Tobacco control policies are egalitarian: A vulnerabilities perspective on clean indoor air laws, cigarette prices, and tobacco use disparities

Abstract

This study models independent associations of state or local strong clean indoor air laws and cigarette prices with current smoker status and consumption in a multilevel framework, including interactions with educational attainment, household income and race/ethnicity and the relationships of these policies to vulnerabilities in smoking behavior. Cross sectional survey data are employed from the February 2002 panel of the Tobacco Use Supplement of the Current Population Survey (54,024 individuals representing the US population aged 15 to 80). Nonlinear relationships between both outcome variables and the predictors were modeled. Independent associations of strong clean indoor air laws were found for current smoker status and consumption among current smokers. Cigarette price was found to have independent associations with both outcomes, an effect that saturated at higher prices. The odds ratio for smoking for the highest versus lowest price over the range where there was a price effect was 0.83. Average consumption declined over the range of effect of price on consumption. Neither policy varied in its effect by educational attainment, or household income. The association of cigarette price with reduced smoking participation and consumption was not found to vary with race/ethnicity. Population vulnerability in consumption appears to be structured by nonwhite race categories, but not at the state and county levels at which the policies we studied were enacted. Clean indoor air laws and price increases appear to benefit all socio-economic and race/ ethnic groups in our study equally in terms of reducing smoking participation and consumption.

Tobacco Smoking, Quitting, and Relapsing Among Adult Males in Mainland China: The China Seven Cities Study

“…In Australia, Europe , and the United States, several population-based strategies have been found to be effective in reducing the number of cigarettes smokers consume per day. This includes clean indoor air laws ( Dinno & Glantz, 2009 ;Eriksen & Cerak, 2008 ), media campaigns ( Bala, Strzeszynski, & Cahill, 2008 ;Messer et al, 2007 ;Vallone, Duke, Cullen, McCausland, & Allen, 2011 ), and increased taxation ( Dinno & Glantz, 2009 ). These strategies have also been associated with smokers being categorized in the later stages of the quitting continuum ( DiClemente et al, 1991 ;Dinno & Glantz, 2009 ;Messer, et al, 2007 ;Pierce, Farkas, & Gilpin, 1998 ;Vallone, et al, 2011 ).…”

The Effect of Five Key Variables on Cigarette Consumption in the Eight Most Developed Countries

“…Approximately 900 million smokers (84 percent of all smokers) live in developing and transitional economy countries, while only about 16 per cent live in developed countries, where cigarette consumption decreased significantly in recent decades. Jha and Chaloupka (1999) refer that "in developing countries, smoking increased since 1970, particularly among the poor and less educated".…”

The effectiveness of tobacco control policies on vulnerable populations in the USA: a review

“…However, studies have shown varying responses to price increases among low-income populations. Individuals may compensate for higher prices by relying on low-priced cigarette products (eg, bootlegged or smuggled cigarette products), foregoing other essential goods24–28 or reducing consumption 23 29 30. Critics raise concerns that cigarette taxes are regressive because they disproportionately affect low-income smokers who smoke more and also devote a higher percentage of their income towards purchasing tobacco 31 32.…”