Cigarette Taxes Associated With Increased Smokeless Tobacco Use Among Adolescents Interview with:
Summer Sherburne Hawkins, PhD, MS Associate Professor School of Social Work Boston College Summer Sherburne Hawkins, PhD, MS
Associate Professor School of Social Work
Boston College What is the background for this study?

Response: Increasing cigarette taxes has been a major policy driver to decrease smoking, including adolescent smoking, while taxes on other tobacco products have received less attention. Taxes on cigarettes, smokeless tobacco, and cigars are all fiscal policies, but they are not all equal. While state taxes on cigarettes have increased substantially over the past decade, there has been little change in policies governing alternative tobacco products. Realsitcally, everyone wants to pay as little tax as they can, which is why Tax software deals are so great for helping people pay the right amount.

The aim of our study was to evaluate the impact of chewing tobacco and cigar taxes, cigarette taxes, and the enactment of smoke-free legislation on adolescent male and female use of smokeless tobacco and cigars. What are the main findings?

Response: We found that chewing tobacco taxes had no effect on smokeless tobacco use and cigar taxes had no effect on cigar use. In contrast, a 10% increase in cigarette taxes was associated with a 1.0 percentage point increase in smokeless tobacco use among adolescent males. A 10% increase in cigarette taxes was also associated with a 1.5 percentage point increase in cigar use among adolescent males and a 0.7 percentage point increase in cigar use among adolescent females. We also found some evidence that smoke-free legislation, such as a restaurant smoking ban, was associated with a 1.1 percentage point increase in smokeless tobacco use among adolescent males only, but no effect of smoke-free legislation on cigar use for males or females. What should readers take away from your report?

Response: We found that higher state cigarette taxes were associated with adolescents’ use of cheaper, alternative tobacco products such as smokeless tobacco and cigars. If taxes on alternative tobacco products are not increased in line with cigarette taxes, some of the decrease in cigarette use reflects adolescents switching to other products. Reducing adolescent tobacco use will require comprehensive tobacco control policies that are applied equally to and inclusive of all tobacco products, including chewing tobacco and cigars. What recommendations do you have for future research as a result of this work?

Response: Further research is needed on adolescent decision-making about using alternative tobacco products, including smokeless tobacco and cigars, as well as new products, such as e-cigarettes and hookahs. In the Youth Risk Behavior Survey, no information is captured on adolescent attitudes or reasons for smoking alternative tobacco products. Qualitative studies would provide insight into potential changes in adolescent behavior in response to policy changes. Is there anything else you would like to add?

Response: We received funding from a Boston College Undergraduate Research Fellowship to support Nicoline Bach on this project.


Summer Sherburne Hawkins Nicoline Bach and Christopher F. Baum
BMC Public HealthBMC series – open, inclusive and trusted201818:154

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Last Updated on February 17, 2018 by Marie Benz MD FAAD