Effects of tobacco discount coupons and policy intervention on tobacco use disparities

2017

Challenge

Tobacco companies have long been distributing discount coupons through direct mail and email. However, there is a lack of public information about which populations are being targeted by these discount coupons and how the coupons influence tobacco use behaviors. Additionally, it is unclear which types of policy interventions could effectively reduce the impact of such coupons on the U.S. population.   

Advance

IRP researchers and collaborators led by Kelvin Choi, Ph.D., examined data from the U.S. Population Assessment of Tobacco and Health (PATH) Study and the International Tobacco Control (ITC) Project in search of answers. They found that poorer adults were more likely than wealthier individuals to receive tobacco discount coupons, regardless of whether or not they smoked. They also found that receipt of these coupons through direct mail or email increased the chances that a non-smoker would begin smoking and decreased the odds that a current smoker would successfully quit. The team subsequently assessed how a national tobacco price promotion ban that prohibits tobacco coupon redemption would potentially affect smoking behaviors, finding that such a policy could eliminate the association between exposure to tobacco price promotions and smoking behavior.

Impact

This research was the first U.S. national study to show that poorer individuals are disproportionately affected by tobacco discount coupons and that policies to eliminate these coupons could reduce tobacco use disparities. The findings also provided evidence that national tobacco price promotion bans can ameliorate the detrimental impact of these coupons on the population by reducing smoking. Together, the results support U.S. federal, state, and local policies that prohibit tobacco price promotions. Some cities and states are already adopting such policies based on evidence provided by these studies.

Publications

Choi K, Soneji S, Tan A. (2017). Receipt of tobacco direct mail coupons and changes in smoking status in a nationally representative sample of US adults. Nicotine and Tobacco Research. Jun 21;20(9):1095-1100.

El-Toukhy S, Choi K, Hitchman S, Bansal-Travers M, Thrasher J, Yong H, O’Connor R, Shang C. (2017). Banning tobacco price promotions, smoking-related beliefs and behavior: Findings from the International Tobacco Control Four Country (ITC 4C) Survey. Tobacco Control. Jul 12;27:310-318.