Keywords: tobacco use, racial disparities, behavior, point of sale, demographic characterization
This study identified demographic, smoking-behavioral and cigarette-purchasing attributes associated with last purchasing cigarettes on Indian reservations among daily smokers. Data from the 2010-11 and 2014-15 Tobacco Use Supplements (n=34,728) were pooled and analyzed. The analytical approach incorporated Rao-Scott chi-square tests, with variance estimated using balanced repeated replications with 160 replicate weights. Post-hoc comparisons were done via Bonferroni method. The rate of last purchasing cigarettes on reservations was 4.2% (SE = 0.3%) in 2010-11 and 3.7% (SE = 0.2%) in 2014-15; the difference was not significant at a 5% level. Cigarette purchases on Indian reservations were significantly associated with all demographic factors considered (all p < 0.005) except education level. Specifically, higher rates of cigarette purchases on reservations corresponded to smokers who were 65+ year-old, female, non-Hispanic (NH) American Indian/Alaska Native (AIAN, 26.4%), not in labor force and currently/previously married; as well as those living in a non-metro area, the West U.S. region and states with Indian reservations. Among non-AIAN racial/ethnic groups, NH Multiracial smokers had the highest rate (5.4%), followed by NH White (4.1%) and Hispanic (3.6%). Also, higher rates of cigarette purchases on reservations corresponded to smoking 20+ cigarettes per day and preferring menthol-type cigarettes or any type of cigarette (all p < 0.001). Cigarettes purchased on reservations were less expensive per pack and more commonly were purchased by the carton than pack (all p < 0.001). Use of coupons was not significantly associated with cigarette purchases on reservations. Among last self-purchases on reservations in 2014-15, about 367,102 (91.7%) were made by non-AIAN daily smokers and 33,015 (8.3%) by AIAN daily smokers, indicating that purchasing cigarettes on Indian reservations is not exclusive to AIAN daily smokers.