NAR Cigarettes: Impact on Smoking, Health, and Local Economy

Cigarette taxation is a widely-used tobacco control policy that can improve public health by discouraging smoking. Due to their legal status, Native American reservations (NAR) and First Nations reserves are important sources of lower- or un-taxed cigarettes in the United States and Canada. In some geographic areas, the prevalence of cigarette purchases from reservations reaches over 40 percent of total purchases.

Donald S. Kenkel, Policy Analysis and Management, is working to understand the impact of this market on smoking rates, birth outcomes, and health disparities. Using multiple large data sets, Kenkel and his team are employing econometric statistical methods to test multiple hypotheses about the impact of NAR cigarettes on smoking. These inquiries probe how the availability of NAR cigarettes impacts adult and youth smoking across the socioeconomic spectrum and whether the effect of cigarette taxes varies, depending upon the availability of NAR cigarettes. A further aim is to understand how the availability of NAR cigarettes impacts health outcomes and health disparities as well as local economies—the indirect effects of NAR cigarettes on the prices charged by off-reservation cigarette retailers.

The team is also conducting a more structural econometric analysis—looking at the impact of NAR cigarettes’ availability on individuals’ joint decisions about smoking, purchase location, and cigarette price paid. The model will directly estimate key mechanisms or links in the chain of causality: the impact of taxes and distance on the probability of NAR purchases and of NAR purchases on cigarette prices paid. NIH Award Number: 1R01DA042064-01A1

Cornell Researchers

Funding Received

$1 Million spanning 3 years