PUBLIC HEALTH POLICY BRIEFS
Higher Price, Fewer Packs: Evaluating a Tobacco Tax Increase With Cigarette Sales Data In 2013, Minnesota increased cigarette taxes by $1.75, the largest US state increase since 2000. We obtained convenience store data of cigarette sales from January 2012 to December 2013 from the Nielsen Company. Analysis revealed significantly greater year-toyear reductions in numbers of packs purchased during posttax (–12.1%) than pretax (–3.2%; P < .001) periods. The results provide contemporary evidence that, despite reduced prevalence and increased tobacco control efforts, tax increases remain an effective tobacco control strategy. (Am J Public Health. 2015;105:e5–e8. doi: 10.2105/AJPH.2014.302438)
Michael S. Amato, PhD, Raymond G. Boyle, PhD, and Betsy Brock, MPH
TOBACCO IS THE GREATEST cause of preventable death in the United States, leading to the premature deaths of more than 480 000 Americans annually.1 Tobacco control strategies to reduce that harm include restrictions on marketing,2 smoke-free policies,3 persuasion and education through mass media,4 assisting smokers to quit,5 and increasing tobacco taxes.6 Collectively these efforts have significantly reduced smoking rates, with prevalence declining from about 42.0% in 1964 to about 18.0% today.1 Previous studies of the effects of past tobacco price increases have found a price elasticity of demand approximately equal to 0.4; that is, a 10.0% increase in the price of cigarettes has historically been associated with a 4.0% reduction in demand for cigarettes.6 However, in a climate of decreased smoking prevalence, policymakers may question whether estimates from earlier eras remain applicable. For example, a sustained comprehensive tobacco control program in Minnesota has reduced adult smoking prevalence from 22.1% in 1999 to 16.1% in 2010.7 Those individuals who continue smoking in 2014, despite statewide comprehensive indoor bans and strong antismoking norms, may differ in important ways from former smokers who have quit, potentially including their responsiveness to price increases. On July 1, 2013, Minnesota increased the combined cigarette excise and sales tax from $1.60 to $3.35 per pack, providing an opportunity for additional study of
March 2015, Vol 105, No. 3 | American Journal of Public Health
the impact of tobacco tax increases. The increase took Minnesota from having the 27th highest US state cigarette excise tax to the 7th highest and was the largest instantaneous state increase on tobacco taxes in the United States since 2000.8 We investigated smokers’ behavioral responses to the tax increase, as measured through changes in sales of cigarette packs. We obtained the data from the Nielsen Company convenience store tracking service, which has been used to evaluate other tobacco control policies, including minimum pricing laws,9 restrictions on locations where cigarettes may be sold10 or advertised,11 and the descriptor ban on advertising “light” cigarettes.12 We used sales data to test the hypothesis that consumption of cigarettes would decrease after the tax increase was implemented.
METHODS The data represent a panel of 403 convenience stores across the Minneapolis market area, which serve 4.5 million people in 39 Minnesota and 8 Wisconsin counties. We purchased 2 years of cigarette sales data, those collected from January 2012 to December 2013. Product data included average price and total packs sold over 4-week periods and were keyed by universal price code. We conducted all analyses with R, version 3.1.1, an open source statistics program published and maintained by the Comprehensive R Archive Network.
The products we selected for inclusion in our analysis met the following 2 criteria: (1) they were sold as individual packs of 20 cigarettes and (2) at least 1 pack was sold in all periods. With these criteria, we selected 296 products, which comprised 92% of total packs sold in the purchased data set. We considered permutations of brands and varieties to be distinct products. We visually inspected the histogram of pretax product prices for peaks to allow a data-driven method for separating products into pricing tiers. We calculated average preincrease and postincrease pack prices as weighted means over all products, with prices adjusted to December 2013 dollars using the consumer price index published by the Bureau of Labor Statistics. We determined each product’s contribution by its total sales. Nielsen Company data are collected at the level of stores but are reported in aggregate, which prevented us from estimating variability at the store level and thereby presented a challenge for inferential testing. Previous studies have dealt with that challenge by analyzing across market areas9 or periods11; we adopted the latter strategy. First, we calculated yearto-year difference scores for each 4-week period as the difference of packs sold in 2013 minus packs sold in 2012. Then, we used analysis of variance to test whether difference scores in posttax periods were greater than were difference scores in pretax periods. Although classical interpretation of inferential statistics as the likelihood that sample estimates generalize to
Amato et al. | Peer Reviewed | Public Health Policy Briefs | e5
PUBLIC HEALTH POLICY BRIEFS
a larger population is inappropriate for these data, P values are appropriately interpreted as testing the likelihood of obtaining the
observed posttax difference scores on the basis only of the pretax difference scores, absent an intervening event.
RESULTS Our inspection of the histogram of pretax product prices (Figure 1)
4
2012 2013
3
Millions of Packs Sold
a
January
July
4 3
Millions of Packs Sold
b
2012 2013
January
July
550 350
450
2012 2013
250
Thousands of Packs Sold
December
Month
c
January
July
December
Month
5 10 15 20
d
Discount 43% of sales
Premium 51% of sales
Super−Premium 6% of sales
DISCUSSION
0
No. of Products at Each Price
December
Month
suggested that product prices clustered around 3 industry pricing tiers: discount ($4.59---$5.50; 43.0% of packs sold over all periods), premium ($5.51---$6.35; 51.0% of packs sold), and superpremium ($6.36---$8.11; 6.0% of packs sold). We categorized products into tiers on the basis of their observed price for the remainder of the analyses. Inflation-adjusted, weighted mean pack prices were $5.77 pretax and $7.51 posttax, indicating a $1.74 (30.2%) increase in total price. Numbers of packs sold are presented in Table 1. Across all tiers, year-to-year cigarette consumption decreased in periods following the tax hike (mean difference = –928 000 packs) more rapidly than in periods preceding it (mean difference = –231 000 packs; F(1,11) = 40.15; P < .001). We observed similar patterns within each tier. Total July through December 2013 sales in Minnesota convenience stores decreased 12.14% compared with the same period in 2012. As seen in Figure 1, year-to-year differences in all tiers were greatest immediately following the tax increase (discount = –555 695; premium = –740 754; superpremium = –86 671). Following a sharp initial drop in July 2013, consumption in all tiers rebounded through early fall before turning downward again but did not recover to 2012 levels in any subsequent periods.
4.5
5.0
5.5
6.0
6.5
7.0
7.5
8.0
Pretax Price, $
FIGURE 1—Total packs of cigarettes sold in convenience stores before and after the July 1, 2013, tax increase for (a) discount cigarettes ($4.59–$5.50), (b) premium cigarettes ($5.51–$6.35), (c) superpremium cigarettes ($6.35–$8.11), and (d) all products: Minnesota and Wisconsin.
e6 | Public Health Policy Briefs | Peer Reviewed | Amato et al.
We found a substantial effect of Minnesota’s cigarette tax increase of $1.75 in 2013. Moreover, decreases in cigarette consumption were not ephemeral but persisted 6 months later. These findings are consistent with current models that consistently
American Journal of Public Health | March 2015, Vol 105, No. 3
PUBLIC HEALTH POLICY BRIEFS
TABLE 1—Total Packs of Cigarettes Sold in Convenience Stores by Price Tier Before and After the July 1, 2013, Tax Increase: Minnesota and Wisconsin Sales 2012
Sales 2013
% Change Total Sales
Mean Change Each Period (95% CI)
20 996 20 235
21 181 17 632
0.9 –12.9
26 (–58, –111) 434 (–518, –349)
Jan–June
26 711
25 172
–5.8
–220 (–305, –135)
July–Dec
22 956
20 342
–11.4
–436 (–520, –351)
Cigarette Type Discount Jan–June July–Dec Premium
Superpremium Jan–June
3067
2 806
–8.5
–37 (–122, 47)
July–Dec
2652
2 303
–13.2
–58 (–143, 26)
Overall Jan–June
50 774
49 159
–3.2
–231 (–315, –146)
July–Dec
45 843
40 276
–12.1
–928 (–1012, –843)
F
P value
F(1,11) = 52.55
< .001
F(1,11) = 4.20
.07
F(1,11) = 6.30
.03
F(1,11) = 40.15
< .001
Contributors
although statistically appropriate, suffered from low power because of a relatively small number of observations. Nonetheless, an effect was detected. It is not clear why consumption of premium cigarettes in the first halves of 2012 and 2013 was so divergent whereas consumption of discount cigarettes was not. During the first half of 2013, the proposed tax increase was intensely discussed in the media. One possibility is that smokers of premium cigarettes may have more disposable income or greater exposure to media than do smokers of discount cigarettes; as a result, premium smokers may have been more motivated or able to stock up before the tax took effect. Additionally, sales data were limited to convenience stores. We did not capture potential sales increases at tobacco outlets on American Indian reservations, on Internet sources, or at other types of stores. Future research measuring change in the distribution of sources where people purchase cigarettes is necessary to know the true impact of the tax increase.
March 2015, Vol 105, No. 3 | American Journal of Public Health
M. S. Amato and R. G. Boyle contributed to the concept, design, analysis, and primary writing of the article. B. Brock contributed to the concept and design and review of the article.
Acknowledgments
Note. CI = confidence interval. We obtained data in 4-wk periods. Sales values and mean change scores represent thousands of packs sold.
find a reduction in demand for cigarettes following a price increase.13 Although we did not calculate price elasticity of demand, the observed ratio of reduced consumption to increased price (12.1%:30.2% = 0.40) is consistent with estimated price elasticity of demand obtained in other studies.6,14 We have added to previous research on the impact of tobacco tax increases in several ways. First, the tax increase was the largest in more than a decade. Second, high temporal resolution of the data provides information about smokers’ behavioral responses over time, which are tightly anchored to the timing of the tax increase. Third, the tax increase (and behavioral response) occurred in the absence of other large tobacco control changes. Interpretation of these results faces several limitations. Limitations inherent to the Nielsen data, in particular aggregate reporting of consumption from all stores in the panel, presented a challenge for inferential testing. The analysis methodology we employed,
Minneapolis, MN. Betsy Brock is with the Association for Nonsmokers—Minnesota, Saint Paul. Correspondence should be sent to Michael S. Amato, PhD, Postdoctoral Research Fellow, Two Appletree Square, Suite 400, 8011 34th Ave S, ClearWay Minnesota, Minneapolis, MN 55425 (e-mail: mamato@ clearwaymn.org). Reprints can be ordered at http://www.ajph.org by clicking the “Reprints” link. This article was accepted October 28, 2014.
The inclusion of stores from the neighboring state of Wisconsin adds noise to the data but also strengthens validity by capturing cross-border sales increases, although posttax prices in the 2 states were roughly equal. Finally, the data offer no information about the individuals purchasing cigarettes, their demographic characteristics, or changes specific to subpopulations. However, these results do provide evidence that the tax increase significantly reduced cigarette sales at convenience stores, the most common source for cigarettes nationwide in 2012 (63% of smokers purchase cigarettes from convenience stores).15 In 2013, Minnesota was 1 of only 3 states to increase tobacco excise taxes. Although the current political climate in many states is prohibitive of new taxes, the evidence suggests that raising the price of tobacco remains among the most powerful tools in the tobacco control toolbox. j
About the Authors Michael S. Amato and Raymond G. Boyle are with ClearWay Minnesota,
ClearWay Minnesota was founded as a private nonprofit corporation in accordance with the Ramsey County district court’s consent judgment of May 8, 1998, in State by Humphrey, et al. v. Philip Morris, Incorporated, et al., Ramsey County District Court File No. C 1-94-8565 (August 1994). All funding for ClearWay Minnesota and this research was part of the court’s consent judgment. The authors are grateful to Kelvin Choi, Barb Schillo, Michael Fiore, and Bruce Christiansen for their assistance with drafts of this article.
Human Participant Protection Institutional review board approval was not required, as this study did not include human participants.
References 1. US National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. The health consequences of smoking— 50 years of progress: a report of the surgeon general. 2014. Available at: http://www.ncbi.nlm.nih.gov/books/ NBK179276. Accessed August 14, 2014. 2. Henriksen L. Comprehensive tobacco marketing restrictions: promotion, packaging, price and place. Tob Control. 2012;21(2):147---153. 3. Centers for Disease Control and Prevention. State smoke-free laws for worksites, restaurants, and bars—United States, 2000---2010. MMWR Morb Mortal Wkly Rep. 2011;60(15):472---475. 4. McAfee T, Davis KC, Alexander RL Jr, Pechacek TF, Bunnell R. Effect of the first federally funded US antismoking national media campaign. Lancet. 2013;382(9909):2003---2011.
Amato et al. | Peer Reviewed | Public Health Policy Briefs | e7
PUBLIC HEALTH POLICY BRIEFS
5. Stead LF, Hartmann-Boyce J, Perera R, Lancaster T. Telephone counselling for smoking cessation. Cochrane Database Syst Rev. 2013;8:CD002850. 6. Chaloupka FJ, Yurekli A, Fong GT. Tobacco taxes as a tobacco control strategy. Tob Control. 2012;21(2):172---180. 7. Centers for Disease Control and Prevention. Decrease in smoking prevalence—Minnesota, 1999---2010. MMWR Morb Mortal Wkly Rep. 2011;60(5):138---141. 8. Boonn A. Cigarette tax increases by state per year 2000---2014. 2014. Available at: http://www.tobaccofreekids.org/ research/factsheets/pdf/0275.pdf. Accessed December 12, 2014. 9. Tynan MA, Ribisl KM, Loomis BR. Impact of cigarette minimum price laws on the retail price of cigarettes in the USA. Tob Control. 2013;22(e1):e78---e85. 10. Seidenberg AB, Behm I, Rees VW, Connolly GN. Cigarette sales in pharmacies in the USA (2005---2009). Tob Control. 2012;21(5):509---510. 11. Quinn C, Lewis S, Edwards R, McNeill A. Economic evaluation of the removal of tobacco promotional displays in Ireland. Tob Control. 2011;20(2):151--155. 12. Behm I, Sokol NA, Kennedy RD, Rees VW, Connolly GN. Population use, sales, and design: a multidimensional assessment of “light” cigarettes in the United States, 2009. Am J Public Health. 2013;103(3):e93---e99. 13. Levy DT, Bauer JE, Lee HR. Simulation modeling and tobacco control: creating more robust public health policies. Am J Public Health. 2006;96(3):494--498. 14. Centers for Disease Control and Prevention. Cigarette prices and smoking prevalence after a tobacco tax increase— Turkey, 2008 and 2012. MMWR Morb Mortal Wkly Rep. 2014;63(21):457--461. 15. Yu A. Most smokers don’t buy their cigarettes at CVS. 2014. Available at: http://www.npr.org/blogs/health/2014/ 02/05/272105414/most-smokersdont-buy-their-cigarettes-at-cvs. Accessed August 12, 2014.
e8 | Public Health Policy Briefs | Peer Reviewed | Amato et al.
American Journal of Public Health | March 2015, Vol 105, No. 3
Higher Price, Fewer Packs: Evaluating a Tobacco Tax Increase With Cigarette Sales Data In 2013, Minnesota increased cigarette taxes by $1.75, the largest US state increase since 2000. We obtained convenience store data of cigarette sales from January 2012 to December 2013 from the Nielsen Company. Analysis revealed significantly greater year-toyear reductions in numbers of packs purchased during posttax (–12.1%) than pretax (–3.2%; P < .001) periods. The results provide contemporary evidence that, despite reduced prevalence and increased tobacco control efforts, tax increases remain an effective tobacco control strategy. (Am J Public Health. 2015;105:e5–e8. doi: 10.2105/AJPH.2014.302438)
Michael S. Amato, PhD, Raymond G. Boyle, PhD, and Betsy Brock, MPH
TOBACCO IS THE GREATEST cause of preventable death in the United States, leading to the premature deaths of more than 480 000 Americans annually.1 Tobacco control strategies to reduce that harm include restrictions on marketing,2 smoke-free policies,3 persuasion and education through mass media,4 assisting smokers to quit,5 and increasing tobacco taxes.6 Collectively these efforts have significantly reduced smoking rates, with prevalence declining from about 42.0% in 1964 to about 18.0% today.1 Previous studies of the effects of past tobacco price increases have found a price elasticity of demand approximately equal to 0.4; that is, a 10.0% increase in the price of cigarettes has historically been associated with a 4.0% reduction in demand for cigarettes.6 However, in a climate of decreased smoking prevalence, policymakers may question whether estimates from earlier eras remain applicable. For example, a sustained comprehensive tobacco control program in Minnesota has reduced adult smoking prevalence from 22.1% in 1999 to 16.1% in 2010.7 Those individuals who continue smoking in 2014, despite statewide comprehensive indoor bans and strong antismoking norms, may differ in important ways from former smokers who have quit, potentially including their responsiveness to price increases. On July 1, 2013, Minnesota increased the combined cigarette excise and sales tax from $1.60 to $3.35 per pack, providing an opportunity for additional study of
March 2015, Vol 105, No. 3 | American Journal of Public Health
the impact of tobacco tax increases. The increase took Minnesota from having the 27th highest US state cigarette excise tax to the 7th highest and was the largest instantaneous state increase on tobacco taxes in the United States since 2000.8 We investigated smokers’ behavioral responses to the tax increase, as measured through changes in sales of cigarette packs. We obtained the data from the Nielsen Company convenience store tracking service, which has been used to evaluate other tobacco control policies, including minimum pricing laws,9 restrictions on locations where cigarettes may be sold10 or advertised,11 and the descriptor ban on advertising “light” cigarettes.12 We used sales data to test the hypothesis that consumption of cigarettes would decrease after the tax increase was implemented.
METHODS The data represent a panel of 403 convenience stores across the Minneapolis market area, which serve 4.5 million people in 39 Minnesota and 8 Wisconsin counties. We purchased 2 years of cigarette sales data, those collected from January 2012 to December 2013. Product data included average price and total packs sold over 4-week periods and were keyed by universal price code. We conducted all analyses with R, version 3.1.1, an open source statistics program published and maintained by the Comprehensive R Archive Network.
The products we selected for inclusion in our analysis met the following 2 criteria: (1) they were sold as individual packs of 20 cigarettes and (2) at least 1 pack was sold in all periods. With these criteria, we selected 296 products, which comprised 92% of total packs sold in the purchased data set. We considered permutations of brands and varieties to be distinct products. We visually inspected the histogram of pretax product prices for peaks to allow a data-driven method for separating products into pricing tiers. We calculated average preincrease and postincrease pack prices as weighted means over all products, with prices adjusted to December 2013 dollars using the consumer price index published by the Bureau of Labor Statistics. We determined each product’s contribution by its total sales. Nielsen Company data are collected at the level of stores but are reported in aggregate, which prevented us from estimating variability at the store level and thereby presented a challenge for inferential testing. Previous studies have dealt with that challenge by analyzing across market areas9 or periods11; we adopted the latter strategy. First, we calculated yearto-year difference scores for each 4-week period as the difference of packs sold in 2013 minus packs sold in 2012. Then, we used analysis of variance to test whether difference scores in posttax periods were greater than were difference scores in pretax periods. Although classical interpretation of inferential statistics as the likelihood that sample estimates generalize to
Amato et al. | Peer Reviewed | Public Health Policy Briefs | e5
PUBLIC HEALTH POLICY BRIEFS
a larger population is inappropriate for these data, P values are appropriately interpreted as testing the likelihood of obtaining the
observed posttax difference scores on the basis only of the pretax difference scores, absent an intervening event.
RESULTS Our inspection of the histogram of pretax product prices (Figure 1)
4
2012 2013
3
Millions of Packs Sold
a
January
July
4 3
Millions of Packs Sold
b
2012 2013
January
July
550 350
450
2012 2013
250
Thousands of Packs Sold
December
Month
c
January
July
December
Month
5 10 15 20
d
Discount 43% of sales
Premium 51% of sales
Super−Premium 6% of sales
DISCUSSION
0
No. of Products at Each Price
December
Month
suggested that product prices clustered around 3 industry pricing tiers: discount ($4.59---$5.50; 43.0% of packs sold over all periods), premium ($5.51---$6.35; 51.0% of packs sold), and superpremium ($6.36---$8.11; 6.0% of packs sold). We categorized products into tiers on the basis of their observed price for the remainder of the analyses. Inflation-adjusted, weighted mean pack prices were $5.77 pretax and $7.51 posttax, indicating a $1.74 (30.2%) increase in total price. Numbers of packs sold are presented in Table 1. Across all tiers, year-to-year cigarette consumption decreased in periods following the tax hike (mean difference = –928 000 packs) more rapidly than in periods preceding it (mean difference = –231 000 packs; F(1,11) = 40.15; P < .001). We observed similar patterns within each tier. Total July through December 2013 sales in Minnesota convenience stores decreased 12.14% compared with the same period in 2012. As seen in Figure 1, year-to-year differences in all tiers were greatest immediately following the tax increase (discount = –555 695; premium = –740 754; superpremium = –86 671). Following a sharp initial drop in July 2013, consumption in all tiers rebounded through early fall before turning downward again but did not recover to 2012 levels in any subsequent periods.
4.5
5.0
5.5
6.0
6.5
7.0
7.5
8.0
Pretax Price, $
FIGURE 1—Total packs of cigarettes sold in convenience stores before and after the July 1, 2013, tax increase for (a) discount cigarettes ($4.59–$5.50), (b) premium cigarettes ($5.51–$6.35), (c) superpremium cigarettes ($6.35–$8.11), and (d) all products: Minnesota and Wisconsin.
e6 | Public Health Policy Briefs | Peer Reviewed | Amato et al.
We found a substantial effect of Minnesota’s cigarette tax increase of $1.75 in 2013. Moreover, decreases in cigarette consumption were not ephemeral but persisted 6 months later. These findings are consistent with current models that consistently
American Journal of Public Health | March 2015, Vol 105, No. 3
PUBLIC HEALTH POLICY BRIEFS
TABLE 1—Total Packs of Cigarettes Sold in Convenience Stores by Price Tier Before and After the July 1, 2013, Tax Increase: Minnesota and Wisconsin Sales 2012
Sales 2013
% Change Total Sales
Mean Change Each Period (95% CI)
20 996 20 235
21 181 17 632
0.9 –12.9
26 (–58, –111) 434 (–518, –349)
Jan–June
26 711
25 172
–5.8
–220 (–305, –135)
July–Dec
22 956
20 342
–11.4
–436 (–520, –351)
Cigarette Type Discount Jan–June July–Dec Premium
Superpremium Jan–June
3067
2 806
–8.5
–37 (–122, 47)
July–Dec
2652
2 303
–13.2
–58 (–143, 26)
Overall Jan–June
50 774
49 159
–3.2
–231 (–315, –146)
July–Dec
45 843
40 276
–12.1
–928 (–1012, –843)
F
P value
F(1,11) = 52.55
< .001
F(1,11) = 4.20
.07
F(1,11) = 6.30
.03
F(1,11) = 40.15
< .001
Contributors
although statistically appropriate, suffered from low power because of a relatively small number of observations. Nonetheless, an effect was detected. It is not clear why consumption of premium cigarettes in the first halves of 2012 and 2013 was so divergent whereas consumption of discount cigarettes was not. During the first half of 2013, the proposed tax increase was intensely discussed in the media. One possibility is that smokers of premium cigarettes may have more disposable income or greater exposure to media than do smokers of discount cigarettes; as a result, premium smokers may have been more motivated or able to stock up before the tax took effect. Additionally, sales data were limited to convenience stores. We did not capture potential sales increases at tobacco outlets on American Indian reservations, on Internet sources, or at other types of stores. Future research measuring change in the distribution of sources where people purchase cigarettes is necessary to know the true impact of the tax increase.
March 2015, Vol 105, No. 3 | American Journal of Public Health
M. S. Amato and R. G. Boyle contributed to the concept, design, analysis, and primary writing of the article. B. Brock contributed to the concept and design and review of the article.
Acknowledgments
Note. CI = confidence interval. We obtained data in 4-wk periods. Sales values and mean change scores represent thousands of packs sold.
find a reduction in demand for cigarettes following a price increase.13 Although we did not calculate price elasticity of demand, the observed ratio of reduced consumption to increased price (12.1%:30.2% = 0.40) is consistent with estimated price elasticity of demand obtained in other studies.6,14 We have added to previous research on the impact of tobacco tax increases in several ways. First, the tax increase was the largest in more than a decade. Second, high temporal resolution of the data provides information about smokers’ behavioral responses over time, which are tightly anchored to the timing of the tax increase. Third, the tax increase (and behavioral response) occurred in the absence of other large tobacco control changes. Interpretation of these results faces several limitations. Limitations inherent to the Nielsen data, in particular aggregate reporting of consumption from all stores in the panel, presented a challenge for inferential testing. The analysis methodology we employed,
Minneapolis, MN. Betsy Brock is with the Association for Nonsmokers—Minnesota, Saint Paul. Correspondence should be sent to Michael S. Amato, PhD, Postdoctoral Research Fellow, Two Appletree Square, Suite 400, 8011 34th Ave S, ClearWay Minnesota, Minneapolis, MN 55425 (e-mail: mamato@ clearwaymn.org). Reprints can be ordered at http://www.ajph.org by clicking the “Reprints” link. This article was accepted October 28, 2014.
The inclusion of stores from the neighboring state of Wisconsin adds noise to the data but also strengthens validity by capturing cross-border sales increases, although posttax prices in the 2 states were roughly equal. Finally, the data offer no information about the individuals purchasing cigarettes, their demographic characteristics, or changes specific to subpopulations. However, these results do provide evidence that the tax increase significantly reduced cigarette sales at convenience stores, the most common source for cigarettes nationwide in 2012 (63% of smokers purchase cigarettes from convenience stores).15 In 2013, Minnesota was 1 of only 3 states to increase tobacco excise taxes. Although the current political climate in many states is prohibitive of new taxes, the evidence suggests that raising the price of tobacco remains among the most powerful tools in the tobacco control toolbox. j
About the Authors Michael S. Amato and Raymond G. Boyle are with ClearWay Minnesota,
ClearWay Minnesota was founded as a private nonprofit corporation in accordance with the Ramsey County district court’s consent judgment of May 8, 1998, in State by Humphrey, et al. v. Philip Morris, Incorporated, et al., Ramsey County District Court File No. C 1-94-8565 (August 1994). All funding for ClearWay Minnesota and this research was part of the court’s consent judgment. The authors are grateful to Kelvin Choi, Barb Schillo, Michael Fiore, and Bruce Christiansen for their assistance with drafts of this article.
Human Participant Protection Institutional review board approval was not required, as this study did not include human participants.
References 1. US National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. The health consequences of smoking— 50 years of progress: a report of the surgeon general. 2014. Available at: http://www.ncbi.nlm.nih.gov/books/ NBK179276. Accessed August 14, 2014. 2. Henriksen L. Comprehensive tobacco marketing restrictions: promotion, packaging, price and place. Tob Control. 2012;21(2):147---153. 3. Centers for Disease Control and Prevention. State smoke-free laws for worksites, restaurants, and bars—United States, 2000---2010. MMWR Morb Mortal Wkly Rep. 2011;60(15):472---475. 4. McAfee T, Davis KC, Alexander RL Jr, Pechacek TF, Bunnell R. Effect of the first federally funded US antismoking national media campaign. Lancet. 2013;382(9909):2003---2011.
Amato et al. | Peer Reviewed | Public Health Policy Briefs | e7
PUBLIC HEALTH POLICY BRIEFS
5. Stead LF, Hartmann-Boyce J, Perera R, Lancaster T. Telephone counselling for smoking cessation. Cochrane Database Syst Rev. 2013;8:CD002850. 6. Chaloupka FJ, Yurekli A, Fong GT. Tobacco taxes as a tobacco control strategy. Tob Control. 2012;21(2):172---180. 7. Centers for Disease Control and Prevention. Decrease in smoking prevalence—Minnesota, 1999---2010. MMWR Morb Mortal Wkly Rep. 2011;60(5):138---141. 8. Boonn A. Cigarette tax increases by state per year 2000---2014. 2014. Available at: http://www.tobaccofreekids.org/ research/factsheets/pdf/0275.pdf. Accessed December 12, 2014. 9. Tynan MA, Ribisl KM, Loomis BR. Impact of cigarette minimum price laws on the retail price of cigarettes in the USA. Tob Control. 2013;22(e1):e78---e85. 10. Seidenberg AB, Behm I, Rees VW, Connolly GN. Cigarette sales in pharmacies in the USA (2005---2009). Tob Control. 2012;21(5):509---510. 11. Quinn C, Lewis S, Edwards R, McNeill A. Economic evaluation of the removal of tobacco promotional displays in Ireland. Tob Control. 2011;20(2):151--155. 12. Behm I, Sokol NA, Kennedy RD, Rees VW, Connolly GN. Population use, sales, and design: a multidimensional assessment of “light” cigarettes in the United States, 2009. Am J Public Health. 2013;103(3):e93---e99. 13. Levy DT, Bauer JE, Lee HR. Simulation modeling and tobacco control: creating more robust public health policies. Am J Public Health. 2006;96(3):494--498. 14. Centers for Disease Control and Prevention. Cigarette prices and smoking prevalence after a tobacco tax increase— Turkey, 2008 and 2012. MMWR Morb Mortal Wkly Rep. 2014;63(21):457--461. 15. Yu A. Most smokers don’t buy their cigarettes at CVS. 2014. Available at: http://www.npr.org/blogs/health/2014/ 02/05/272105414/most-smokersdont-buy-their-cigarettes-at-cvs. Accessed August 12, 2014.
e8 | Public Health Policy Briefs | Peer Reviewed | Amato et al.
American Journal of Public Health | March 2015, Vol 105, No. 3
