INTRODUCTION
Although smoking declined significantly in the United States (US) from 2011–2022, prevalence remained stagnant for those ages 65 and older, and, within this group, it increased among people in the lowest income group.1 In recent years, against a backdrop of declining sales, sales of cigarettes in the lowest price tier (i.e., “deep-discount”) have grown.2,3 Increasing cigarette prices is a proven strategy to reduce cigarette smoking; however, cheap cigarettes may undermine this, as purchasing cheaper cigarette brands is one of several price minimizing strategies consumers use when cigarette prices increase.4–6 Yet, little is known about who is using deep-discount cigarettes and the potential impact of deep-discount cigarettes on tobacco use behavior. This study examines demographic characteristics and smoking patterns associated with using deep-discount cigarettes among US adults in 2021.
METHODS
This cross-sectional analysis of data from the National Survey on Drug Use and Health (NSDUH)7 2021—the last year that cigarette brand information was collected for NSDUH—was considered non–human subjects research by Rutgers University and followed STROBE reporting guidelines. We included adults who smoked cigarettes in the past 30-days and reported a usual cigarette brand (N=6,853). We categorized cigarette brands based on how they are marketed by the tobacco industry to reflect factors beyond price (e.g., marketing, brand recognition) that impact consumer preferences.8 Cigarette brands were designated as: Premium if explicitly marketed as “premium” by the parent company (e.g., Marlboro, Nat Sherman), Value if offered by major tobacco companies that sell cigarettes in the US (i.e., Altria, British American Tobacco, Imperial Brands, and Japan Tobacco) and not explicitly marketed as “premium” or “deep-discount” (e.g., Basic, Pall Mall), or Deep-discount if a non-premium brand offered by smaller companies (e.g., 305’s) or a brand from major tobacco companies explicitly labeled as “deep-discount” (e.g., Sonoma; Appendix A).8,9 Using Stata version 18 (StataCorp), pairwise chi-square tests assessed differences in demographic and tobacco use variables across brand tiers. We used multinomial logistic regression to examine associations between demographic and tobacco use variables and odds of using value and deep-discount cigarettes (versus premium). Probabilities derived from these odds were used to calculate relative prevalence ratios (RPRs). All analyses accounted for the complex sampling design and were weighted to generate estimates representative of the US civilian, noninstitutionalized population.10 We present weighted percentages, RPRs (adjusted for sex, age group, race/ethnicity, income, education, receiving government assistance, daily smoking, mean cigarettes smoked per day [categorical, groupings based on standard cigarette pack size of 20], and nicotine dependence), and 95% confidence intervals. Respondents were considered nicotine dependent if they reported smoking within 30 minutes of waking on days that they smoked cigarettes (a strong predictor of nicotine dependence commonly used in the literature).11 Individuals with missing information were not included in the respective analyses.
RESULTS
Premium cigarettes were most prevalent (77.23%, n=5,607), followed by value (13.22%, n=743) and deep-discount (9.56%, n=503; Table 1). Distributions of all reported variables except for educational attainment differed significantly across brand tiers, with value and deep-discount tiers having higher proportions of people who were female, non-Hispanic White, aged 50 or older, had household incomes below $50,000, and received government assistance. Daily smoking, nicotine dependence, and smoking more than a pack per day were most prevalent among individuals using deep-discount cigarettes.
TABLE 1. Demographic and Tobacco Use Characteristics of US Adults Using Premium, Value, and Deep-Discount Cigarettes, and Adjusted Relative Prevalence Ratios for Proportion of Adults Using Value and Deep-Discount Brands (vs Premium), by Demographics and Tobacco Use (NSDUH 2021).
| Distribution of Demographic and Tobacco Use Characteristics† | Absolute Difference in Prevalence (vs Premium) | Adjusted‡§ Relative Prevalence Ratios (RPRs) | |||||
|---|---|---|---|---|---|---|---|
|
| |||||||
| Premium n=5,607, 77.23 [75.07–79.25] |
Value n=743, 13.22 [11.67–14.94] |
Deep-Discount n=503, 9.56 [8.08–11.27] |
Premium vs Value |
Premium vs Deep-Discount |
Value vs Premium |
Deep-Discount vs Premium |
|
| n, weighted % [95% CI] | n, weighted % [95% CI] | n, weighted % [95% CI] | Weighted Percentage Points | Weighted Percentage Points | RPR [95% CI] | RPR [95% CI] | |
|
| |||||||
| Sex | |||||||
| Male (ref) | 2,772, 54.51 [51.89, 57.11]A | 342, 41.83 [35.12, 48.85]B | 212, 48.75 [41.25, 56.31]A,B | 12.68 | 5.76 | 1.00 | 1.00 |
| Female | 2,835, 45.49 [42.89, 48.11] | 401, 58.17 [51.15, 64.88] | 291, 51.25 [43.69, 58.75] | −12.68 | −5.76 | 1.53** [1.13–2.07] | 1.11 [0.76–1.63] |
| Age Group | |||||||
| 18–25 (ref) | 1,439, 10.38 [9.36, 11.51]A | 114, 4.36 [2.76, 6.81]B | 75, 3.57 [2.42, 5.26]B | 6.02 | 6.81 | 1.00 | 1.00 |
| 26–34 | 1,457, 21.38 [19.53, 23.36] | 140, 11.25 [8.22, 15.20] | 97, 9.37 [6.60, 13.13] | 10.13 | 12.01 | 1.08 [0.72–1.62] | 0.87 [0.48–1.58] |
| 35–49 | 1,836, 30.87 [28.34, 33.51] | 255, 26.39 [21.65, 31.75] | 165, 24.07 [17.61, 31.99] | 4.48 | 6.80 | 1.63* [1.04–2.54] | 1.41 [0.83–2.40] |
| 50–64 | 628, 27.24 [24.14, 30.56] | 140, 36.13 [28.49, 44.54] | 99, 38.81 [29.92, 48.52] | −8.89 | −11.57 | 2.23** [1.29–3.87] | 2.15** [1.25–3.70] |
| 65+ | 247, 10.13 [8.40, 12.17] | 94, 21.88 [15.79, 29.48] | 67, 24.17 [17.04, 33.10] | −11.75 | −14.04 | 4.36*** [2.26–8.41] | 5.56*** [2.79–11.08] |
| Race/Ethnicity | |||||||
| NH White (ref) | 3,464, 62.87 [59.54, 66.09]A | 539, 78.47 [72.34, 83.55]B | 412, 86.16 [80.29, 90.48]B | −15.60 | −23.29 | 1.00 | 1.00 |
| NH Black | 814, 15.81 [14.11, 17.68] | 65, 7.60 [5.22, 10.93] | 15, 2.94 [1.09, 7.70] | 8.21 | 12.87 | 0.34*** [0.22–0.54] | 0.12*** [0.04–0.34] |
| Hispanic | 738, 13.91 [11.56, 16.64] | 69, 8.47 [5.30, 13.29] | 33, 6.20 [3.30, 11.36] | 5.44 | 7.71 | 0.71 [0.40–1.27] | 0.52 [0.25–1.08] |
| NH Other Race | 591, 7.41 [6.18, 8.85] | 70, 5.46 [3.30, 8.90] | 43, 4.70 [2.62, 8.29] | 1.95 | 2.71 | 0.73 [0.40–1.33] | 0.58 [0.29–1.18] |
| Income | |||||||
| <$20,000 | 1,645, 27.37 [24.63, 30.30]A | 254, 35.80 [29.37, 42.77]B | 197, 38.24 [30.28, 46.89]B | −8.43 | −10.87 | 2.21** [1.24–3.93] | 2.77** [1.53–4.99] |
| $20,000 - $49,999 | 1,894, 34.36 [31.47, 37.36] | 270, 38.92 [32.21, 46.09] | 199, 39.81 [31.98, 48.21] | −4.56 | −5.45 | 1.77* [1.07–2.93] | 2.28** [1.32–3.96] |
| $50,000 - $74,999 | 797, 15.46 [13.84, 17.24] | 103, 9.97 [7.60, 12.98] | 55, 11.08 [6.41, 18.47] | 5.49 | 4.38 | 1.07 [0.61–1.89] | 1.52 [0.82–2.83] |
| ≥$75,000 or More (ref) | 1,271, 22.81 [20.52, 25.27] | 116, 15.31 [10.91, 21.05] | 52, 10.87 [7.39, 15.71] | 7.50 | 11.94 | 1.00 | 1.00 |
| Receives Govt Assistance | |||||||
| No (ref) | 3,684, 63.62 [61.38, 65.81]A | 419, 58.78 [51.53, 65.67]A,B | 245, 50.90 [42.58, 59.17]B | 4.84 | 12.72 | 1.00 | 1.00 |
| Yes | 1,923, 36.38 [34.19, 38.62] | 324, 41.22 [34.33, 48.47] | 258, 49.10 [40.83, 57.42] | −4.84 | −12.72 | 1.12 [0.81–1.56] | 1.75** [1.19–2.57] |
| Educational Attainment | |||||||
| Less than High School | 945, 17.71 [15.50, 20.17]A | 142, 16.24 [11.40, 22.61]A | 103, 19.24 [13.89, 26.03]A | 1.47 | −1.53 | 1.02 [0.45, 2.29] | 0.82 [0.37, 1.81] |
| High School Graduate | 1,909, 36.94 [34.46, 39.49] | 306, 41.85 [34.73, 49.32] | 205, 42.69 [34.73, 51.04] | −4.91 | −5.75 | 1.39 [0.73, 2.65] | 1.01 [0.50, 2.05] |
| Some College/Associate | 1,869, 32.20 [29.35, 35.18] | 228, 33.34 [26.65, 40.79] | 158, 28.25 [22.40, 34.94] | −1.14 | 3.95 | 1.41 [0.71, 2.80] | 0.95 [0.46, 1.97] |
| College Graduate (ref) | 884, 13.15 [11.39, 15.14] | 67, 8.57 [4.51, 15.67] | 37, 9.82 [5.33, 17.41] | 4.58 | 3.33 | 1.00 | 1.00 |
| Days Smoked (Past 30 Days) | |||||||
| Non-Daily (<30 Days) (ref) | 2,605, 43.11 [40.64, 45.60]A | 240, 25.33 [20.38, 31.01]B | 90, 16.98 [11.97, 23.52]B | 17.78 | 26.13 | 1.00 | 1.00 |
| Daily/All 30 Days | 2,977, 56.89 [54.40, 59.36] | 502, 74.67 [68.99, 79.62] | 409, 83.02 [76.48, 88.03] | −17.78 | −26.13 | 1.14 [0.75–1.72] | 1.75* [1.01–3.01] |
| Mean Cigarettes/Day | |||||||
| <10 (<0.5 packs) | 3,286, 54.31 [51.86, 56.74]A | 301, 32.35 [25.72, 39.78]B | 139, 22.84 [16.45, 30.80]B | 21.96 | 31.47 | 1.00 | 1.00 |
| 10 to 19 (0.5 to <1 pack) | 1,274, 23.03 [20.78, 25.44] | 238, 33.17 [27.03, 39.95] | 166, 35.40 [29.04, 42.33] | −10.14 | −12.37 | 1.80* [1.08, 3.02] | 1.75 [0.96–3.18] |
| 20 (1 pack) | 814, 17.51 [15.06, 20.26] | 147, 26.04 [19.86, 33.33] | 147, 28.06 [21.39, 35.85] | −8.53 | −10.55 | 1.77 [0.95, 3.31] | 1.56 [0.79–3.08] |
| >20 (>1 pack) | 228, 5.16 [4.08, 6.50] | 54, 8.44 [4.89, 14.17] | 51, 13.70 [8.64, 21.03] | −3.28 | −8.54 | 1.99 [0.89–4.45] | 2.41* [1.23–4.73] |
| Nicotine Dependent | |||||||
| No | 2,902, 49.63 [46.38, 52.88]A | 276, 36.86 [31.07, 43.06]B | 137, 22.32 [17.28, 28.32]C | 12.77 | 27.31 | 1.00 | 1.00 |
| Yes | 2,476, 50.37 [47.12, 53.62] | 443, 63.14 [56.94, 68.93] | 353, 77.68 [71.68, 82.72] | −12.77 | −27.31 | 1.20 [0.92–1.56] | 2.25*** [1.58–3.20] |
: Categories that do not share superscripts (A, B, or C) refer to statistically significant differences between brand tiers at a Bonferroni corrected alpha of 0.017.
Bolded RPRs indicate statistical significance (*p<0.05, **p<0.01, ***p<0.001).
Unweighted n’s and weighted %’s provided.
Complete cases for multinomial regression model = 6,555. Sex, age category, race/ethnicity, income, education, and government assistance were derived variables provided in NSDUH, and none of these variables were missing among individuals in the sample. Distribution of missingness for the remaining variables is as follows (unweighted n, weighted %): Daily Smoking (Premium: n=25, 0.42%; Value: n=1, 0.24%; Deep-Discount: n=4, 0.49%); Cigarettes Per Day: (Premium: n=5, 0.25%; Value: n=3, 0.77%, Deep-discount: n=0); and Nicotine Dependence: (Premium=229, 2.67%, Value=24, n=1.71%; Deep-Discount: n=13, 0.86%). When treating missing values as separate categories (rather than excluding them), RPR for Daily Smoking for deep-discount (vs premium) was no longer statistically significant (RPR=1.64 [95% CI: 0.96, 2.80]), and RPR for 10–19 cigarettes per day among deep-discount smokers (versus premium) was statistically significant (RPR=1.90 [95% CI: 1.04, 3.47]). However, for all other variables, direction and magnitude of estimates were not meaningfully different.
Adjusted for sex, age category, race/ethnicity, income, education, receiving government assistance, daily smoking (past 30 days), mean number of cigarettes smoked per day (past 30 days, categorical), and nicotine dependence.
Use of value and deep-discount (versus premium) brands was significantly more prevalent for people 50 and older (versus 18–25) and earning less than $50,000 annually (versus ≥$75,000, Table 1). Use of both brand tiers (versus premium) was significantly less prevalent among non-Hispanic Black than non-Hispanic White people. Value (versus premium) cigarette use was significantly more prevalent among females (versus males) and people ages 35–49 (versus 18–25); however, neither sex nor the 35–49 age group were associated with relative prevalence of deep-discount cigarette use. Value (versus premium) cigarette use was significantly more prevalent among individuals smoking 10–19 (versus <10) cigarettes per day, while deep-discount cigarette use was significantly more prevalent among individuals smoking more than a pack per day. Use of deep-discount—but not value—cigarettes (compared to premium) was more prevalent among people receiving government assistance, smoking daily, and with nicotine dependence.
DISCUSSION
Using nationally representative data from NSDUH 2021, this study found that use of deep-discount—but not value—cigarettes (versus premium) was more prevalent among individuals who received government assistance, smoked heavily, and met the criteria for nicotine dependence. A limitation of this study is that only one year of data is analyzed; thus, trends in deep-discount cigarette use could not be assessed. Additionally, this cross-sectional analysis cannot provide insight into the impact of deep-discount cigarettes on longitudinal tobacco use patterns; therefore, research using longitudinal survey data is needed to better understand how deep-discount cigarettes may impact tobacco use behavior (including smoking cessation), particularly among older and lower-income adults, who are more likely to smoke cheaper cigarettes. Finally, use prevalence by brand tier observed in 2021 may differ from broader trends, given the impact of the COVID-19 pandemic on tobacco use behaviors around the study period.12 Nevertheless, these findings are an important first step in understanding who may be most impacted by the growing deep-discount cigarette segment and smoking patterns associated with deep-discount cigarettes. To address deep-discount cigarettes, policymakers can consider implementing non-tax price policies (e.g., minimum floor prices for cigarettes), which are less likely than taxes to be undermined by discounts.4
Supplementary Material
Funding
This work was supported by grants U01CA278695 and U54CA229973 from the National Cancer Institute and the US Food and Drug Administration. This content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or FDA.
Footnotes
Competing Interest Statement
RJO is a Senior Editor with Tobacco Control; he had no role in editorial decisions or handling peer review for the manuscript and recused himself from any discussion about it. CDD has received personal fees from the US Food and Drug Administration (FDA) for being the chair of the FDA’s Tobacco Products Scientific Advisory Committee. The remaining authors have no competing interests to disclose.
REFERENCES
- 1.Meza R, Cao P, Jeon J, Warner KE, Levy DT. Trends in US adult smoking prevalence, 2011 to 2022. JAMA Health Forum. 2023;4(12):e234213. doi: 10.1001/jamahealthforum.2023.4213 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Robichaud MO, O’Connor RJ, Villanti AC, Edwards KC, Delnevo CD. Declining cigarette sales and shifts in the US cigarette marketplace from 2016 to 2024: Analysis of market scanner sales data in US convenience stores. Prev Med Rep. 10.1016/j.pmedr.2026.103381 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3.Covino RM. Cigarette category weathers highs & lows. Convenience Store News. June 3, 2025. Accessed October 8, 2025. https://csnews.com/cigarette-category-weathers-highs-lows [Google Scholar]
- 4.Ribisl KM, Golden SD, Huang J, Scollo M. Addressing lower-priced cigarette products through three-pronged comprehensive regulation on excise taxes, minimum price policies and restrictions on price promotions. Tob Control. 2022;31(2):229–234. doi: 10.1136/tobaccocontrol-2021-056553 [DOI] [PubMed] [Google Scholar]
- 5.Kalousova L, Levy D, Titus AR, et al. Cigarette taxes, prices, and disparities in current smoking in the United States. SSM Popul Health. 2020;12:100686. doi: 10.1016/j.ssmph.2020.100686 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 6.Cho A, Lim C, Sun T, Chan G, Gartner C. The effect of tobacco tax increase on price-minimizing tobacco purchasing behaviours: A systematic review and meta-analysis. Addiction. 2024;119(11):1923–1936. doi: 10.1111/add.16618 [DOI] [PubMed] [Google Scholar]
- 7.Substance Abuse and Mental Health Services Administration. 2021 NSDUH methodology resources. February 13, 2025. Accessed October 8, 2025. https://www.samhsa.gov/data/data-we-collect/nsduh-national-survey-drug-use-and-health/methodology/2021 [Google Scholar]
- 8.Cornelius ME, Driezen P, Fong GT, et al. Trends in the use of premium and discount cigarette brands: findings from the ITC US Surveys (2002–2011). Tob Control. 2014;23 Suppl 1(0 1):i48–53. doi: 10.1136/tobaccocontrol-2013-051045 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 9.Tobacco Insider. USA: Cheap cigarettes. Tobacco Insider. February 2, 2025. Accessed September 5, 2025. https://tobaccoinsider.com/usa-cheap-cigarettes/ [Google Scholar]
- 10.Substance Abuse and Mental Health Services Administration. 2021 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions. Published online October 2022. Accessed November 7, 2025. https://www.samhsa.gov/data/sites/default/files/reports/rpt39442/2021NSDUHMethodSummDefs100422.pdf [Google Scholar]
- 11.Branstetter SA, Muscat JE, Mercincavage M. Time to first cigarette: A potential clinical screening tool for nicotine dependence. J Addict Med. 2020;14(5):409–414. doi: 10.1097/ADM.0000000000000610 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 12.Asare S, Majmundar A, Islami F, et al. Changes in Cigarette Sales in the United States During the COVID-19 Pandemic. Ann Intern Med. 2022;175(1):141–143. doi: 10.7326/M21-3350 [DOI] [PMC free article] [PubMed] [Google Scholar]
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