Increased cigarette tax is associated with reductions in alcohol consumption in a longitudinal U.S. sample.

paper Cited Public

Authors: Young-Wolff, Kelly C; Kasza, Karin A; Hyland, Andrew J; McKee, Sherry A
Year: 2014
Journal: Alcoholism, clinical and experimental research
PMID: 23930623
DOI: 10.1111/acer.12226
PMCID: PMC3830619

BACKGROUND: Cigarette taxation has been recognized as one of the most significant policy instruments to reduce smoking. Smoking and drinking are highly comorbid behaviors, and the public health benefits of cigarette taxation may extend beyond smoking-related outcomes to impact alcohol consumption. The current study is the first to test whether increases in cigarette taxes are associated with reductions in alcohol consumption among smokers using a large, prospective U.S. sample. METHODS: Our sample included 21,473 alcohol consumers from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC). Multiple linear regression analyses were conducted to evaluate whether increases in cigarette taxes between Waves 1 (2001 to 2002) and 2 (2004 to 2005) were associated with reductions in quantity and frequency of alcohol consumption, adjusting for demographics, baseline alcohol consumption, and alcohol price. Stratified analyses were conducted by sex, hazardous drinking status, and age and income group. RESULTS: Increases in cigarette taxes were associated with modest reductions in typical quantity of alcohol consumption and frequency of binge drinking among smokers. Cigarette taxation was not associated with changes in alcohol consumption among nonsmokers. In analyses stratified by sex, the inverse associations of cigarette taxes with typical quantity and binge drinking frequency were found only for male smokers. Further, the inverse association of cigarette taxation and alcohol consumption was stronger among hazardous drinkers (translating into approximately 1/2 a drink less alcohol consumption per episode), young adult smokers, and smokers in the lowest income category. CONCLUSIONS: Findings from this longitudinal, epidemiological study suggest increases in cigarette taxes are associated with modest to moderate reductions in alcohol consumption among vulnerable groups. Additional research is needed to further quantify the public health benefits of cigarette taxation on alcohol consumption and to evaluate the potential broader crossover effects of cigarette taxation on other health behaviors.

#	Section	Preview
0	Introduction	Tobacco use is the leading cause of preventable death and disability in the U.S (Centers for Disease…
1	Introduction	Heavy drinking is common and costly in the U.S. (Substance Abuse and Mental Health Services…
2	Introduction	versus singular abuse of alcohol and tobacco are multiplicative (McKee & Weinberger, 2013). Economic…
3	Introduction	Given the high co-occurrence of tobacco and alcohol use, researchers have hypothesized that the…
4	Introduction	benefits of cigarette taxation may also extend beyond smoking to alcohol-related outcomes. However,…
5	Introduction	The current study was conducted to address this gap in the literature. Using data from a…
6	Materials and Methods — Participants	The present study included data from U.S. civilian, non-institutionalized adults (>18 years of age),…
7	Materials and Methods — Participants	The current sample included 10,936 participants from 31 states that increased cigarette taxes…
8	Materials and Methods — Measures	Frequency of alcohol consumption, amount of alcohol typically consumed, and frequency of binge…
9	Materials and Methods — Measures	Frequency of alcohol consumption was assessed with the question, “During the last 12 months, about…
10	Materials and Methods — Measures	Amount of alcohol typically consumed was assessed using the following question: “Counting all…
11	Materials and Methods — Measures	Frequency of binge drinking was assessed with the item: “During the last 12 months, about how…
12	Materials and Methods — Measures	Basic smoking status was assessed using the question, “Did you smoke in the past 12 months?” For…
13	Materials and Methods — Measures	Cigarette taxation policy data were obtained from The Tax Burden on Tobacco (2009). State excise tax…
14	Materials and Methods — Measures	We examined several covariates that could alter the associations between changes in cigarette…
15	Materials and Methods — Data Analysis	We conducted a series of stratified linear regression analyses to investigate the influence of…
16	Materials and Methods — Data Analysis	Analyses were conducted using Stata Version 11 (StataCorp, 2009). Multilevel mixed-effects…
17	Results	Demographic characteristics and alcohol consumption measures among past year drinkers, stratified by…
18	Results	Table 2 provides the mean change in alcohol consumption outcomes as a function of change in…
19	Results	Table 3 presents change in alcohol consumption as a function of change in cigarette tax among…

Name	Type
31 states local	cohort
ACCRA local	cohort
adolescents	cohort
adolescent sample	cohort
adults	cohort
Adults aged 18–24 local	phenotype
adult sample	cohort
adult smokers aged 50 and older local	cohort
African American	cohort
age	phenotype
age group	cohort
alcohol	phenotype
Alcohol consumption frequency local	phenotype
alcohol price local	phenotype
alcohol-related morbidity local	phenotype
alcohol-related mortality local	phenotype
alcohol-related outcomes	phenotype
alcohol-tobacco comorbidity local	phenotype
alcohol‑tobacco comorbidity local	phenotype
Alcohol Use	phenotype
Alcohol Use Disorder	phenotype
alcohol use disorders	phenotype
baseline cigarette tax local	drug
binge drinking	phenotype
cancer	phenotype
cardiovascular disease	phenotype
change in alcohol price local	drug
Changes in cigarette taxes local	drug
cigarettes	phenotype
cigarette tax	drug
cigarette taxation local	phenotype
Cigarette taxation policy local	drug
Cohort attrition local	phenotype
current daily smoking	phenotype
death	phenotype
drinking	phenotype
drunk driving	phenotype
education	phenotype
ethanol consumption	phenotype
female smokers local	cohort
Female smokers local	cohort
frequency of alcohol use	phenotype
Gastrointestinal Bleeding local	phenotype
hazardous drinkers local	cohort
hazardous drinking	phenotype
hazardous drinking status local	phenotype
heavy drinking	phenotype
Hispanic	phenotype
income	phenotype
income category local	cohort
Increased Tax Cohort local	cohort
Less educated	phenotype
Liver cirrhosis	phenotype
Low income	phenotype
Low SES local	cohort
Low SES populations local	cohort
male smokers local	cohort
Male smokers local	cohort
marital status	phenotype
men	cohort
NESARC	cohort
NIAAA guidelines local	drug
nicotine dependence	phenotype
Non-hazardous drinkers local	phenotype
Non-hazardous drinking local	phenotype
non-smokers	phenotype
non-smoking men local	cohort
Non-smoking men local	cohort
Past-year alcohol abstainers local	cohort
physical abuse	phenotype
Quit behavior local	phenotype
race/ethnicity	phenotype
sex	phenotype
smoke-free bar policies local	drug
smoke-free legislation local	drug
Smoke-free policies local	drug
smoke‑free policies in drinking venues local	drug
smokers aged 50 and older local	cohort
smokers in lowest annual income group ($0 – $19,999) local	cohort
smokers in the lowest annual income group ($0 – $19,999) local	cohort
smoking	phenotype
smoking bans local	phenotype
smoking behaviors	phenotype
smoking initiation	phenotype
smoking status	phenotype
State excise cigarette tax local	drug
State excise tax on cigarettes local	drug
Taiwan local	cohort
Taiwan adult cohort local	cohort
The Tax Burden on Tobacco (2009) local	drug
tobacco-related policies local	drug
tobacco use	phenotype
trauma	phenotype
Unchanged Tax Cohort local	cohort
United States	cohort
Unmarried	phenotype
U.S. adolescent cohort local	cohort
U.S. adult cohort local	cohort
U.S. civilian, non-institutionalized adults (>18 years of age) local	phenotype
US sample local	cohort
violence	phenotype
voluntary alcohol consumption	phenotype
voluntary ethanol consumption	phenotype
vulnerable groups local	cohort
wave 2	cohort
Wave I local	cohort
Wave II local	cohort
Waves I local	cohort
Waves II local	cohort
women	cohort
young adults	cohort
young adult smokers local	cohort
young adult smokers local	phenotype
young adult smokers aged 18–29 local	cohort
younger cohort	cohort

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