by Christina Echegaray of Vanderbilt University
Higher prices and taxes for cigarettes are strongly associated with lower infant mortality rates in the United States, according to a new study that shows the association is stronger for African-American infants than for non-Hispanic white babies.
That finding has implications for trying to reduce disparities in infant mortality between the two groups, researchers say.
The study shows that for every $1 tax increase per pack of cigarettes, there were about two fewer infant deaths each day. Overall, there was an estimated 3.2 percent decrease in annual infant mortality rates, or 750 fewer infant deaths per year, associated with the tax increase.
“Exposure to cigarettes during pregnancy is associated with numerous health problems for newborns, including preterm birth, which is the leading cause of infant mortality in the United States,” says lead author Stephen Patrick, assistant professor of pediatrics and health policy at Vanderbilt University.
“Taxing cigarettes is known to help convince people to quit smoking, or not to start. This study helps physicians, public health officials, and policymakers understand just how much benefit cigarette tax increases can have on infant health.”
“Our approach is a different way to think about cigarette taxes,” says senior author Matthew M. Davis, professor of pediatrics at the University of Michigan. “Usually taxes are used in public health as a way to discourage smoking and therefore improve the health of the person who previously smoked, or is considering starting. But connecting tax increases to smoking reductions and to fewer infant deaths brings in an entirely new type of benefit.”
Tobacco use is the leading cause of preventable death, disease, disability, and death in the United States, research shows.
At the same time, previous studies have shown that women who smoke cigarettes during pregnancy are more likely to give birth to infants who have health problems including low birthweight, prematurity, birth defects, and sudden infant death syndrome (SIDS)—all leading causes of infant mortality, which is defined as death in the first year of life.
Higher cigarette taxes are known to be associated with lower rates of smoking during pregnancy and improvements in some birth outcomes, including birth weight. Until now, however, no US study has evaluated the impact of the higher taxes on infant mortality rates.
For their analysis in the journal Pediatrics, researchers used public data from 1999 to 2010 to determine the association of cigarette tax and price increases over time with infant mortality rates in the United States. They looked at data from the US Centers for Disease Control and Prevention’s Wide-Ranging Online Data for Epidemiologic Research (WONDER) system as well as a multi-year survey from retailers regarding cigarette taxes and prices.
The study also found that higher cigarette taxes were more effective in reducing infant mortality rates among African-American infants than non-Hispanic white infants. Across the US, African-American infants are twice as likely to die before their first birthday as non-Hispanic whites.
“Over the last several decades we have made substantial improvements in the medical care we provide to sick newborns in U.S. hospitals. Extremely preterm infants born today are far more likely to survive than they were just a few years ago. Despite this, the US is doing worse than almost all other industrialized nations in infant deaths. The solution may lie in public health solutions that prevent infants from being born early in the first place—like cigarette taxes,” Patrick says.