People who smoke both tobacco and cannabis are more sensitive to paying more for cigarettes than those who just smoke cigarettes, according to a new UC San Francisco study.
Raising the cost of a pack of cigarettes, whether because of taxes or price hikes, has long been associated with lower consumption. But little is known about how it affects those who use both cannabis and cigarettes.
UCSF researchers used data from the National Survey on Drug Use and Health from 2004 to 2019 as well as state-level cigarette pricing data. They compared cigarette price sensitivity between adults who use cannabis with those who did not use it and estimated the change in demand by using standard economic techniques.
Cannabis users were significantly more likely to buy fewer cigarettes due to costs than those who just smoked tobacco. For example, cigarette smokers who currently use cannabis are twice as likely to reduce the number of cigarettes they smoked per day than cigarette smokers who do not currently use cannabis.
"Our study shows that raising cigarette prices remains a powerful strategy to curb smoking, especially among individuals who use both tobacco and cannabis," said the paper's first author, Tingting Yao , PhD, associate professor in the Institute for Health & Aging in the School of Nursing at UCSF.
The findings appear Oct. 29 in the journal Nicotine & Tobacco Research .
Tobacco smoking and cannabis use in the U.S. have gone in opposite directions in recent years. Between 2004 and 2019, the smoking rate decreased from 24.5% to 16.6%. At the same time, cannabis use increased from 5.8% to 11.6%, and the percentage of people who smoked both tobacco and cannabis rose from 3.6% to 4.5%.
States with higher cigarette prices generally have lower smoking rates. As of Aug. 1, New York, Maryland, Rhode Island, and DC have the highest state cigarette excise taxes in the country, while prices remain comparatively low in Missouri, Georgia, North Dakota, and North Carolina. Among the lower-cost states, cannabis is only legal in Missouri.
The UCSF analysis did not consider vaping because statistics on e-cigarettes did not become available until midway through the study period. More research is needed to find out whether smokers who use both substances will substitute tobacco with cannabis if cigarette prices increase.
Authors: Additional co-authors include Hai-Yen Sung, PhD, Lela Chu, Joanne Spetz, PhD, and Wendy Max, PhD.
Funding: The paper was funded by the Tobacco Related Disease Research Program at the UC Office of the President (T301R0897).
