Table 3.
Association between implementation of tobacco taxation and primary outcomes
| Details of intervention | Population at risk (n) | Events (n) | Slope before intervention (% change in events per year) | Direct change in events (step change, %; 95% CI) | Sustained change in events per year (slope change, %; 95% CI) | Summary of findings | |
|---|---|---|---|---|---|---|---|
| Preterm birth | |||||||
| Hawkins (2014)46 | Effect of cigarette excise tax increase (in USD$; December 2010 rates) on mothers, by years of maternal education | 9 981 855 | NR | NR | White mothers: 0–11 years, −0·07%§ (−0·11 to −0·02); 12 years, −0·02%§ (−0·05 to 0·01); 13–15 years, −0·01%§ (−0·03 to 0·00); ≥16 years, −0·00%§ (−0·01 to 0·01) per USD$ increase in tax | NA | Cigarette taxes were associated with a decrease in preterm birth among white mothers with the least amount of education |
| Hawkins (2014)46 | Effect of cigarette excise tax increase (in USD$; December 2010 rates) on mothers, by years of maternal education | 2 722 846 | NR | NR | Black mothers: 0–11 years, −0·08%§ (−0·14 to −0·03); 12 years, −0·04%§ (−0·07 to −0·01); 13–15 years, −0·03%§ (−0·05 to −0·01); ≥16 years, −0·01%§ (−0·01 to −0·00) per USD$ increase in tax | NA | Cigarette taxes were associated with a decrease in preterm births among black mothers with any level of education; among black mothers, there was a gradient across maternal education levels, with the largest decreases among mothers with the least amount of education |
| Hawkins (2014)46 | Effect of cigarette excise tax increase (in USD$; December 2010 rates) on mothers, by years of maternal education | 2 444 673 | NR | NR | Hispanic mothers: 0–11 years, 0·01%§ (−0·00 to 0·02); 12 years, −0·00%§ (−0·01 to 0·00); 13–15 years, −0·01%§ (−0·02 to 0·00); ≥16 years, −0·00%§ (−0·00 to 0·00) per USD$ increase in tax | NA | Cigarette taxes were not associated with significant changes in preterm births among Hispanic mothers with any level of education |
| Hawkins (2014)46 | Effect of cigarette excise tax increase (in USD$; December 2010 rates) on mothers, by years of maternal education | 804 447 | NR | NR | Asian/Pacific Islander mothers: 0–11 years, 0·01%§ (−0·01 to 0·04); 12 years, −0·01%§ (−0·01 to 0·00); 13–15 years, −0·00%§ (−0·01 to 0·01); ≥16 years, 0·00%§ (−0·00 to 0·00) per USD$ increase in tax | NA | Cigarette taxes were not associated with significant changes in preterm births among Asian/Pacific Islander mothers with any level of education |
| Hawkins (2014)46 | Effect of cigarette excise tax increase (in USD$; December, 2010, rates) on mothers, by years of maternal education | 244 823 | NR | NR | Native American/Alaska Native mothers: 0–11 years, −0·02%§ (−0·08 to 0·04); 12 years, 0·01%§ (−0·02 to 0·03);13–15 years, 0·00%§ (−0·03 to 0·03); ≥16 years, −0·01%§ (−0·02 to 0·01) per USD$ increase in tax | NA | Cigarette taxes were not associated with significant changes in preterm births among Native American/Alaska Native mothers with any level of education |
| Markowitz (2013)53 | Cigarette excise tax increase (in 2008 USD$)Cigarette price increase (in 2008 USD$) | Maternal age <20 years: 54 132Maternal age 20–24 years: 101 723Maternal age 25–34 years: 183 763Maternal age >34 years: 53 109 | Maternal age <20 years: 5413Maternal age 20–24 years: 7120Maternal age 25–34 years: 11 026Maternal age >34 years: 3718 | NR | Cigarette excise tax: maternal age <20 years, −2·0%§ (−4·0 to 0·0) per USD$ increase in tax;maternal age 20–24 years, −0·7%§ (−1·4 to −0·0) per USD$ increase in tax; maternal age 25–34 years, −0·2%§ (−1·0 to 0·6) per USD$ increase in tax; maternal age >34 years, −1·0%§ (−1·9 to −0·1) per USD$ increase in taxCigarette price: NR | NA | State-wide increases in cigarette excise tax were associated with a 0·7 percentage point decrease in preterm births among women aged 20–24 years, and a 1·0 percentage point decrease among women aged >34 years |
| Asthma exacerbations requiring hospital attendance | |||||||
| Hawkins (2016)18 | Cigarette excise tax increase in USD$ | NR | 128 807 | NR | −5% (−11 to 1) per USD$ increase in tax | NA | State-wide increase in cigarette excise tax was not associated with significant changes in emergency department visits for paediatric asthma |
| Landers (2014)49 | Cigarette excise tax increase in USD$ | NR | NR | Mean rate across all states and years: 9·02 per 10 000 (SD 9·66; range 0·00– 144·47) | −0·53%§ (−0·99 to −0·06) per USD$ increase in tax | NA | State-wide increase in cigarette excise tax was associated with a 0·5 percentage point decrease in asthma discharge rates |
| Ma (2013)50 | USD$0·69 cigarette excise tax increase;USD$0·35 cigarette excise tax increase | 28 498 070 | 702 771 | 0·04 | USD$0·69 cigarette excise tax increase: −11·01% (−24·71 to 2·77);USD$0·35 cigarette excise tax increase: −22·02% (−33·46 to −9·95) | USD$0·69 cigarette excise tax increase: 4·88% (1·29 to 8·59)USD$0·35 cigarette excise tax increase: −4·72% (−8·01 to −1·44) | The first cigarette excise tax increase (USD$0·69) was not associated with significant immediate changes, but was associated with a significant, gradual increase in asthma-related hospital admissions of 0·5% per year; the second cigarette excise tax increase (USD$0·35) was associated with both a 22% immediate decrease as well as a gradual 5% decrease in asthma-related hospital admissions per year |
| Upper RTI admissions | |||||||
| Hawkins (2016)18 | Cigarette excise tax increase in USD$ | NR | 410 686 | NR | −2% (−6% to 2%) per USD$ increase in tax | NA | State-wide increase in cigarette excise tax was not associated with significant changes in emergency department visits for upper RTIs |
| Lower RTI admissions | |||||||
| Hawkins (2016)18 | Cigarette excise tax increase in USD$ | NR | 139 239 | NR | −9% (−16 to −2) per USD$ increase in tax | NA | State-wide increase in cigarette excise tax was associated with a 9% decrease in emergency department visits for lower RTIs |
NA=not applicable. NR=not reported. RTI=respiratory tract infection.