Tobacco taxes lengthen lives and reduce income-related health disparities

Aaron Baum, I, and others just published “Estimating the long-run relationship between state cigarette taxes and county life expectancy” in Tobacco Control that contributes to the growing literature that tobacco taxes can help reduce health disparities.  Using life expectancy data from all US counties from 1996 trough 2012, we found that a one-dollar increase in cigarette tax per pack (in 2016 dollars) translated to an increase in life expectancy of 1 year over the following decades, with the first 6-month increase in life expectancy appearing after 10 years.  There was a larger life-expectancy benefit of increases in cigarette excise taxes in lower-income counties compared with higher-income counties, which is evidence that cigarette taxes can help reduce health disparities.

Here is the abstract:

Introduction While a large body of literature suggests that tobacco control legislation—including fiscal measures such as excise taxes—effectively reduces tobacco smoking, the long-run (10+ years) relationship between cigarettes excise taxes and life expectancy has not been directly evaluated. Here, we test the hypothesis that increases in state cigarette excise taxes are positively associated with long-run increases in population-level life expectancy.

Methods We studied age-standardised life expectancy among all US counties from 1996 to 2012 by sex, in relation to state cigarette excise tax rates by year, controlling for other demographic, socioeconomic and county-specific features. We used an error-correction model to assess the long-run relationship between taxes and life expectancy. We additionally examine whether the relationship between cigarette taxes and life expectancy was mediated by changes to county smoking prevalence and varied by the sex, income and rural/urban composition of a county.

Results For every one-dollar increase in cigarette tax per pack (in 2016 dollars), county life expectancy increased by 1 year (95% CI 0.60 to 1.40 years) over the long run, with the first 6-month increase in life expectancy taking 10 years to materialise. The association was mediated by changes in smoking prevalence and the magnitude of the association steadily increased as county income decreased.

Conclusions Results suggest that increasing cigarette excise tax rates translates to consequential population-level improvements in life expectancy, with larger effects in low-income counties.

The full citation is Baum A, Aguilar-Gomez S, Lightwood J, et al.  Estimating the long-run relationship between state cigarette taxes and county life expectancy.  Tobacco Control Published Online First: 31 January 2019. doi: 10.1136/tobaccocontrol-2018-054686.  The paper is available here.