A prospective cohort study of cigarette prices and smoking cessation in older smokers

Background: Cigarette price increases effectively prevent smoking initiation and reduce cigarette consumption among young smokers. However, the impact of cigarette prices on smoking cessation among older smokers is less clear, particularly for those aged 65 years and older, a group that is at highest risk of smokingrelated disease and will almost double in the United States between 2012 and 2050. Methods: Biennial questionnaires administered between 1997 and 2013 assessed smoking status for 9,446 Cancer Prevention Study-II Nutrition Cohort participants who were 50 years old and lived in Washington, DC, and 48 states. For each interval between biennial questionnaires, change in price per pack and average price level per pack were calculated. The separate associations between these price variables and smoking cessation during the same time interval were determined. Results: In multivariable-adjusted models, each 1.00 price increase was associated with a 9% higher rate of quitting [rate ratio (RR) 1.09; 95% confidence interval (CI), 1.04-1.14). Each 1.00 increase in average price was associated with a 6% higher rate of quitting (RR 1.06; 95% CI, 1.02-1.10). The association with average price was strongest among smokers aged 65 years and older (RR 1.07; 95% CI, 1.04-1.11) and, for price change, for smokers with no major prevalent disease (RR 1.13; 95% CI, 1.07-1.19). Conclusions: These results suggest that increasing cigarette prices will promote quitting even among smokers aged 65 years and older. Impact: Increasing cigarette prices through higher taxes could reduce smoking rates among older adults and decrease risk of smoking-related cancers and diseases in this high-risk group.