Cigarette tax rates, behavioral disengagement, and quit ratios among daily smokers

Abstract

<p class="first" id="P2">Cigarette taxation is an economics-based policy associated with increased population-level quit ratios. However, the estimated effects of tax increase on smoking behavior vary substantially, underscoring the need to identify moderating variables. We examined whether <i>behavioral disengagement</i> – the tendency to abandon goals when experiencing stress – modified the association between cigarette taxes and daily smoking behavior. We connected state-level cigarette tax rate data with individual-level behavioral data, including a national sample of 725 US adults who smoked daily at baseline and reported follow-up data approximately 10 years later, and 376 who were resampled a third time after another 10 years. Analyses involved multilevel logistic regression (with time as a nested variable and anonymized state codes as a grouping variable), where current smoking status (dichotomous) was regressed on behavioral disengagement, state-level cigarette tax at baseline and current time, and the interaction between disengagement and current tax. Consistent with hypotheses, tax rate interacted with disengagement ( <i>OR</i>=0.95, <i>95% CI</i>=0.90,0.99, <i>p</i>=.0255): Among those one <i>SD</i> above the mean for disengagement, tax rate was unassociated with quit ratio ( <i>OR</i>=0.99, <i>95% CI</i>=0.85,1.16, <i>p</i>=.6975). However, among those one <i>SD</i> below the mean, tax rate was significantly associated with higher quit ratio ( <i>OR</i>=1.22, <i>95% CI</i>=1.04,1.43, <i>p</i>=.0163). Our data suggest the possibility that cigarette taxes may be more effective in facilitating cessation among smokers low in behavioral disengagement or when accompanied by interventions that reduce stress or maintain goal pursuit. Identifying psychological moderators of policy effectiveness holds promise for improving policy design and targeting. </p>