Impact of state excise tax on the trend of smoking prevalence in the United States from 1996 to 2011

Background Increases in cigarettes taxes are widely regarded as a highly effective strategy for reducing tobacco use and its consequences, but surprisingly few studies have empirically measured the impact of this fiscal policy on smoking rates.;Methods This study exploits variation in state level tobacco taxes over a fifteen year period to examine the relationship between increases in tobacco taxes and changes in state level smoking prevalence controlling for other factors that may impact smoking prevalence. The study draws on publicly available data from the Centers for Disease Control (CDC) and the United States Census Bureau to construct a longitudinal dataset of cigarette excise taxes, smoking prevalence and key demographic characteristics from 1996 to 2011. Using repeat measure generalized estimating equations, the study estimates the relationship between increases in state cigarette excise taxes and state smoking prevalence controlling for race, poverty, median household income, education and other smoke free indoor air regulations.;Result The analysis found that increases in state cigarette excise taxes significantly predicted reductions in state smoking prevalence over the period 1996-2011 net of other demographic characteristics or smoking restriction policies. Specifically, we found that for every 1;Conclusions The findings from this study suggest that significant increases in cigarette taxes are an effective smoking control strategy independent of other policies (smoking restrictions) and lead to substantial changes in health behaviors that can result in improvements in public health. Whether fiscal policies will work the same for other public health conditions such as obesity remains to be seen, but the experience from smoking suggests that pricing policies are an effective means of influencing health behaviors and have the additional benefit of raising revenue for health promotion efforts. However, marginal taxes (<...