Longitudinal Associations of Cigarette Prices with Smoking Cessation: The Coronary Artery Risk Development in Young Adults (CARDIA) Study

Mayne, Stephanie L.; Gordon-Larsen, Penny; Schreiner, Pamela J.; Widome, Rachel; Jacobs, David R., Jr.; & Kershaw, Kiarri N. (2019). Longitudinal Associations of Cigarette Prices with Smoking Cessation: The Coronary Artery Risk Development in Young Adults (CARDIA) Study. Nicotine & Tobacco Research, 21(5), 678-85. PMCID: PMC6468125

Mayne, Stephanie L.; Gordon-Larsen, Penny; Schreiner, Pamela J.; Widome, Rachel; Jacobs, David R., Jr.; & Kershaw, Kiarri N. (2019). Longitudinal Associations of Cigarette Prices with Smoking Cessation: The Coronary Artery Risk Development in Young Adults (CARDIA) Study. Nicotine & Tobacco Research, 21(5), 678-85. PMCID: PMC6468125

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Introduction: Few studies have used longitudinal cohort data to examine associations of cigarette prices with smoking cessation or whether price sensitivity varies by income or education. This study examines these associations in a multi-center U.S. cohort and explores whether associations vary by education and income. Methods: Longitudinal data from baseline daily cigarette smokers aged 18-30 years old in the Coronary Artery Risk Development in Young Adults (CARDIA) study were linked to inflation-adjusted cigarette carton prices from the Council for Community and Economic Research Cost of Living Index based on residential address at baseline and in years 7, 10, and 15 (1985-2001). Multivariable Cox models estimated hazard ratios (HRs) of first (any) smoking cessation and sustained smoking cessation (no relapse) associated with each $1 increase in time-dependent cigarette price over 15 years of follow-up. Models adjusted for socio-demographic, health-related, and policy covariates. We assessed effect modification by education and household income. Results: Among 1,489 participants, a $1.00 higher cigarette carton price was associated with a 16% higher likelihood of first smoking cessation (HR: 1.16, 95% CI: 1.11, 1.21) and an 8% higher likelihood of sustained smoking cessation (HR: 1.08, 95% CI: 1.02, 1.14). Associations were strongest among participants with lower income for first cessation, and among those with higher income for sustained cessation. Associations were strongest for participants with less than a high school degree for both outcomes. Conclusions: Results suggest higher cigarette prices promote smoking cessation among young to middle-aged adults, and that price sensitivity may differ by socioeconomic status. Implications: Few studies have examined longitudinal associations of cigarette prices with smoking cessation, and findings are mixed on whether price sensitivity varies by education or income. In a cohort of U.S. adult daily smokers, cigarette prices were associated with greater likelihood of both a first cessation and sustained cessation. Price associations with first cessation were stronger among low income smokers, but associations with sustained cessation were stronger among high income smokers. Results suggest that while higher cigarette prices may promote short-term smoking cessation among smokers at all income levels, additional supports may be needed to facilitate sustained smoking cessation among low income smokers.




JOUR



Mayne, Stephanie L.
Gordon-Larsen, Penny
Schreiner, Pamela J.
Widome, Rachel
Jacobs, David R., Jr.
Kershaw, Kiarri N.



2019

P2C-No. NIH-Yes. "The Coronary Artery Risk Development in Young Adults Study (CARDIA) is conducted and supported by the National Heart, Lung, and Blood Institute (NHLBI) in collaboration with the University of Alabama at Birmingham (HHSN268201300025C & HHSN268201300026C), Northwestern University (HHSN268201300027C), University of Minnesota (HHSN268201300028C), Kaiser Foundation Research Institute (HHSN268201300029C), and Johns Hopkins University School of Medicine (HHSN268200900041C). CARDIA is also partially supported by the Intramural Research Program of the National Institute on Aging (NIA) and an intra-agency agreement between NIA and NHLBI (AG0005). Additional support was provided by NHLBI (R01-HL114091). This manuscript has been reviewed by CARDIA for scientific content. The sponsors had no role in the collection, analysis, or interpretation of data, writing of the report, or decision to submit the article for publication. Research reported in this publication was also supported by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health under Award Number T32HL069771."

Nicotine & Tobacco Research

21

5

678-85








PMC6468125


11003

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