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This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: AJPH.2006.090134v1 97/10/1873    most recent Submit a response Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Franks, P. Articles by Lee, S. Search for Related Content PubMed PubMed Citation Articles by Franks, P. Articles by Lee, S. Related Collections Tobacco Control Health Policy Socioeconomic Factors Other Tobacco Smoking Cessation

Peter Franks, MD, Anthony F. Jerant, MD, J. Paul Leigh, PhD, Dennis Lee, BS, Alan Chiem, MPH, BS, Ilene Lewis, BS, BA and Sandy Lee, MPH, BS

Peter Franks and J. Paul Leigh are with the Center for Health Services Research in Primary Care, School of Medicine, University of California, Davis. Anthony F. Jerant is with the Department of Family and Community Medicine, School of Medicine, University of California, Davis. Dennis Lee, Alan Chiem, Ilene Lewis, and Sandy Lee are medical students at the University of California, Davis.

Correspondence: Requests for reprints should be sent to Peter Franks, MD, Professor, Center for Health Services Research in Primary Care, Department of Family and Community Medicine, University of California, Davis, School of Medicine, 4860 Y St, Suite 2300, Sacramento, CA 95817 (e-mail: pfranks{at}ucdavis.edu).

Objective. We examined the relationship between smoking participation and cigarette pack price by income group and time period to determine role of cigarette prices in income-related disparities in smoking in the United States.

Methods. We used data from the 1984–2004 Behavioral Risk Factor Surveillance System surveys 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]).

Results. Increased real cigarette-pack price over time was associated with a marked decline in smoking among higher-income but not among lower-income persons. Although the pre–MSA association between cigarette pack price and smoking revealed a larger elasticity in the lower- versus higher-income persons (–0.45 vs –0.22), the post–MSA association was not statistically significant (P>.2) for either income group.

Conclusions. Despite cigarette price increases after the MSA, income-related smoking disparities have increased. Increasing cigarette prices may no longer be an effective policy tool and may impose a disproportionate burden on poor smokers.

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