Impact of Tobacco Control Policies on Adolescent Smoking

J Adolesc Health. 2016 Jun;58(6):679-85. doi: 10.1016/j.jadohealth.2016.02.014. Epub 2016 Apr 14.


Purpose: Our aims were to examine the impact of cigarette taxes and smoke-free legislation on current adolescent smoking and smoking frequency overall as well as test whether there were differential policy effects by age.

Methods: Using data on 717,543 adolescents from 43 states in the 1999-2013 Youth Risk Behavior Surveys, we used difference-in-differences regression models to evaluate the impact of tobacco control policies on current adolescent smoking (yes/no) and, separately, smoking frequency (defined as 0, 1-5, 6-29, 30+ days per month). We tested an interaction between age and cigarette taxes and, separately, smoke-free legislation.

Results: From 1999 to 2013, adolescent smoking decreased from 35.3% to 13.9% and 41 of 43 states increased their cigarette tax in real terms by an average of 257%. By the end of the study period, 29 of 43 states had 100% smoke-free restaurant legislation. Although we found no overall effect of cigarette taxes on current smoking, there was a significant interaction by age. Among 14- and 15-year olds, every $1.00 cigarette tax increase was associated with a 2.2 and 1.6 percentage point reduction in smoking, respectively. The enactment of 100% smoke-free restaurant legislation was associated with an overall reduction in adolescent smoking by 1.1 percentage points and there were no differences by age. Cigarette taxes and smoke-free legislation were also associated with decreased smoking frequency.

Conclusions: The youngest adolescents are the most price sensitive, and cigarette taxes continue to be a successful approach to reduce adolescent smoking. Smoke-free legislation may also be an effective strategy to reduce smoking among all adolescents.

Keywords: Adolescent; Cigarette smoking; Smoke-free policy; Taxes.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adolescent Behavior*
  • Age Factors
  • Commerce / statistics & numerical data
  • Female
  • Humans
  • Male
  • Regression Analysis
  • Risk-Taking
  • Smoke-Free Policy / legislation & jurisprudence*
  • Smoking / epidemiology
  • Smoking / legislation & jurisprudence
  • Smoking Prevention*
  • Taxes / statistics & numerical data*
  • Tobacco Products / legislation & jurisprudence*
  • Tobacco Products / statistics & numerical data
  • United States / epidemiology