
- Gospodinov, N.; Irvine, I. Tobacco taxes and regressivity. J. Health Econ. 2009, 28, 375–384. [Google Scholar]
- Lance, P.M.; Akin, J.S.; Dow, W.H.; Loh, C.P. Is cigarette smoking in poorer nations highly sensitive to price? Evidence from Russia and China. J. Health Econ. 2004, 23, 173–189. [Google Scholar]
- Wiltshire, S.; Bancroft, A.; Amos, A.; Parry, O. “They’re doing people a service”—Qualitative study of smoking, smuggling, and social deprivation. BMJ 2001, 323, 203–207. [Google Scholar]
- Kamin, D. Justifying the Tobacco Tax; Swarthmore College: Swarthmore, PA, USA, 2002. Available online: http://www.swarthmore.edu/x10949.xml accessed on 16 September 2008.
- Warner, K.E. The economics of tobacco: Myths and realities. Tob. Control 2000, 9, 78–89. [Google Scholar]
- Wilson, N.; Thomson, G. Tobacco taxation and public health: Ethical problems, policy responses. Soc. Sci. Med 2005, 61, 649–659. [Google Scholar]
- Wilson, N.; Thomson, G.; Tobias, M.; Blakely, T. How much downside? Quantifying the relative harm from tobacco taxation. J. Epidemiol. Community Health 2004, 58, 451–454. [Google Scholar]
- Tekin, E.; Mocan, N.; Liang, L. Do adolescents with emotional or behavioral problems respond to cigarette prices? South. Econ. J. 2009, 76, 67–85. [Google Scholar]
- Levy, D.T.; Romano, E.; Mumford, E. The relationship of smoking cessation to sociodemographic characteristics, smoking intensity, and tobacco control policies. Nicotine Tob. Res. 2005, 7, 387–396. [Google Scholar]
- Greaves, L.; Johnson, J.; Bottorff, J.; Kirkland, S.; Jategaonkar, N.; McGowan, M.; McCullough, L.; Battersby, L. What are the effects of tobacco policies on vulnerable populations: A better practice review. Can. J. Public Health 2006, 97, 310–315. [Google Scholar]
- Taylor, A.J.; Langdon, M.; Campion, P. Smuggled tobacco, deprivation and addiction. Eur. J. Public Health 2005, 15, 399–403. [Google Scholar]
- Callaghan, R.C.; Tavares, J.; Taylor, L. Another example of an illicit cigarette market: A study of psychiatric patients in Toronto, Ontario. Letter to the Editor. Am. J. Public Health 2008, 98, 4–5. [Google Scholar]
- Jha, P. Death and Tobacco Taxes; Project Syndicate: New York, NY, USA, 2007. Available online: http://www.project-syndicate.org accessed on 1 December 2008.
Subpopulation size and smoking prevalence (2006–2008) [28
Subpopulation size and smoking prevalence (2006–2008) [28–32].
|Subpopulation||% of Total population||Smoking prevalence (%)|
|General Population||33,212,696 (total population)||303,824,640 (total population)||19||20.8|
|Heavy and/or Long-term Smokers||**||**||**||**|
Impact of increased taxation and price on youth smoking behavior.
Impact of increased taxation and price on youth smoking behavior.
|Results||Initiation||Cessation||Stages of smoking uptake||Participation (prevalence)||Consumption (quantity smoked by smokers)|
|Yes, reduces youth smoking||7||5||3||23||17|
|No, does not reduce youth smoking||9||3||0||4||2|
|It depends—reduces smoking in some cases||6||2||2||4||1|
Impact of increased taxation and price on young adult smoking behavior.
Impact of increased taxation and price on young adult smoking behavior.
|Results||Initiation||Cessation||Stages of smoking uptake||Participation (prevalence)||Consumption (quantity smoked by smokers)|
|Yes, reduces young adult smoking||1||4||1||9||10|
|No, does not reduce young adult smoking||3||1||0||1||0|
|Total # Studies||4||5||1||10||10|
Conduct further studies on the impact of cigarette price on smoking initiation
Evaluate the distinctions and differential impacts of higher cigarette prices on subsets of youth—e.g., by gender, income, school status, age (younger vs. older)
Conduct research on the importance of other determinants of youth and young adult smoking behavior in addition to cigarette price (e.g., peer and parental influence)
Combine price increases with a comprehensive tobacco prevention and control program for maximum effectiveness.
Accompany increased prices with other tobacco control measures, specific to low SES populations, e.g., expanding/improving smoking cessation resources and providing ways to mitigate hardships due to higher taxes, such as free nicotine replacement therapies.
Heavy and/or Long-Term Smokers
Examine the effectiveness of increasing the price of cigarettes as a policy tool for reducing smoking among Aboriginal people.
Conduct research on the following topics: impediments to using taxation as a tobacco control policy; effective processes for implementing taxes on tobacco products; impact of taxation and price of cigarettes on smoking behavior of those living on-reserve and off-reserve, and in reducing contraband sales.
© 2011 by the authors; licensee MDPI, Basel, Switzerland This article is an open-access article distributed under the terms and conditions of the Creative Commons Attribution license (http://creativecommons.org/licenses/by/3.0/).