Public policy and youth smokeless tobacco use.

• Author: Chaloupka, Frank J.

1. Introduction

   Tobacco use has gone through many stages in the U.S. Prior to 1900, over 60% of all tobacco consumed in the U.S. took the form of smokeless tobacco (U.S. Department of Health and Human Services [USDHHS] 1993). Cigarette smoking gained popularity in the early 1900s and, by 1935, more tobacco was being consumed in the form of cigarettes than all other tobacco products combined (USDHHS 1993). As the popularity of cigarettes increased, the consumption of smokeless tobacco declined. This decline continued until the 1970s, when smokeless tobacco consumption experienced a resurgence. This resurgence may have initially been spurred by the 1964 Surgeon General's report identifying smoking as a major cause of lung cancer. With the public's heightened awareness of the hazards of smoking, many people began consuming increased quantities of smokeless tobacco. The resurgence of smokeless tobacco consumption was further spurred by the tobacco industry's aggressive marketing of new smokeless tobacco products.

   Smokeless tobacco consumption continued to increase at a rate of 10-11% per year (USDHHS 1993) until 1986, when two significant events occurred: the Surgeon General's report entitled The Health Consequences of Using Smokeless Tobacco (USDHHS 1986) was released, and Congress passed the Comprehensive Smokeless Tobacco Act of 1986. The Surgeon General's report stated that smokeless tobacco use is not a safe substitute for cigarette smoking and represents a significant health risk. It also emphasized that smokeless tobacco can cause cancerous and noncancerous oral conditions and can lead to nicotine addiction and dependence. The Comprehensive Smokeless Tobacco Act of 1986 banned advertising of smokeless tobacco products on television and radio and required three health warnings be placed on smokeless tobacco packages.

   Despite the actions taken in 1986, which were followed by a three-year decline in sales for smokeless tobacco products, the prevalence of smokeless tobacco use in the U.S. has been increasing in recent years, particularly among young adult and adolescent males (USDHHS 1993). From 1972 to 1991, total U.S. consumption of smokeless tobacco has risen from 99 million pounds per year to 125 million pounds per year (USDHHS 1993). Almost 90% of all adolescent smokeless tobacco use is done by male youths (USDHHS 1994). From 1970 to 1985, the percentage of males aged 16-19 years using smokeless tobacco products increased by 321%, from 1.4% to 5.9% (Marcus et al. 1989). After declining from 1986 through 1989, however, some recent surveys indicate that smokeless tobacco use among young males is again on the rise (USDHHS 1994). These trends, coupled with the growing evidence on the addictive nature of smokeless tobacco (USDHHS 1986), have led to an increased emphasis on policies aimed at discouraging the use of smokeless tobacco among adolescents.

   This paper examines the effectiveness of several tobacco control policies in discouraging smokeless tobacco use among male adolescents. These policies include increased smokeless tobacco taxes (which result in higher smokeless tobacco prices) and limits on the availability of tobacco products to youths. The data used in this research are taken from the 1992, 1993, and 1994 surveys of 8th-, 10th-, and 12th-grade students conducted by the University of Michigan's Institute for Social Research as part of the Monitoring the Future Project. This is a particularly interesting age group to study since addictive behaviors are most likely to become established during adolescence. As the recent Surgeon General's report concludes, nearly all first use of tobacco occurs before high school graduation (USDHHS 1994), suggesting that, if adolescents can be kept free of tobacco, most will never start using tobacco. Therefore, tobacco control policies aimed at this age group may be the most effective way of achieving and sustaining long-run reductions in smokeless tobacco consumption in all segments of the population.

2. Selected Review of Econometric Studies of Tobacco Demand

   Numerous econometric studies of cigarette demand have been published over the past several decades.(1) Most of these have used diverse data and methods to estimate the effects of cigarette prices and taxes on smoking participation and cigarette consumption in the overall population and have concluded that higher cigarette prices reduce cigarette smoking. Relatively few of these econometric studies have focused on the price responsiveness of youth, with the majority of these concluding that cigarette demand among youths and young adults is more sensitive to price than cigarette demand among adults.(2)

   Unlike the numerous econometric studies published pertaining to cigarette demand, only two studies have examined the impact of price and tobacco control policies on smokeless tobacco use (Ohsfeldt and Boyle 1994; Ohsfeldt, Boyle, and Capilouto 1995). In the only published study, Ohsfeldt and Boyle (1994) estimated smokeless tobacco participation equations for adults (ages 16 and older) using state-level aggregates constructed from the 1985 Current Population Survey. They estimated an own-tax elasticity of demand for adults of -0.55, which is at the higher end of the range when compared to the elasticities obtained from studies of adult cigarette smoking. In addition, they estimated that the cross-tax elasticity of any smokeless tobacco use with respect to cigarettes was 0.49. Given that cigarette taxes were increasing relative to smokeless tobacco taxes throughout the early 1980s, Ohsfeldt and Boyle concluded that the increase in smokeless tobacco use during this period was, in part, the result of substitution away from cigarettes towards smokeless tobacco products.

   Expanding on their original study, Ohsfeldt, Boyle, and Capilouto (1995) used the individual level data from the September 1985 Current Population Survey to estimate cigarette smoking and smokeless tobacco participation equations for males aged 16 years and older. In addition, for males, they estimated separate participation equations for the 16-24-year-old and 25 and older samples. They found a negative and significant effect of smokeless tobacco taxes on smokeless tobacco use among males, with an estimated own-tax elasticity of any smokeless tobacco use of -0.15. However, they find that restrictive laws on cigarette smoking have no impact on smokeless tobacco use. In addition, they estimated cross-tax elasticities of any smokeless tobacco use with respect to cigarettes of 0.10 and with respect to beer of 0.04. Finally, they generally estimated larger own- and cross-tax elasticities for younger males relative to older males.

   While the recent study by Ohsfeldt, Boyle, and Capilouto (1995) examines the impact of smokeless tobacco taxes on smokeless tobacco use among young males, it uses data from 1985. As they note, these data predate the Comprehensive Smokeless Tobacco Act of 1986, which they suggest may lead to different conclusions about the impact of smokeless tobacco taxes on smokeless tobacco use. Similarly, it predates the widespread passage of legislation at the state level resulting from the Synar amendment, which restricts youth access to all tobacco products. Thus, this study is the first to examine the impact of smokeless tobacco taxes on young males' smokeless tobacco use after the Comprehensive Smokeless Tobacco Act of 1986, as well as the first to examine the effects of policies restricting youth access to tobacco products.

3. Data and Methods

   The data for this study are taken from the 1992, 1993, and 1994 surveys of 8th-, 10th-, and 12th-grade students conducted by the Institute for Social Research (ISR) at the University of Michigan as part of the Monitoring the Future Project. ISR has collected a nationally representative sample of 15,000 to 19,000 high school seniors each year since 1975. In 1991, ISR began conducting an annual survey of similar numbers of 8th- and 10th-grade students. These surveys focus on the use of alcohol, tobacco, and illicit drugs among youths. Given the nature of the data being collected, extensive efforts are made by ISR to ensure that the data collected are informative. For example, parents are not present during the completion of the surveys and are not informed about...