The relation between tobacco taxes and youth and young adult smoking: what happened following the 2009 U.S. federal tax increase on cigarettes?

BACKGROUND: On April 1, 2009, the federal government raised cigarette taxes from $0.39 to $1.01 per pack. This study examines the impact of this increase on a range of smoking behaviors among youth aged 12 to 17 and young adults aged 18 to 25. METHODS: Data from the 2002-2011 National Survey on Drug Use and Health (NSDUH) were used to estimate the impact of the tax increase on five smoking outcomes: (1) past year smoking initiation, (2) past-month smoking, (3) past year smoking cessation, (4) number of days cigarettes were smoked during the past month, and (5) average number of cigarettes smoked per day. Each model included individual and state-level covariates and other tobacco control policies that coincided with the tax increase. We examined the impact overall and by race and gender. RESULTS: The odds of smoking initiation decreased for youth after the tax increase (odds ratio (OR)=0.83, p<0.0001). The odds of past-month smoking also decreased (youth: OR=0.83, p<0.0001; young adults: OR=0.92, p<0.0001), but the odds of smoking cessation remained unchanged. Current smokers smoked on fewer days (youth: coefficient=-0.97, p=0.0001; young adults: coefficient=-0.84, p<0.0001) and smoked fewer cigarettes per day after the tax increase (youth: coefficient=-1.02, p=0.0011; young adults: coefficient=-0.92, p<0.0001). CONCLUSIONS: The 2009 federal cigarette tax increase was associated with a substantial reduction in smoking among youths and young adults. The impact of the tax increase varied across male, female, white and black subpopulations.