Problem/Objective: Smokers reduce daily cigarette consumption in response to rising prices. A small literature suggests that smokers compensate by smoking more intensively and/or switching varieties. Our objective is to estimate the association between cigarette prices and the strength of cigarettes smoked using a large nationally representative survey of U.S. adults.

Methods: Machine measured tar and nicotine were merged to the 2000-2003 National Household Survey on Drug Use and Health, in which smokers identified the brand, type, and price of cigarette smoked. Logistic regression modeled choice of full-strength vs. light or ultralight. Linear regression modeled tar and nicotine per cigarette. The key explanatory variable was price per pack. Control variables included individual socioeconomic characteristics, daily cigarette consumption, and year. Models were stratified by menthol, and age-by-menthol, gender-by-menthol, and race-by-menthol.

Results: Smokers paying more than $4/pack were significantly more likely to smoke full-strength cigarettes and the effect is greater for menthol smokers (OR=1.544) than non-menthol smokers (OR=1.263). Menthol smokers who reported paying $4/pack or more choose cigarettes that have significantly more tar and nicotine (0.071 and 0.725 mg/cig, respectively) than nonmenthol smokers. There was no statistically significant relationship between price and tar and nicotine per cigarette for nonmenthol smokers.

Conclusions: High cigarette prices are associated with increased use of full-strength cigarettes and cigarettes that have higher tar and nicotine yields. This relationship appears to be strongest for menthol smokers, and is robust when stratified by race, age, and gender. The health implications of this behavior are not understood and require further research.