Tobacco Taxation and Its Prospective Impact on Disparities in Smoking Initiation and Progression Among Young Adults

Michael J. Parks, Megan E Patrick, David T. Levy, James F. Thrasher, Michael R. Elliott, Nancy L. Fleischer

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Purpose: Limited research exists on tobacco taxes and cigarette smoking initiation and progression, particularly across different sociodemographic groups in young adulthood. This project examines how cigarette pack price in late adolescence prospectively relates to smoking initiation and progression by 21 years of age, focusing on differences across demographics. Methods: Data are from the longitudinal Monitoring the Future project (2001–2017). Monitoring the Future examines drug use behaviors with nationally representative samples of 12th graders annually. Subsamples of 12th graders are followed up longitudinally. We examined past 30-day cigarette smoking among baseline never smokers (N = 9,232) and daily smoking among youths who were not daily cigarette smokers at baseline (N = 15,141). Using logistic regression, we examined state-level cigarette pack price at a modal age of 18 years and smoking at follow-up ages 19–20 years; we used interaction terms to assess differences across sociodemographic groups (by gender, race/ethnicity, and parental education). Results: For each dollar increase in price at baseline, the odds of initiation by age 19–20 years were reduced by 12% (adjusted odds ratio =.88; 95% confidence interval =.78,.99) and the odds of progression to daily smoking were reduced by 16% (adjusted odds ratio =.84; 95% confidence interval =.76,.92). After adjusting for multiple testing, for both outcomes there were no statistically significant interactions between price and demographics. Conclusions: Cigarette prices in late adolescence were associated with a prospective reduction in cigarette smoking initiation and progression among young adults, with limited differences across sociodemographic characteristics. Higher cigarette prices can prevent smoking initiation and progression; however, complementary interventions are needed to reduce initiation and progression among subgroups disproportionately affected by tobacco.

Original languageEnglish (US)
Pages (from-to)765-772
Number of pages8
JournalJournal of Adolescent Health
Issue number4
StatePublished - Apr 1 2021

Bibliographical note

Funding Information:
Research reported in this publication was supported by the National Cancer Institute of the National Institutes of Health [grant number R37CA214787]. Data were collected with support from the National Institute on Drug Abuse of the National Institutes of Health [grant numbers R01DA001411 & R01DA016575]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. We have listed everyone who contributed significantly to the work. This work was presented as a poster presentation at the 2020 Society for Research on Nicotine and Tobacco's Annual Meeting.

Publisher Copyright:
© 2020 Society for Adolescent Health and Medicine


  • Adolescence
  • Progression to regular smoking
  • Smoking initiation
  • Tobacco taxes
  • Tobacco-related disparities
  • Young adulthood

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural


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