The Problem: Tobacco use is a source of chronic and fatal illnesses for users and persons with secondary exposure. Smoking is responsible for approximately one in five deaths in the United States, causing 480,000 deaths annually. Smoking increases risk for stroke by as much as four times, coronary heart disease by as much as four times, lung cancer by about 25 times, and diminishes overall health. Quitting smoking vastly reduces risk; within 2-5 years following cessation, risk of stroke drops to that of a non-smoker. CDC: Health Effects of Cigarette Smoke.
The Law: All states have laws that tax cigarettes to discourage continued use. Tobacco Free Kids: Fact Sheet. For example, under California Proposition 99, Cal Rev & Tax Code § 30122-3, adopted in 1988, cigarette distributors are taxed $0.025 per cigarette. For other examples of cigarette excise tax laws, see ALM GL ch. 64C, § 6(Massachusetts) and ORS § 323.030(1) (Oregon).
The Evidence: In a systematic review, a Community Guide expert panel reviewed 17 studies that assessed the effectiveness of California Proposition 99 and similar cigarette excise tax laws as public health interventions aimed at reducing tobacco use and its associated harms. Community Guide Task Force: Changing Risk Behaviors and Addressing Environmental Change - Tobacco, 27-29. The underlying studies used time-series analyses of aggregate data collected by state authorities to measure price elasticity related to sales or overall consumption trends. According to the reviewers, the findings across the studies suggest that increasing cigarette prices reduces cigarette sales and or consumption. For example, the seven underlying studies focusing on California found that the $0.25 per pack tax instituted by Proposition 99 reduced per capita cigarette consumption by 4 – 16 percent in the short term.
The Bottom Line: In the judgment of a Community Guide expert panel, excise taxes are an effective public health intervention aimed at decreasing the amount of cigarettes purchased and the prevalence of smoking. The effects are generally proportional to the size of the tax increase.
Additional Information: Tobacco Free Kids provides online access to a number of resources including informative briefs and fact sheets.
The National Conference on State Legislatures (NCSL) provides online access to a map illustrating state cigarette excise taxes and tracks cigarette excise tax legislation.