Purchasing patterns and smoking behaviors after a large tobacco tax increase: A study of Chinese Americans living in New York City

Tobacco taxes are one of the most effective policy interventions to reduce tobacco use. Tax avoidance, however, lessens the public health benefits of higher-priced cigarettes. Few studies examine responses to cigarette tax policies, particularly among high-risk minority populations. The present study examines the prevalence and correlates of tax avoidance and changes in smoking behaviors among Chinese-American smokers in New York City (NYC) after a large tax increase. Data for 614 male smokers were from in-person and telephone interviews using a comprehensive household-based survey conducted with 2,537 adults aged 18-74 years. Interviews were conducted in Mandarin, Cantonese, and other Chinese dialects. A total of 52.3% of respondents reported engaging in at least one low or no-tax strategy after the NYC and State tax increases. The most common strategies for tax avoidance were purchasing cigarettes from a private supplier/importer and purchasing duty free/overseas. Higher consumption, younger age, and number of years in the U.S. were consistently associated with engaging in tax avoidance. Younger and heavier continuing smokers were less likely to make a change in smoking behavior in response to the tax increase. Despite high levels of tax avoidance and varying prices, nearly half of continuing smokers made a positive change in their smoking behavior after the tax increase. Expanded legislation and enforcement must be directed toward minimizing the availability of legal and illegal low or no-tax cigarette outlets. Public education and cessation assistance customized for the Chinese-American community is key to maximizing the effectiveness of tobacco tax policies among this population.