SAVI Community Trends Report: Unequal Access Tobacco Epidemic Report 2017 FINAL | Page 8

SAVI community trends » unequal access: tobacco retail in the indianapolis metro area
Action Toward Tobacco Control
Tobacco control interventions are among the
most thoroughly researched strategies to im-
prove public health, and we know a lot about
which are most effective, in large measure
because of funding provided through the 1998
Master Tobacco Settlement. 4 One result of this
research are the recommendations from the
Institute of Medicine’s (IOM) Ending the Tobacco
Problem: A Blueprint for the Nation. [55, 56].
Listed in the table on page 9 are the recom-
mended actions that are appropriate at state
and local levels. They can serve as a framework
for discussing current and potential action.
Increasing the price of tobacco products
(IOM Recommendation 2) is the single most
powerful tool available for curtailing tobacco
consumption. [15] Several peer-reviewed
economic evaluations have reached the same
conclusion—the demand for cigarettes, like
other consumer products, is responsive to
price. As the price of cigarettes increases, the
sale of cigarettes decreases. [57] For every 10%
rise in the price of cigarettes, overall cigarette
consumption goes down 3 to 5% and smoking
among pregnant women goes down 7%. [15,
58] [59] [60-63] Responsiveness to price is
most pronounced among males, Blacks,
Hispanics, and lower-income smokers. [58, 62,
64, 65] Raising the price of cigarettes is also
the most cost-effective tobacco control
intervention, because tax increases have
consistently increased state revenues after
they were enacted. [66]
Photo courtesy of WhyQuit.com
these areas have limited mobility – that is,
residents in high access areas may more often
find themselves in close proximity to higher
concentrations of tobacco retailers than
residents in low access areas.
Demographic disparities in tobacco access in
Indianapolis also reflect those found elsewhere.
The high tobacco access group had the
highest percentage of people of color.
Tobacco access in the Indianapolis metro area
is similar to what has been found in other parts
of the country, with poor and minority areas
having a higher density of tobacco outlets. In
disadvantaged communities, higher tobacco
retail density has been shown to have an even
greater negative association with cessation
efforts and an even greater positive association
with smoking initiation. [3, 25] Because of the
previously noted economic burden to Indiana,
these disparities impact us all. As such, we
have additional incentive to explore how local
tobacco control policy and practice can
respond to disparities in tobacco access.
Indiana currently levies a $0.995 tax on a pack
of cigarettes, placing the State of Indiana 37th
among states. [58] The average state tax
nationally is $1.69 per pack. A broad coalition
of business, health care, not-for-profit and
academic groups have joined forces to
advocate for legislation to raise the tax by
$1.50. This increase will not elevate Indiana’s
cigarette tax into the top quintile of states as
The Master Settlement resulted from a class action suit filed by several states, including Indiana, against the tobacco
companies for excess health care costs due to smoking.
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