Standardising the measurement of e-cigarette taxes in the USA, 2010–2020

IntroductionE-cigarette taxes have been enacted by 30 states through April 2020. E-cigarette tax schemas vary, in contrast to cigarette taxes in the USA that are levied almost exclusively as excise taxes per pack. Some states use excise taxes on liquid and containers, others ad valorem taxes on wholesale prices and others sales taxes. It is therefore difficult to understand the relative magnitudes of these e-cigarette taxes and the overall e-cigarette tax size relative to the cigarette tax size.ObjectiveTo create and publish a database of state and local quarterly e-cigarette taxes from 2010 to 2020, standardised as the rate per millilitre of fluid.MethodsUsing Universal Product Code-level e-cigarette sales from the NielsenIQ Retail Scanner Data along with e-cigarette product characteristics collected from internet searches and visits to e-cigarette retailers, we develop a method to standardise e-cigarette taxes as an equivalent average excise tax rate measured per millilitre of fluid.ResultsIn 2020, the average American resided in a location with $3.08 in cigarette taxes and $0.34 in e-cigarette taxes (assuming 1 pack=0.7 fluid mL).ConclusionsThe public availability of this state and local standardised e-cigarette tax data will allow tobacco control researchers to study the relationship between e-cigarette taxes and tobacco and related outcomes more effectively.

Pharmaceutical manufacturers ranking by sales profit for 2020

The amount of sales profit is one of the indicators of the manufacturer’s business performance. This is the financial result from the main activity of the manufacturer, which can be carried out in any form registered in its charter (and not prohibited by law). The product sales profit is defined as the difference between the proceeds from sales (without value added tax and excise taxes) and the costs of production and sales included in the product costs.

Genetic predispositions moderate the effectiveness of tobacco excise taxes

Background Tobacco consumption is one of the leading causes of preventable death. In this study, we analyze whether someone’s genetic predisposition to smoking moderates the response to tobacco excise taxes. Methods We interact polygenic scores for smoking behavior with state-level tobacco excise taxes in longitudinal data (1992-2016) from the US Health and Retirement Study (N = 12,058). Results Someone’s genetic propensity to smoking moderates the effect of tobacco excise taxes on smoking behavior along the extensive margin (smoking vs. not smoking) and the intensive margin (the amount of tobacco consumed). In our analysis sample, we do not find a significant gene-environment interaction effect on smoking cessation. Conclusions When tobacco excise taxes are relatively high, those with a high genetic predisposition to smoking are less likely (i) to smoke, and (ii) to smoke heavily. While tobacco excise taxes have been effective in reducing smoking, the gene-environment interaction effects we observe in our sample suggest that policy makers could benefit from taking into account the moderating role of genes in the design of future tobacco control policies.

A Salient Sugar Tax Decreases Sugary-Drink Buying

Many governments have introduced sugary-drink excise taxes to reduce purchasing and consumption of such drinks; however, they do not typically stipulate how such taxes should be communicated at the point of purchase. Historical, field, and experimental data consisting of more than 225,000 purchase decisions indicated that introducing a $0.01-per-ounce sugar-sweetened beverage (SSB) tax—without making it salient on price tags—had no significant effect on purchasing (−1.26%, p = .28). However, when the phrase “includes sugary drink tax” was added to tax-inclusive price tags, SSB purchasing was lower than (a) in the pretax period (−9.78%, p < .001), (b) in a posttax period when drinks did not bear price tags (−5.04%, p < .001), and (c) in a posttax period when drinks bore tax-inclusive price tags that did not mention the tax (−3.83%, p = .002). Making the tax’s beneficiary (student programs) salient on price tags had no added effect. Two follow-up studies suggested that tax salience was effective partly because consumers overestimated the tax amount, leading to reduced purchase intentions.

Cigarette taxation and price differentials in 195 countries during 2014–2018

IntroductionRaising tobacco prices via increased taxation may be undermined by tobacco industry tactics to keep budget cigarettes on the market. Price differentials between budget and premium cigarettes allow smokers to trade down in the face of average price rises thus attenuating health benefits. This study examines global trends of price differentials and associations with taxation.MethodsEcological analysis of country-level panel data of 195 countries’ price differentials was performed and compared against total, specific excise, ad valorem and other taxation. Price differentials were expressed as the difference between budget cigarette and premium pack prices (as % of premium pack prices). Two-level linear regression models with repeated measurements (2014, 2016 and 2018) nested within each country assessed the association between country-level taxation structures and price differentials, adjusted for year, geographical region and income group.ResultsWorldwide, median price differential between budget and premium 20-cigarette packs was 49.4% (IQR 25.9%–70.0%) in 2014 and 44.4% (IQR 22.5%–69.4%) in 2018 with significant regional variation. The largest price differentials in 2018 were in Africa, with the lowest in Europe. Total taxation was negatively associated with price differentials (−1.5%, 95% CI −2.5% to −0.4% per +10% total taxation) as was specific excise taxation (−2.5%, 95% CI −3.7% to −1.2% per +10% specific excise tax). We found no statistically significant association between ad valorem taxation and price differentials.ConclusionTotal levels of taxation and specific excise taxes were associated with smaller price differentials. Implementing high specific excise taxes may reduce price differentials and improve health outcomes.

Tobacco control policies and smoking cessation treatment utilization: A moderated mediation analysis

Background Tobacco policies, including clean indoor air laws and cigarette taxes, increase smoking cessation in part by stimulating the use of cessation treatments. We explored whether the associations between tobacco policies and treatment use varies across sociodemographic groups. Methods We used data from 62,165 U.S. adult participants in the 2003 and 2010/11 Tobacco Use Supplement to the Current Population Survey (TUS-CPS) who reported smoking cigarettes during the past-year. We built on prior structural equation models used to quantify the degree to which smoking cessation treatment use (prescription medications, nicotine replacement therapy, counseling/support groups, quitlines, and internet resources) mediated the association between clean indoor air laws, cigarette excise taxes, and recent smoking cessation. In the current study, we added selected moderators to each model to investigate whether associations between tobacco polices and smoking cessation treatment use varied by sex, race/ethnicity, education, income, and health insurance status. Results Associations between clean indoor air laws and the use of prescription medication and nicotine replacement therapies varied significantly between racial/ethnic, age, and education groups in 2003. However, none of these moderation effects remained significant in 2010/11. Higher cigarette excise taxes in 2010/2011 were associated with higher odds of using counseling among older adults and higher odds of using prescription medications among younger adults. No other moderator reached statistical significance. Smoking cessation treatments did not mediate the effect of taxes on smoking cessation in 2003 and were not included in these analyses. Conclusions Sociodemographic differences in associations between clean indoor air laws and smoking cessation treatment use have decreased from 2003 to 2010/11. In most cases, policies appear to stimulate smoking cessation treatment use similarly across varied sociodemographic groups.

Follow the Money: A Closer Look at US Tobacco Industry Marketing Expenditures

Introduction: While much of the concern with tobacco industry marketing has focused on direct media advertising, a less explored form of marketing strategy is to discount prices. Price discounting is important because it keeps the purchase price low and can undermine the impact of tax increases. Methods: We examine annual marketing expenditures from 1975 to 2019 by the largest cigarette and smokeless tobacco companies. We consider three categories: direct advertising, promotional allowances, and price discounting. In addition to considering trends in these expenditures, we examine how price discounting expenditures relate to changes in product prices and excise taxes. Results: US direct advertising expenditures for cigarettes fell from 80% of total industry marketing expenditures in 1975 to less than 3% in 2019, while falling from 39% in 1985 to 6% in 2019 for smokeless tobacco. Price-discounting expenditures for cigarettes became prominent after the Master Settlement Agreement and related tax increases in 2002. By 2019, 87% of cigarette marketing expenditures were for price discounts and 7% for promotional allowances. Smokeless marketing expenditures were similar: 72% for price promotions and 13% for promotional allowances. Price discounting increased with prices and taxes until reaching their currently high levels. Conclusions: While much attention focuses on direct advertising, other marketing practices, especially price discounting, has received less attention. Local, state and federal policies that use non-tax mechanisms to increase tobacco prices and restrict industry contracts with retailers are needed to offset/disrupt industry marketing expenditures. Further study is needed to better understand industry decisions about marketing expenditures.