Cigarette Prices in Rural and Urban Ohio: Effects of Census Tract Demographics

The prevalence of smoking among rural Americans and Americans of lower socioeconomic status (SES) remains higher than among their urban and higher SES counterparts. Potential factors contributing to these disparities are area-based differences in the retail environment and tobacco control policies. We describe the association between neighborhood demographics and cigarette prices in rural and urban areas. Prices of one pack of Marlboro Reds, Newport menthols, and the cheapest cigarettes in the store were recorded from a stratified random sample of tobacco retailers in urban (N = 104) and rural (N = 109) Ohio in 2016. Associations between prices and census tract demographics (SES and race) were modeled separately in each region, controlling for store type. In the rural region, as the census tract income increased, the price of Marlboro and Newport cigarettes decreased, and the price of the cheapest pack of cigarettes increased. In the urban region, as the census tract income and percentage of White non-Hispanic people increased, the price of Marlboro decreased; there were no associations between census tract characteristics and the price of Newports or the cheapest cigarettes. Results describe a complex association between cigarette brand, prices, and area characteristics, where the cheapest brands of cigarettes can be obtained for the lowest prices in lower SES rural areas. Tobacco control policies that raise the price of cheap cigarettes, particularly minimum price laws, have the potential to reduce SES-related smoking disparities in both rural and urban populations.