ORIGINAL RESEARCH

Use of Interrupted Time-Series Method to Evaluate the Impact of Cigarette Excise Tax Increases in Pennsylvania, 2000–2009

Quarterly smoking prevalence increased from 31.95% in 1998 Q1 to 38.86% in 2003 Q4 before the second tax increase. Quarterly smoking prevalence dropped to 26.65% after the second tax increase and continued to decrease to 22% in 2010 Q4.

Year/Quarter	Adults Aged 18–39
1998 Q1	31.95
1998 Q2	28.14
1998 Q3	29.22
1998 Q4	28.47
1999 Q1	30.49
1999 Q2	33.73
1999 Q3	30.72
1999 Q4	29.29
2000 Q1	31.68
2000 Q2	29.15
2000 Q3	32.43
2000 Q4	32.86
2001 Q1	30.45
2001 Q2	28.47
2001 Q3	29.14
2001 Q4	32.79
2002 Q1	28.78
2002 Q2	33.75
2002 Q3	29.33
2002 Q4	32.73
2003 Q1	34.31
2003 Q2	31.07
2003 Q3	31.39
2003 Q4	38.86
2004 Q1	26.65
2004 Q2	32.51
2004 Q3	28.39
2004 Q4	28.33
2005 Q1	31.61
2005 Q2	29.11
2005 Q3	32.01
2005 Q4	27.68
2006 Q1	22.27
2006 Q2	29.80
2006 Q3	29.19
2006 Q4	28.80
2007 Q1	29.78
2007 Q2	26.93
2007 Q3	23.41
2007 Q4	26.51
2008 Q1	28.63
2008 Q2	25.27
2008 Q3	26.40
2008 Q4	28.25
2009 Q1	24.46
2009 Q2	26.16
2009 Q3	28.58
2009 Q4	23.72
2010 Q1	22.48
2010 Q2	20.44
2010 Q3	23.61
2010 Q4	22.00

Figure 1a. Quarterly smoking prevalence for adults aged 18–39 years, Pennsylvania, 1998–2010. Source: 1998–2010 Behavioral Risk Factor Surveillance System survey data.

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The age-adjusted AMI hospitalization rate decreased from 74.39/100,000 population in 2000 Q1 to 68.78/100,000 population in 2003 Q4. There was an immediate reduction of 3.22/100,000 population in age-adjusted AMI hospitalization rate level after the 2nd tax increase with no trend change. The age-adjusted AMI rate decreased from 67.14/100,000 population in 2004 Q1 to 49.10/100,000 in 2009 Q4.

Year/Quarter	All
2000 Q1	74.39
2000 Q2	70.62
2000 Q3	68.14
2000 Q4	77.00
2001 Q1	72.97
2001 Q2	70.39
2001 Q3	64.18
2001 Q4	71.42
2002 Q1	71.47
2002 Q2	67.77
2002 Q3	65.34
2002 Q4	69.31
2003 Q1	68.69
2003 Q2	66.00
2003 Q3	62.72
2003 Q4	68.78
2004 Q1	67.14
2004 Q2	60.81
2004 Q3	58.09
2004 Q4	61.95
2005 Q1	64.72
2005 Q2	57.40
2005 Q3	51.52
2005 Q4	56.93
2006 Q1	56.73
2006 Q2	54.63
2006 Q3	52.52
2006 Q4	55.38
2007 Q1	53.85
2007 Q2	52.62
2007 Q3	48.45
2007 Q4	51.81
2008 Q1	54.48
2008Q2	51.75
2008 Q3	47.40
2008 Q4	50.56
2009 Q1	49.83
2009 Q2	48.21
2009 Q3	45.56
2009 Q4	49.10

Figure 1b. Quarterly age-adjusted AMI hospitalization rates, Pennsylvania, 2000–2009. Source: 2000–2009 Pennsylvania Health Care Cost Containment Council (PHC4) hospital discharge database.

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Quarterly age-specific asthma hospitalization rates for children under age 18 increased from 60.62/100,000 population in 2000 Q1 to 90.61/100,000 population in 2003 Q4; after the second tax increase, the rate dropped to 66.78/100,000 population in 2004 Q1 but rose to 81.01/100,000 population in 2009 Q4.

Year/Quarter	Under 18 y
2000 Q1	60.62
2000 Q2	49.96
2000 Q3	55.10
2000 Q4	82.03
2001 Q1	68.37
2001 Q2	63.23
2001 Q3	46.24
2001 Q4	89.25
2002 Q1	63.02
2002 Q2	51.42
2002 Q3	42.97
2002 Q4	80.89
2003 Q1	64.70
2003 Q2	68.60
2003 Q3	69.37
2003 Q4	90.61
2004 Q1	66.78
2004 Q2	53.35
2004 Q3	41.04
2004 Q4	78.33
2005 Q1	52.65
2005 Q2	56.83
2005 Q3	33.85
2005 Q4	78.83
2006 Q1	53.74
2006 Q2	54.52
2006 Q3	45.51
2006 Q4	90.00
2007 Q1	53.39
2007 Q2	53.81
2007 Q3	44.87
2007 Q4	88.38
2008 Q1	56.91
2008 Q2	50.50
2008 Q3	42.89
2008 Q4	67.46
2009 Q1	54.45
2009 Q2	52.21
2009 Q3	66.99
2009 Q4	81.01

Figure 1c. Quarterly age-specific asthma hospitalization rates for children under age 18, Pennsylvania, 2000–2009. Source: 2000–2009 Pennsylvania Health Care Cost Containment Council (PHC4) hospital discharge database.

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The male age-adjusted SCD rate decreased from 28.63/100,000 population in 2000 Q1 to 26.11/100,000 population in 2003 Q4. There was a 1.34/100,000 population immediate reduction in the age-adjusted SCD rate level after the 2nd tax increase with no trend change. The female age-adjusted SCD rate decreased from 13.94/100,000 population in 2000 Q1 to 7.79/100,000 in 2009 Q4 with no reduction in level or trend change.

Year/Quarter	Male	Female
2000 Q1	28.63	13.94
2000 Q2	26.16	11.33
2000 Q3	25.55	10.78
2000 Q4	28.33	12.49
2001 Q1	27.81	12.86
2001 Q2	26.19	11.02
2001 Q3	23.89	10.08
2001 Q4	26.68	11.89
2002 Q1	26.54	12.49
2002 Q2	23.88	10.08
2002 Q3	23.23	10.15
2002 Q4	27.38	11.53
2003 Q1	27.06	11.51
2003 Q2	23.69	10.07
2003 Q3	22.38	9.34
2003 Q4	26.11	10.38
2004 Q1	23.73	10.70
2004 Q2	22.59	9.24
2004 Q3	19.43	8.77
2004 Q4	23.26	9.71
2005 Q1	24.52	10.69
2005 Q2	21.23	9.27
2005 Q3	20.22	8.01
2005 Q4	23.89	10.07
2006 Q1	20.74	9.03
2006 Q2	20.58	8.56
2006 Q3	20.51	8.05
2006 Q4	21.80	9.00
2007 Q1	22.62	8.61
2007 Q2	19.93	8.35
2007 Q3	18.37	7.47
2007 Q4	21.36	8.35
2008 Q1	22.32	9.09
2008 Q2	19.07	8.67
2008 Q3	17.48	7.16
2008 Q4	19.78	8.51
2009 Q1	21.92	8.71
2009 Q2	17.93	7.37
2009 Q3	17.05	7.40
2009 Q4	19.67	7.79

Figure 1d. Quarterly age-adjusted sudden cardiac death (SCD) rates by sex, Pennsylvania, 2000–2009. Source: Pennsylvania 2000–2009 Vital Statistics death certificate data.

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