174262 Cigarette Price Sensitivity of Smokers with Comorbid Alcohol, Drug, or Mental Disorders

Monday, October 27, 2008

Michael K. Ong, MD PhD , Division of General Internal Medicine & Health Services Research, University of California, Los Angeles, Los Angeles, CA
Qiong Zhou, MS , Division of General Internal Medicine & Health Services Research, David Geffen School of Medicine at UCLA, Los Angeles, CA
Hai-Yen Sung, PhD , Institute for Health & Aging, University of California, San Francisco, San Francisco, CA
Theodore E. Keeler, PhD , Department of Economics, University of California, Berkeley, Berkeley, CA
Background: Individuals with comorbid alcohol, drug, or mental (ADM) disorders combined make up over 40% of all smokers in the U.S., and are more likely to be a current and a heavy smoker compared to the general population. Comorbid ADM disorders may make smokers less responsive to cigarette price increases, due to the underlying biological effect of nicotine.

Methods: We examined 7,909 respondents to the 2000-2001 Healthcare for Communities (HCC) survey. We conducted nationally weighted bivariate analyses and logistic regressions that examined the likelihood of being a current smoker in the entire sample, and on subsamples with and without an ADM disorder in the past twelve months. The model of smoking participation included logarithmically transformed cigarette prices based on state of residence and year of the survey; demographic, health insurance, employment, and income covariates; and specific ADM disorders in the past twelve months.

Results: Among all respondents, 24.6% were current smokers and 18.4% had an ADM disorder; 34.6% of current smokers had an ADM disorder. Among those with an ADM disorder, the current smoking prevalence rate was 46.1%, and 60.2% among those with alcohol dependence (23.5% of individuals with ADM disorders). After controlling for alcohol dependence, a 10% increase in cigarette prices would result in cessation among 18% of smokers with ADM disorders. Non-alcohol-dependent binge drinkers are particularly price sensitive.

Conclusions: Increasing cigarette taxes would increase smoking cessation and improve overall health among smokers with ADM disorders. However, alternative approaches are needed for smokers with alcohol dependence.

Learning Objectives:
1) Recognize that cigarette price increases are an effective method to encourage smoking cessation among smokers with comorbid alcohol, drug, or mental disorders. 2) Identify smokers with comorbid alcohol, drug, or mental disorders as a priority population for tobacco control 3) Recognize that smokers with alcohol dependence require other smoking cessation measures than cigarette price increases

Keywords: Smoking Cessation, Mental Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the principal investigator for this study. I designed the study, acquired the data, analyzed results, and wrote the abstract.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.