Jahnke SA, Haddock CK, Poston WSC, Hyder ML, Lando H. A National Survey of Cigarette Prices at Military Retail Outlets. JAMA. 2011;306(22):2456-2457. doi:10.1001/jama.2011.1774
Author Affiliations: Institute for Biobehavioral Health Research, National Development and Research Institutes Inc, New York, New York (Drs Jahnke, Haddock, Poston, and Hyder) (firstname.lastname@example.org); and Division of Epidemiology and Community Health, University of Minnesota, St Paul (Dr Lando).
To the Editor: Smoking among military personnel impedes readiness and results in poorer job performance and substantial costs from smoking-related illness and absenteeism.1 Smoking rates among junior enlisted personnel remain higher than the general population, leading the Department of Defense to take steps to reduce tobacco use.2 In 2005, the Department of Defense Instruction 1330.9 mandated that prices for tobacco products sold in US military retail outlets be “no lower than 5 percent below the most competitive commercial prices in the local community” to “communicate to Service members that tobacco use is detrimental to health and readiness.” The Instruction was intended to equalize the cost to consumers, including taxes. No studies address the Instruction's effect on tobacco pricing, although military personnel believe cigarettes are sold at deeply discounted prices.3 We investigated cigarette prices at military retail outlets compared with the local market.
The study was approved by the National Development and Research Institute's institutional review board. We obtained contact information for all military exchanges in 50 states in 2011 using official Web sites. Because tobacco pricing is consistent across retail outlets at any installation, we only called the main exchange for each. Prices were determined by calling each exchange and its nearest Walmart. Walmart was chosen as the local market to allow consistent comparisons across installations, given their competitive pricing and ease of locating stores. Also, Walmart has been used as a benchmark for military cigarette pricing in congressional testimony.4
We collected price data on a single Marlboro Red hard pack and a pack of the lowest-priced brand sold after all taxes to determine the cost to consumers. Marlboro was chosen because it captures approximately 50% of the domestic market and has traditionally been heavily marketed to the military.5 We asked stores to identify their least expensive brand and its price to determine the lowest consumer price for cigarettes. Comparisons were based on the equation:
The 95% confidence intervals were computed as mean ± (1.96 × standard error of the mean). Comparisons among service branches were conducted using 2-tailed analysis of variance with SPSS version 19 (SPSS Inc); a P value of less than .05 was considered significant.
Of 201 military exchanges, we obtained 145 matched exchanges and Walmart comparisons for Marlboro and 133 for the lowest-priced brand. The mean distance between an exchange and the nearest Walmart was 5.8 miles (SD = 5.9).
Smokers who purchase cigarettes at exchanges would realize a mean of 25.4% (95% CI, 23.7%-27.1%) in savings vs the nearest Walmart for a pack of Marlboro ($4.99 vs $6.73) and a mean of 14.5% (95% CI, 11.5%-17.5%) in savings on the lowest-priced brand ($3.98 vs $4.77) (Table). Only 4.8% (7/145) of exchanges had savings of 5% or less vs Walmart for Marlboro, while 15.8% (21/133) were within 5% of the lowest-priced brand. In 3.4% (5/145) of the comparisons for Marlboro and 6.8% (9/133) for the lowest-priced brand, the price was higher at the exchange. There was no statistically significant difference in savings among the military service branches (Marlboro: F = 2.28, P = .08; lowest-priced brand: F = 2.44, P = .07). For Marlboro, the savings at exchanges were large across most locations, reaching 73% at 1 Navy exchange.
With few exceptions, prices of cigarettes at military exchanges were lower than at the nearest Walmart. A limitation of the study is that the Instruction does not define “the most competitive commercial prices in the local community.” It is possible that lower prices than those found at Walmart may be available, but conducting a comprehensive pricing search for all retail outlets in every community with a military exchange would be prohibitive. When prices were investigated in a limited number of locations, prices at exchanges remained considerably lower.6 The military's policy on tobacco pricing should be strengthened and enforced if the goal is to communicate the message that tobacco is harmful to personnel.
Author Contributions: Drs Jahnke and Haddock had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
Study concept and design: Jahnke, Haddock, Poston, Lando.
Acquisition of data: Hyder.
Analysis and interpretation of data: Jahnke, Haddock, Poston.
Drafting of the manuscript: Jahnke, Haddock, Poston.
Critical revision of the manuscript for important intellectual content: Hyder, Lando.
Statistical analysis: Jahnke, Haddock.
Obtained funding: Jahnke, Haddock, Poston, Lando.
Administrative, technical, or material support: Jahnke, Haddock, Poston, Lando.
Study supervision: Jahnke, Haddock, Poston, Hyder.
Conflict of Interest Disclosures: All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.
Funding/Support: This research was supported by National Cancer Institute grant 2RO1CA109153.
Role of the Sponsors: The National Cancer Institute had no role in the design and conduct of the study; in the collection, analysis, and interpretation of the data; or in the preparation, review, or approval of the manuscript.
Additional Contributions: Jennifer E. Taylor, PhD (Vanderbilt Medical School) provided assistance in project development and Chris Kaipust and Brianne Tuley, BA (National Development and Research Institutes Inc) provided research assistance. Dr Haddock and Ruth Malone, PhD, were principal investigators of this study. Compensation was provided to Ms Tuley but no one else received compensation.