Hypothetical Cigarette Purchasing Behavior: Findings From a Multi-State Rapid-Response Survey in the U.S

Area of Science:

• Public Health
• Health Economics
• Tobacco Control

Background:

• Cigarette smoking prevalence is higher in U.S. Midwest and South states, termed high-tobacco-burden states.
• These states also exhibit lower cigarette costs compared to the national average.
• Understanding price sensitivity is crucial for targeted tobacco control interventions.

Purpose of the Study:

• To investigate cigarette price sensitivity among adults in high-tobacco-burden states versus low-tobacco-burden states.
• To compare demand indices, including intensity, maximum expenditure (Omax), price at Omax (Pmax), breakpoint, and overall price sensitivity (alpha).
• To inform tobacco control policies by assessing the impact of price increases on cigarette consumption.

Main Methods:

• Utilized data from an American Cancer Society online survey of U.S. adults (aged 18-65) conducted in April-May 2024.
• Employed the Cigarette Purchase Task to assess hypothetical cigarette purchases at various price points ($2-$40 per pack).
• Compared demand curves and five key demand indices between high-tobacco-burden (n=4,550) and low-tobacco-burden states (n=1,600).

Main Results:

• Cigarette demand was significantly lower in high-tobacco-burden states at prices exceeding $6 per pack.
• Key demand indices differed significantly: Omax ($42.82 vs $50.37), Pmax ($7.76 vs $10.24), and breakpoint ($13.03 vs $17.14) were lower in high-tobacco-burden states.
• Individuals in high-tobacco-burden states exhibited higher overall price sensitivity (alpha: 0.00499 vs 0.00389).

Conclusions:

• Cigarette demand is notably lower in high-tobacco-burden states, especially at higher price points.
• Increasing cigarette prices to approximately $13 per pack may effectively suppress smoking in high-tobacco-burden states.
• Findings support price increases as a viable strategy for tobacco control in regions with high smoking prevalence.