Background There is evidence that the cheapest cigarettes cost even less in neighbourhoods with higher proportions of youth, racial/ethnic minorities and low-income residents. This study examined the relationship between the price of the cheapest cigarette pack and neighbourhood demographics in a representative sample of tobacco retailers in the USA.
Methods Data collectors recorded the price of the cheapest cigarette pack (regardless of brand) in 2069 retailers in 2015. Multilevel linear modelling examined the relationship between price and store neighbourhood (census tract) characteristics, specifically median household income and percentage of youth, Black, Asian/Pacific Islander and Hispanic residents.
Results Average price for the cheapest pack was $5.17 (SD=1.73) and it was discounted in 19.7% of stores. The price was $0.04 less for each SD increase in the percentage of youth and $0.22 less in neighbourhoods with the lowest as compared with the highest median household incomes. Excluding excise taxes, the average price was $2.48 (SD=0.85), and associations with neighbourhood demographics were similar.
Conclusion The cheapest cigarettes cost significantly less in neighbourhoods with a greater percentage of youth and lower median household income. Non-tax mechanisms to increase price, such as minimum price laws and restrictions on discounts/coupons, may increase cheap cigarette prices.
- public health
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Contributors SDM and TLQ made substantial contributions to the design of the work and the analysis and interpretation of data. SDG made substantial contributions to the design of the work and the interpretation of data. LH made substantial contributions to the design of the work and the acquisition of data. AYK made substantial contributions to the acquisition and interpretation of data. KMR made substantial contributions to the design of the work and the acquisition and interpretation of data. SDM drafted and revised the work critically for important intellectual content. SDG, LH, AYK, TLQ and KMR revised the work critically for important intellectual content. All authors provided final approval of the version to be published and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Funding Advancing Science and Practice in the Retail Environment (ASPiRE) is funded by the National Cancer Institute grant U01-CA15428. LH was supported by the National Cancer Institute grant 5R01-CA067850. SDM receives funding from the National Cancer Institute grant T32-CA057726. LH receives funding from the National Cancer Institute, Tobacco-Related Disease Research Program and the California Department of Public Health.
Disclaimer The funders had no involvement in the design, data collection, analysis, interpretation or decision to publish.
Competing interests LH has consulted for FDA’s Center for Tobacco Products and their Centers for Tobacco Regulatory Science. KMR serves as an expert consultant in litigation against tobacco companies and has a royalty interest in a store mapping and audit system owned by the University of North Carolina at Chapel Hill, but these systems were not used in this study.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed.