246715 Using Google Search Query Surveillance to Monitor Smokers' Real-Time Responses to Cigarette Tax Increases

Tuesday, November 1, 2011

Kurt Ribisl, PhD , Gillings School of Global Public Health, UNC, Chapel Hill, NC
John W. Ayers , Children's Health Informatics Program at the Harvard-MIT Division of Health Sciences and Technology, Harvard Medical School, Boston, MA
John Brownstein, DPhil , Department of Emergency Medicine/Informatics Program, Children's Hospital Boston, Boston, MA
Raising cigarette taxes is an evidence-based approach to decreasing tobacco use. Smokers can respond by using the web to seek out cessation assistance or avoid taxes by purchasing cheap cigarettes online. We examined how smokers' smoking cessation and tax avoidance Internet search queries were motivated by the United States' (US) 2009 State Children's Health Insurance Program (SCHIP) federal cigarette excise tax increase and several other state specific tax increases. Google keyword searches among residents in a taxed geography in the US were compared to an untaxed geography (Canada) for two years around each tax increase. Search data were normalized to a relative search volume (RSV) scale, where the highest search proportion was labeled 100 with lesser proportions scaled by how they relatively compared to the highest proportion. Changes in RSV were estimated by comparing means during and after the tax increase to means before the tax increase, across taxed and untaxed geographies. The SCHIP tax was associated with an 11.8% (95% CI, 5.7 to 17.9; p<.001) immediate increase in cessation searches; however, searches quickly abated in subsequent months, approximating differences from pre-tax levels in Canada. Tax avoidance searches spiked 27.9% (95%CI, 15.9 to 39.9; p<.001) and 5.3% (95%CI, 3.6 to 7.1; p<.001) during and in the months after the tax compared to Canada, respectively, suggesting avoidance was the stronger and more durable response. Trends were similar for Florida and New York. Search query surveillance is a valuable real-time, free and public method that states should adopt for tobacco control surveillance.

Learning Areas:
Communication and informatics
Implementation of health education strategies, interventions and programs
Public health or related laws, regulations, standards, or guidelines
Public health or related public policy

Learning Objectives:
1. Explain how Google Insights for search can be used to provide surveillance for tobacco control programs on tobacco related behaviors. 2. Assess how smokers respond to price increases from excise taxes and either use the Internet to search for information on quitting or to buy cheap cigarettes online.

Keywords: Tobacco Policy, Surveillance

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an Associate Professor at the UNC Gillings School of Global Public Health. I am an established tobacco control policy researcher who has published over 25 articles on tobacco control and received NIH and other external funding for this work. My expertise is in the area to point-of-sale advertising and the sales and marketing of tobacco products on the Internet.
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.