State tobacco excise taxes and adolescent smoking behaviors in the United States.

The objective of the study described in this article was to examine the association between state cigarette excise taxes and smoking behaviors among youth in the United States. A survey was nationally mailed to adolescents in the Growing Up Today Study, an ongoing cohort of offspring of participants in the Nurses' Health Study II. A volunteer sample of 10,981 adolescent boy and girl participated in the Growing Up Today Study, who were 12 to 18 years old in 1999. Logistic regression was used to examine the relationship between state cigarette excise taxes (in quartiles) and experimentation (ever smoked) and established smoking (smoked at least 100 cigarettes in a lifetime). State tax levels in 1999 ranged from 2.5 to 100 cents. In a model that adjusted for age, gender, peer smoking, parental smoking, state clustering, state poverty level, and possession of tobacco promotional items, higher tax rates were associated with decreased odds of experimentation (test for trend p < 0.01). The highest quartile of tax (60-100 cents) was significantly associated with lower odds of experimentation (OR = 0.79; 95% CI, 0.64-0.98) and appeared protective against established smoking (OR = 0.80; 95% CI, 0.49-1.29). This study provides recent evidence that higher state cigarette excise taxes are associated with decreased experimental smoking among adolescent boys and girls. Higher state cigarette taxes may also be associated with lower odds of established smoking in this age group, although the association appears to be attenuated by peer and parental smoking. These results support the inclusion of tobacco taxes in state tobacco control programs.