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

Cigarette smoking prevalence is higher (and cigarette cost lower) than the national average in several states within the U.S. Midwest and South (high-tobacco-burden states). In this study, cigarette price sensitivity was investigated among those living in high- versus low-tobacco-burden states using the Cigarette Purchase Task.

Data came from an American Cancer Society online probability-based rapid-response survey of U.S. adults (aged 18-65 years) collected in April-May 2024 (high-tobacco-burden states, n=4,550; low-tobacco-burden states, n=1,600). Respondents were asked, How many packs of your usual brand of cigarettes would you purchase and consume in the next 7 days at: $2, $4, $6, $8, $10, $12, $14, $16, $18, $20, and $40 per pack? Demand curves and 5 demand indices-intensity (quantity demanded at lowest cost), Omax (maximum expenditure), Pmax (price at Omax), breakpoint (price-suppressing purchases), and alpha (overall price sensitivity)-were compared between high- and low-tobacco-burden states.

Demand was significantly lower in high- than in low-tobacco-burden states at prices >$6 per pack (all ps<0.001), as were Omax (maximum expenditure, $42.82 vs $50.37, p=0.001), Pmax (price at Omax, $7.76 vs $10.24, p<0.001) and breakpoint (price suppressing purchases, $13.03 vs $17.14, p<0.001). Individuals in high-tobacco-burden states had overall higher alpha (sensitivity to changes in prices, 0.00499 vs 0.00389, p<0.001). No significant differences were observed for intensity.

Cigarette smoking in high-tobacco-burden states may be suppressed by increasing cigarette prices to approximately $13 per pack.