This US-based study examined the relationship between smoking participation and cigarette pack price by income group and time period to determine the role of cigarette prices in income-related disparities in smoking. Data from the 1984–2004 Behavioral Risk Factor Surveillance System surveys were linked to information on cigarette prices to examine the adjusted prevalence of smoking participation and smoking participation–cigarette pack price elasticity (change in percentage of persons smoking relative to a 1% change in cigarette price) by income group (lowest income quartile [lower] vs all other quartiles [higher]) and time period (before vs after the Master Settlement Agreement [MSA]). Overall, the study found that the increasing price of cigarettes over time was associated with a marked decline in smoking for higher-income individuals, but not for lower-income persons. Prior to the MSA, the association between cigarette pack price and smoking participation revealed a significantly larger elasticity among lowerversus higher-income persons (–0.45 vs –0.22). After the MSA, the association was not statistically significant for either income group. The authors conclude that “despite cigarette price increases after the MSA, income-related smoking disparities have increased”. Cigarette prices are no longer an effective strategy to reduce smoking prevalence and may impose a disproportionate burden on poor smokers.
