This work is devoted to re-evaluating the association between cigarette prices and taxes and smoking behaviors in the United States using BRFSS data from the 2000-2019 period. The estimates in Tables 1 and 2 reconfirm that higher cigarette prices and taxes significantly impact smoking prevalence and the proportion of smokers who make quit attempts. The results are qualitatively compatible across all three models. Our findings largely align with those reported by Sharbaugh et al.  with exceptions highlighted and discussed below.
Changes in cigarette taxes and prices produce the most powerful impact on 18- to 24-year-olds [3, 5]. Young adults are more sensitive to price changes than are other age groups, which is probably due to their income instability and the likelihood of having a less established smoking habit [19, 32]. One interesting fact is that, in this age group, the reduction in smoking prevalence (Table 1) is much more pronounced than the increase in the proportion of smokers who have made quit attempts in the past 12 months (Table 2), relative to the other age groups. Previous studies have pointed out that most smokers initiate smoking at early ages. Therefore, raising the cost of cigarettes is likely to primarily reduce the number of new established smokers, in addition to encouraging smoking cessation, which shapes the future smoking trend.
When stratifying by gender, our estimates indicate that males tend to be more price responsive than females , i.e., a 1-dollar increase in a cigarette price per pack lowers the smoking prevalence by 0.77% among males and 0.59% among females as estimated by model 1 (Table 1). However, male and female smokers are likely to attempt to quit in response to the changes at the same rate as shown in Table 2. On the other hand, Sharbaugh et al.  reported no statistically significant difference in the cigarette price and tax effects on smoking prevalence among males and females.
According to the results from models 1-3, raising cigarette prices and taxes is estimated to be the most effective in reducing smoking consumption among non-Hispanic Blacks and Hispanics compared to non-Hispanic whites. The same observation has been reported in previous studies [3, 33]. However, this observation, as well as the one by gender (discussed above), is inconsistent with the findings in  based on the same dataset, BRFSS, but during different periods. These disagreements may stem from different factors. First, we used the BRFSS data from 2000 through 2019, while Sharbaugh et al. did from 2001 through 2014. Second, in contrast to Sharbaugh et al., our results were explicitly adjusted for state tobacco control programs, smoke-free laws, temporal autocorrelation, inflation, and the changes in weighting and surveying methodologies that occurred in 2011, which makes our estimates more reliable. Table 2 shows Non-Hispanic Blacks are least likely to make quit attempts in the past 12 years in response to the increases in cigarette prices and taxes across all races.
Cigarette price and tax changes seem to have a minimal effect on individuals with annual income under $25 000, relative to higher income levels . In particular, raising the cigarette prices per pack by one dollar is associated with a decline of 0.39% in the smoking prevalence among participants with annual income below $25 000, whereas the decline is more than 0.90% among those with annual income greater than $25 000 (model 1 in Table 1). This is not a surprise since low-income individuals have been found to have a high smoking prevalence . Even though the likelihood of having made a quit attempt in the past 12 months is similar across income groups (Table 2), the lack of a significant decline in smoking prevalence among the lower-income group is probably due to their limited exposure to cessation treatment and anti-smoking programs. Poor working conditions are also linked to high smoking prevalence. Both low- and high-income smokers pay the same tax amount per cigarette pack, so low-income smokers spend a disproportionately large share of their income on smoking. Thus, if low-income individuals are price-insensitive, as our study suggests, raising cigarette taxes and prices would further deepen income disparities.
Our study has some limitations. We used the state-specific BRFSS data from 2000 through 2019. We accounted for temporal autocorrelation, we did not account for spatial autocorrelation, while the smoking prevalence of neighboring states has a high chance of correlation. In addition, we considered only states with comprehensive smoke-free laws, while states with some levels of indoor smoking restriction may contribute to declines of smoking prevalence and quit attempts. There are probably other factors linking with positive changes in smoking behaviors that were not included in our models.