A major state tobacco tax increase, the master settlement agreement, and cigarette consumption: the California experience.

Objectives: We evaluated the combined effects on California cigarette consumption of an additional 50 cent per pack state tax imposed by Proposition 10 of January 1999 and a 45 cent per pack increase in cigarette prices stemming from the Master Settlement Agreement (MSA) of November 1998.

Methods: We used quarterly cigarette sales data for the period 1984-2002 to estimate a time-series intervention model adjusting for seasonal variations and time trend.

Results: Over the period 1999 through 2002, the combined effect was to reduce cigarette consumption by 2.4 packs per capita per quarter (1.3 billion packs total over the 4-year period) and to raise state tax revenues by $2.1 billion. These effects were similar to the effects of a 25 cent per pack tax increase enacted by Proposition 99 a decade earlier, although with decreased relative effectiveness as measured by percentage of reduction in cigarette consumption divided by percentage of increase in taxation (-0.44 vs -0.60).

Conclusions: A major increase in price through taxation and the MSA provided a strong economic disincentive for smokers in a state with a low smoking prevalence. This effect could be reinforced if part of the MSA payments were devoted to tobacco control programs.