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A recent study has found that an Oakland, Calif. law requiring cigarette prices to increase to a minimum of $8 per pack led to a decline in sales, suggesting that these minimum floor price laws (MFPLs) could complement tobacco taxation to reduce smoking rates.
Tobacco price policies, such as taxation, are effective public health strategies that have long shown to reduce tobacco use by raising the prices of cigarettes and other tobacco products. MFPLs, which set a minimum price below which cigarettes cannot be sold, represent a newer fiscal tool that may also discourage tobacco use, according to a study led by researchers at the Boston School of Public Health (BUSPH).
Study Findings
Published in the journal Tobacco Control, the study examined cigarette and cigar sales in Oakland, Calif., following the city’s implementation of an $8 floor price per pack/package of cigarettes and cigars in 2020. Researchers found that the MFPL led to a 15% decrease in cigarette sales overall and a 25% decrease in sales of lower-priced cigarettes during the first 17 months of implementation.
Notably, the study explored whether the MFPL led consumers to purchase tobacco products in neighboring areas outside Oakland. However, researchers did not observe any significant changes in tobacco sales in these areas, nor did they find evidence of consumers switching from cigarettes to e-cigarettes or vaping products.
Impact on Public Health
“Our findings show that setting a minimum price on tobacco products can be an effective policy for reducing tobacco sales, especially in local jurisdictions that are preempted by state law from establishing an excise tax,” said study lead and corresponding author Dr. Justin White, associate professor of health law, policy & management at BUSPH.
The study suggests that MFPLs may be particularly effective at curbing tobacco initiation and prevalence by increasing the cost of lower-priced tobacco products. This price increase could deter purchasing by price-sensitive groups, including youth and low-income individuals, who are disproportionately burdened by smoking and its associated health risks. Smoking remains the leading cause of preventable disease and death in the United States, and most individuals who smoke begin during adolescence.
The study did not assess the effects of the MFPL policy on specific subgroups of the population, but Dr. White emphasized that lower-income people likely benefited significantly from the policy.
“Lower-income people tend to smoke more than higher-income individuals, so they are more likely to cut back on smoking as a result of the policy,” said Dr. White. “They benefit in terms of improved health, more savings on money previously spent on tobacco, and reduced health care costs from being less sick later in life.”
Study Methodology and Compliance Issues
For the study, Dr. White and colleagues from the University of California, San Francisco (UCSF) utilized retail scanner data to assess cigarette and cigar spending habits at more than 3,500 stores in and around Oakland, as well as throughout California, between August 2020 and December 2021.
The study found that nearly all retail stores complied with the MFPL requirements for cigarette sales. However, compliance for cigars was significantly lower, with only 7% of retailers adhering to the price requirements. The researchers noted that various challenges, including the COVID-19 pandemic, affected compliance. Many retailers reportedly struggled to stock cigar products that met a minimum pack size requirement enacted alongside the MFPL, leading to lax enforcement by Oakland’s public health officials.
“Ultimately, lack of compliance for cigars meant that cigar prices did not go up as a result of the floor price policy,” said Dr. White. “Policy enforcement is a critical component for having public health policies work as intended.”
Future Considerations
Despite the promising results, the study found that smoking cessation product sales did not increase following the implementation of the MFPL. This suggests that cessation promotion needs to be better integrated into tobacco policies.
“We know that recommended approaches such as nicotine replacement therapy or prescription medications can increase smoking cessation, but only about one-third of people trying to quit use one of these approaches,” said Dr. White. “We need to make it easier for individuals to access evidence-based approaches, and there may be opportunities to use digital technology like smartphone apps and text-messaging programs to deliver timely support.”
The study was coauthored by Serge Atherwood, research data analyst at UCSF, and Dr. Dorie Apollonio, professor in the Department of Clinical Pharmacy at the UCSF School of Pharmacy.
More Information: Justin S White et al., “Effect of a minimum floor price law for tobacco products on tobacco sales in Oakland, California, USA: a synthetic difference-in-differences analysis,” Tobacco Control (2024). DOI: 10.1136/tc-2024-058853
Journal Information: Tobacco Control
Disclaimer: This article is for informational purposes only and does not constitute medical or legal advice. Readers should consult relevant professionals for guidance on health and policy matters.
