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BRIGHAM AND WOMEN’S HOSPITAL. HARVARD MEDICAL SCHOOL. State Tobacco Excise Taxes and Adolescent Smoking Behaviors in the United States. Carey Conley Thomson, MD, MPH 1,2,3,7 Laurie B. Fisher, SM 1 Jonathan P. Winickoff, MD, MPH 2,4,7 Graham A. Colditz, MD, DrPH 1,7,8
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Carey Conley Thomson, MD, MPH1,2,3,7
Laurie B. Fisher, SM1
Jonathan P. Winickoff, MD, MPH 2,4,7
Graham A. Colditz, MD, DrPH 1,7,8
Carlos A. Camargo, Jr., MD, DrPH 1,5,7
Charles King III, JD, PhD9
A. Lindsay Frazier, MD, MSc1,6,7
Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital1; Tobacco Research and Treatment Center2, Pulmonary and Critical Care Unit, Department of Medicine3, MGH Center for Child and Adolescent Health Policy4, and the Department of Emergency Medicine5, Massachusetts General Hospital; Department of Pediatric Oncology, Dana-Farber Cancer Institute6; Harvard Medical School7;
Department of Health Policy and Management and Epidemiology, Harvard School of Public Health8;
and Greylock McKinnon Associates9.
OBJECTIVES: To examine the association between state cigarette excise taxes and smoking behaviors among youth in the United States.
METHODS: Experimentation (ever-smoking) and established smoking (> 100 cigarettes in a lifetime) were assessed in a cross-sectional sample of 10,981 boy and girl participants of the Growing Up Today Study, ages 12 to 18 in 1999. Logistic regression was used to examine the odds of experimentation and/or established smoking across increasing quartiles of state cigarette excise taxes.
RESULTS: State tax levels in 1999 ranged from 2.5 to 100 cents. In a fully controlled model that utilized generalized estimating equations to account for state clustering, and adjusted for age, gender, peer smoking, parental smoking, state poverty level, and possession of tobacco promotional items, the test for trend across increasing levels of tax was significant (p<0.05) for experimentation. The highest quartile of tax (60-100 cents) was significantly associated with lower odds of experimentation (OR 0.79; 95% CI, 0.64-0.98) and appeared protective against established smoking (OR 0.80; 95% CI, 0.49-1.29).
CONCLUSIONS: This study demonstrates that higher cigarette excise taxes are associated with decreased experimental smoking among adolescent boys and girls, and may be associated with lower odds of established smoking in this age group. These results support the inclusion of tobacco taxes in state tobacco control programs.
To examine the association between state
cigarette excise taxes and smoking behaviors
among boys and girls in the United States
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