The effect of cigarette and e‐cigarette taxes on prescriptions for smoking cessation medications

OBJECTIVE: To test the effect of cigarette and e‐cigarette taxes on prescriptions for smoking cessation medications. DATA SOURCE: Symphony Health, IDV all‐payer prescription claims data for the United States over the period 2009–2017. Prescription fills for smoking cessation products were provided at the patient's age, patient's sex, brand/generic, payment type, year, and quarter levels. STUDY DESIGN: We study the effect of state‐level cigarette and e‐cigarette tax rates on prescriptions for smoking cessation medications using two‐way fixed effect modified difference‐in‐differences regressions. We also use a multiperiod difference‐in‐differences estimator robust to bias from dynamic and heterogeneous treatment effects with a staggered policy rollout. DATA COLLECTION/EXTRACTION METHODS: We use fills for Chantix, Zyban, and their generics, as well as Food and Drug Administration‐approved nicotine replacement therapies that are paid for by insurance. PRINCIPAL FINDINGS: We observe no statistically significant change in prescription fills following an increase in the e‐cigarette tax rate, though we are unable to rule out potentially large effects. However, following a $1.00 increase in the cigarette tax rate, we observe a 1052 increase in prescription fills per 100,000 adults (95% CI: 57, 2046; 4.2% increase). The effect of cigarette taxes on prescription fills was particularly large for 18–34 year‐olds. CONCLUSIONS: Our findings suggest that, during a period when e‐cigarettes are widely available, cigarette tax increases remain effective in increasing use of these medications, but e‐cigarette taxes do not increase use of these medications.