Cigarette price, smoking behaviors, and lung cancer mortality in Indiana.
Authors:Ryan Nguyen, Nasser H. Hanna; Indiana University School of Medicine, Indianapolis, IN; Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN
Increasing tobacco costs have been proven to be one of the most effective interventions of decreasing tobacco use. The relationship between tobacco cost and lung cancer mortality has not been as well established. We investigated the relationship of cigarette price with smoking prevalence, cigarette consumption, and lung cancer incidence and mortality in Indiana and nationally.
We obtained average cigarette pack prices, cigarette pack sales, smoking prevalence, and lung cancer incidence and mortality rates in Indiana and nationally from 1995-2015. Average cigarette pack prices were inflation adjusted to 2015 then assessed for Pearson correlation coefficient (r) with cigarette pack sales, smoking prevalence, and lung cancer incidence and mortality. Cigarette price was also correlated with smoking prevalence among state-level characteristics that included gender, age, ethnicity, education, and income.
From 1995 to 2015, average cigarette pack price in Indiana rose from $2.29 to $5.41. Increasing cigarette price in Indiana was associated with decreasing cigarette consumption (r= -0.91, p < 0.001) and decreasing overall smoking prevalence (r= -0.72, p < 0.001). However, those in the lowest income level had higher smoking prevalence associated with rising cigarette price (r= 0.67, p = 0.001). Increasing cigarette price correlated with decreasing lung cancer mortality both in Indiana (r= -0.79, p < 0.001) and nationally (r= 0.96, p < 0.001).
Increasing tobacco taxes and subsequent increasing cigarette prices were associated with decreased smoking prevalence, cigarette consumption, and lung cancer mortality in Indiana. Lower socioeconomic populations in Indiana may not be as price-responsive as similar populations nationally. Policies aimed at increasing tobacco prices should prioritize diverting revenues towards health programs and tobacco-cessation initiatives for lower-income individuals.