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Merkaj E, Zhllima E, Imami D, Gjika I, Guerrero-López CM, Drope J. Impact of cigarette price and tobacco control policies on youth smoking experimentation in Albania. Tob Control 2024; 33:s38-s43. [PMID: 38443163 PMCID: PMC11187397 DOI: 10.1136/tc-2023-058196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 02/17/2024] [Indexed: 03/07/2024]
Abstract
BACKGROUND Albania has one of the highest smoking prevalence in Europe especially among the youth. There is a lack of evidence in Albania, as well as in most of Eastern Europe and middle-income countries, regarding the effect of price on smoking experimentation. OBJECTIVE The study aims to assess the effect of price and tobacco control policies on youth smoking experimentation in Albania. METHODS We used microdata from the Global Youth Tobacco Survey in Albania for 2004, 2009, 2015 and 2020. We constructed a pseudo-longitudinal dataset and estimated a split-population model to assess the hazard of smoking experimentation. RESULTS Price is a significant predictor of smoking experimentation among teenagers in Albania for both males and females (p<0.001). Being male increases the odds for smoking experimentation by more than 50% as compared with females (p<0.001), whereas females appear to be more price sensitive. Peer and parent smoking are also important determinants for smoking experimentation. Introducing penalties for smokers and legal entities violating smoke-free policies implemented in 2014 is also associated with a lower hazard of smoking experimentation. CONCLUSION Price is a significant predictor of smoking experimentation among teenagers in Albania for both males and females. A combination of increasing taxes and strengthening the rule of law to control tobacco use in public spaces, in addition to public awareness campaigns targeting both youth and smoking parents, could help to significantly reduce the probability of smoking experimentation.
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Affiliation(s)
| | - Edvin Zhllima
- Agricultural University of Tirana, Tirana, Albania
- Development Solutions Associates (DSA), Tirana, Albania
| | - Drini Imami
- Agricultural University of Tirana, Tirana, Albania
- Development Solutions Associates (DSA), Tirana, Albania
| | | | | | - Jeffrey Drope
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Nguyen CV, Vellios N, Nguyen NH, Le TT. The impact of cigarette prices on smoking onset and cessation: evidence from Vietnam. Tob Control 2024; 33:e48-e53. [PMID: 36697222 DOI: 10.1136/tc-2022-057689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 01/12/2023] [Indexed: 01/26/2023]
Abstract
BACKGROUND Vietnam is a country with very high smoking rates among men. According to a Global Adult Tobacco Survey (GATS) conducted in 2015, the daily smoking prevalence among Vietnamese men was 39%. METHODS We used data from the 2010 and 2015 Vietnamese GATSs and cigarette price data from General Statistics Office of Vietnam. Since smoking prevalence is low among women, we only considered men. Using discrete-time hazard models, we estimated the effect of cigarette prices on smoking onset and cessation. Sensitivity analyses are conducted using different model specifications. RESULTS We find that higher cigarette prices reduce the probability of smoking onset. A 1% increase in the cigarette price reduces the hazard of smoking onset by 1.2% (95% CI -2.12% to -0.28%). This suggests that increases in tobacco taxation, which translate to price increases, can reduce smoking onset. We did not find evidence that cigarette prices impact smoking cessation among men in Vietnam. CONCLUSION Vietnam should continue to increase excise taxes on tobacco products to reduce smoking onset. Since smokers are resilient to excise tax increases, other tobacco control policies, such as smoke-free areas and tobacco advertisement bans, should be better enforced to encourage people to quit. Other policies not yet implemented, such as plain packaging of tobacco products, may also encourage smokers to quit.
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Affiliation(s)
- Cuong Viet Nguyen
- International School, Vietnam National University Hanoi, Hanoi, Vietnam
- Thang Long Institute of Mathematics and Applied Sciences (TIMAS), Thang Long University, Hanoi, Vietnam
| | - Nicole Vellios
- Research Unit on the Economics of Excisable Products, School of Economics, University of Cape Town, Cape Town, South Africa
| | | | - Thu Thi Le
- HealthBridge Foundation of Canada, Vietnam Office, Hanoi, Vietnam
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3
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Nguyen CV, Le TT, Nguyen NH, Hoang KT. Socioeconomic inequality in smoking: Evidence from a decomposition analysis. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2023. [DOI: 10.1016/j.cegh.2022.101213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
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4
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Viet Nguyen C, Le TT, Nguyen NH. The impact of cigarette prices on smoking participation and tobacco expenditure in Vietnam. PLoS One 2021; 16:e0260415. [PMID: 34905542 PMCID: PMC8670683 DOI: 10.1371/journal.pone.0260415] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 11/09/2021] [Indexed: 11/18/2022] Open
Abstract
Vietnam is one of countries with the highest number of smokers in the world and the high smoking prevalence among men in the region. Although the real cigarette prices increased by around 4% during the 2010-2015 period, the prevalence of daily cigarette smoking among men decreased slightly from 31.3% to 30.7% during this period. This raises the question of whether cigarette consumption is sensitive to price. In this study, we estimated the effect of cigarette prices on smoking participation and tobacco expenditure in Vietnam. We found that a one-percent increase in the real cigarette price reduced the probability of cigarette smoking among males by 0.08 percentage points (95% CI from -0.06 to -0.10), equivalent to the price elasticity of the smoking prevalence at -0.26 (95% CI from -0.16% to -0.33%). Using this estimate, we predict that if the cigarette price is increased by 10%, the daily cigarette smoking prevalence among men would decrease from 30.7% to 29.9% and the number of male smokers would decline by around 270 thousand. Higher cigarette prices also reduced per capita tobacco expenditure of households. A one-percent increase in the cigarette price decreased per capita expenditure on tobacco consumption expenditure of households by 0.43 percent (the 95% CI from -0.029 to 0.822). This finding suggests that raising tobacco taxes and prices can be an effective measure to reduce tobacco use.
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Affiliation(s)
- Cuong Viet Nguyen
- International School, Vietnam National University, Hanoi, Vietnam
- IPAG Business School, Paris, France
| | - Thu Thi Le
- HealthBridge Foundation of Canada, Hanoi, Vietnam
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5
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Palali A, van Ours JC. The impact of tobacco control policies on smoking initiation in eleven European countries. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2019; 20:1287-1301. [PMID: 31485831 PMCID: PMC6856042 DOI: 10.1007/s10198-019-01090-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 07/31/2019] [Indexed: 06/10/2023]
Abstract
We investigate the effect of tobacco control policies on smoking initiation in eleven European countries. Based on individual data about age of onset of smoking, we use hazard rate models to study smoking initiation. Thus, we are able to take into account observed and unobserved personal characteristics as well as the effect of the introduction of a variety of tobacco control policies including price and and non-price policies, i.e., bans on tobacco advertisements, smoke-free air regulation, health warnings on packages of cigarettes, and treatment programs to help smokers quit smoking. We find that higher tobacco prices have a negative effect on the initiation into smoking for males but not for females. We find no effect of non-price tobacco control policies on smoking initiation.
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Affiliation(s)
| | - Jan C. van Ours
- Erasmus School of Economics, Erasmus University Rotterdam, Rotterdam, The Netherlands
- Department of Economics, University of Melbourne, Parkville, Australia
- Tinbergen Institute, Rotterdam, The Netherlands
- CEPR, London, UK
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6
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How Raising Tobacco Prices Affects the Decision to Start and Quit Smoking: Evidence from Argentina. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16193622. [PMID: 31569603 PMCID: PMC6801604 DOI: 10.3390/ijerph16193622] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 09/04/2019] [Accepted: 09/06/2019] [Indexed: 11/17/2022]
Abstract
We used a two-part model for the estimation of the price elasticity of participation and consumption of cigarettes by the duration of the smoking habit and a continuous-time split-population model for the estimation of prevalence and duration of smoking onset and smoking addiction, allowing for covariates in the participation component of the model. Results: We computed the total price elasticity of consumption of cigarettes by quartiles of addiction and found that for the people located in the lowest quartile of addiction the total price elasticity is around -0.51; while for those located in the highest quartile of addiction this figure is only -0.19. Then, a 10% increase in cigarette prices, via taxes, reduces the consumption of those in the early stages of the addiction by 5% and for those with a longer history of addiction by only 1.9%. Estimating the continuous-time split-population model we found that, at the mean starting age of 15 years, an increase of 10% in real cigarette prices is expected to delay smoking onset by almost two and a half years. On the other hand, the same policy is less effective to reduce the duration of the habit because there is no meaningful relationship between the duration of the smoking habit and the real price of cigarettes.The policy of raising cigarette excise taxes, to increment prices, seems to be more effective to delay smoking onset. On the other hand, the same policy is less effective to reduce the duration of the habit. A policy recommendation that emerges from this evidence is that for people with a developed addiction a combination of increasing taxes and other public health policies, like cessation therapies, could prove more effective.
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7
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Shang C, Chaloupka FJ, Fong GT, Gupta PC, Pednekar MS. The Association Between State Value-Added Taxes and Tobacco Use in India-Evidence From GATS and TCP India Survey. Nicotine Tob Res 2019; 20:1344-1352. [PMID: 29059339 DOI: 10.1093/ntr/ntx184] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 08/17/2017] [Indexed: 01/17/2023]
Abstract
Introduction State value-added taxes (VAT) on tobacco products have been increased significantly in recent years in India. Evidence on how these VATs were associated with smoking is highly needed. Methods State bidi and cigarette VAT rates were linked to Global Adult Tobacco Survey (GATS) India 2009-2010 and Tobacco Control Policy (TCP) India Survey waves 1 (2010-2011) and 2 (2012-2013), respectively. These linked data were used to analyze the associations between bidi VAT rates and bidi smoking, between cigarette VAT rates and cigarette smoking, and between the two VAT rates and dual use of bidis and cigarettes. Weighted logistic regressions were employed to examine GATS cross-sectional data, whereas generalized estimating equations (GEE) were employed to examine longitudinal TCP data. We further stratified the analyses by gender. Results A 10% increase in cigarette VAT rates was associated with a 6.5% (p < .001) decrease in dual use of cigarettes and bidis among adults and a 0.9% decrease (p < .05) in cigarette smoking among males in TCP; and with a 21.6% decrease (p < .05) in dual use among adults and a 17.2% decrease (p < .001) in cigarette smoking among males in GATS. TCP analyses controlling for state fixed effects are less likely to be biased and indicate a cigarette price elasticity of -0.44. As female smoking prevalence was extremely low, these associations were nonsignificant for females. Conclusions Higher state cigarette VAT rates in India were significantly associated with lower cigarette smoking and lower dual use of cigarettes and bidis. Increasing state VAT rates may significantly reduce smoking in India. Implications Both Global Adult Tobacco Survey and Tobacco Control Policy (TCP) India datasets suggest that higher state cigarette value-added tax rates were significantly associated with lower male cigarette smoking and lower dual use of cigarettes and bidis among all adults in India. TCP analyses indicate a cigarette price elasticity of -0.44. As shown in this study, state tobacco taxes in the current taxation system are likely effective in reducing smoking. Given this, a future central goods and service tax (GST) system could consider keeping states' authority in implementing local tobacco taxes or designing a GST system that is equally or more effective in reducing tobacco use.
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Affiliation(s)
- Ce Shang
- Health Policy Center, Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL
| | - Frank J Chaloupka
- Health Policy Center, Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL.,Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, IL
| | - Geoffrey T Fong
- Department of Psychology, University of Waterloo, Waterloo, Canada.,Ontario Institute for Cancer Research, Toronto, Canada
| | - Prakash C Gupta
- Healis Sekhsaria Institute for Public Health, Navi Mumbai, India
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8
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Guindon GE, Paraje GR, Chaloupka FJ. Association of Tobacco Control Policies With Youth Smoking Onset in Chile. JAMA Pediatr 2019; 173:754-762. [PMID: 31180455 PMCID: PMC6563596 DOI: 10.1001/jamapediatrics.2019.1500] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Tobacco smoking is still responsible for more than 6 million preventable deaths annually, most of which occur in low- and middle-income countries. South American countries, Chile in particular, endure some of the highest cigarette smoking prevalence rates globally. Despite the lack of any meaningful increases in cigarette taxes (the most effective tobacco control measure) between 1999 and 2014, cigarette prices in Chile increased sharply almost entirely driven by British American Tobacco (BAT). OBJECTIVE To examine the associations between cigarette prices and nonprice tobacco control policies targeted at youth introduced in 2006 (Law 20105) and smoking onset among Chilean youths. DESIGN, SETTING, AND PARTICIPANTS This study used data from 8 waves of a large national school survey of urban communities in Chile conducted between October and December in 2001, 2003, 2015, 2007, 2009, 2011, 2013, and 2015 and discrete-time hazard models. Data analysis was performed from May 2017 to January 2019. EXPOSURES Prices, advertising, and retail restrictions. MAIN OUTCOMES AND MEASURES Smoking onset (the transition between never smoking and smoking) in youth. RESULTS In this study of 181 624 survey respondents in 8751 Chilean secondary schools, higher prices (own-price elasticity [percentage change in quantity demanded in response to a 1% change in price], -0.40; 95% CI, -0.45 to -0.36) and the tobacco control policies enacted in 2006 (hazard ratio, 0.83; 95% CI, 0.81-0.85) were associated with lower hazards of starting smoking. The study found that an increase in real prices of 58.6% and the introduction of Law 20105 were associated with similar lower hazards of starting smoking (hazard ratio, 0.83; 95% CI, 0.81-0.85); in comparison, between 1999 and 2017, inflation-adjusted cigarette prices increased by 206%. CONCLUSIONS AND RELEVANCE The findings suggest that higher prices initiated by BAT and the tobacco control policies enacted by the Ministry of Health in 2006 were associated with lower hazards of starting smoking in Chilean youth. Large cigarette tax increases may be a strategy that can be used to help reduce smoking among youths in Chile.
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Affiliation(s)
- G. Emmanuel Guindon
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada,Department of Economics, McMaster University, Hamilton, Ontario, Canada,Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada
| | | | - Frank J. Chaloupka
- Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago,National Bureau of Economic Research, Cambridge, Massachusetts,Institute for Health Research and Policy, University of Illinois at Chicago, Chicago
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9
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Shang C, Chaloupka FJ, Gupta PC, Pednekar MS, Fong GT. Association between tobacco prices and smoking onset: evidence from the TCP India Survey. Tob Control 2018; 28:s3-s8. [PMID: 30275169 DOI: 10.1136/tobaccocontrol-2017-054178] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 09/05/2018] [Accepted: 09/07/2018] [Indexed: 11/04/2022]
Abstract
BACKGROUND Tobacco use is prevalent among youth and adults in India. However, direct evidence on how increasing taxes or prices affect tobacco use onset is scarce. OBJECTIVE To analyse the associations between cigarette and bidi prices and smoking onset in India, and how these associations differ by socioeconomic status. METHODOLOGY The Wave 1 of the Tobacco Control Policy Evaluation India Survey by the International Tobacco Control Project contains information on the age at smoking onset for cigarettes and bidis. Using this information, data were expanded to a yearly pseudo-panel dataset that tracked respondents at risk of smoking onset from 1998 to 2011. The associations between bidi prices and bidi smoking onset, between cigarette prices and cigarette smoking onset, and between bidi and cigarette prices and any smoking onset were examined using a discrete-time hazard model with a logit link function. Stratified analyses were conducted to examine the difference in these associations by rural versus urban division. RESULTS We found that higher bidi prices were significantly associated with a lowered hazard of bidi smoking onset (OR 0.42, 95% CI 0.35 to 0.51). Higher cigarette prices were significantly (OR 0.87, 95% CI 0.83 to 0.92) associated with a lowered hazard of cigarette smoking onset among urban residents, but this association was non-significant when SEs were clustered at the state level. In addition, the association between increasing bidis prices and lowered hazards of bidi smoking onset was greater for urban residents than for rural ones (p<0.01). CONCLUSIONS Under the new regime of a central goods and service system, policymakers may need to raise the prices of tobacco products sufficiently to curb smoking onset.
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Affiliation(s)
| | - Frank J Chaloupka
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois, USA.,Department of Economics, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Prakash C Gupta
- Healis Sekhsaria Institute for Public Health, Mumbai, Maharashtra, India
| | - Mangesh S Pednekar
- Healis Sekhsaria Institute for Public Health, Mumbai, Maharashtra, India
| | - Geoffrey T Fong
- Department of Psychology, University of Waterloo, Toronto, Ontario, Canada.,Ontario Institute for Cancer Research, Toronto, Ontario, Canada
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Duc DM, Vui LT, Son HN, Minh HV. Smoking Initiation and Cessation among Youths in Vietnam: A Longitudinal Study Using the Chi Linh Demographic-Epidemiological Surveillance System (CHILILAB DESS). AIMS Public Health 2016; 4:1-18. [PMID: 29546208 PMCID: PMC5696561 DOI: 10.3934/publichealth.2017.1.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 12/23/2016] [Indexed: 12/04/2022] Open
Abstract
Study of smoking initiation and cessation is particularly important in adolescent population because smoking prevention and cessation at this time may prevent several health consequences later in life. There is a very limited knowledge about the determinants of smoking initiation and cessation among youths in Vietnam. This limits the development and implementation of appropriately targeted anti-smoking prevention interventions. This study applied pooled data from 3 rounds of a longitudinal survey in the Chi Linh Demographic—Epidemiological Surveillance System (CHILILAB DESS) in a northern province in Vietnam to analyse the determinants of smoking initiation and cessation among youths. The total of youths in the first round, second, and third rounds was 12,406, 10,211, and 7,654, respectively. The random-effects logit model controlling for both time-variant and time-invariant variables was conducted to explore the associated factors with new smokers and quitters. We found an increase trend of new smokers (7.0% to 9.6%) and quitters (27.5% to 31.4%) during 2009–2013. Smoking initiation and cessation are the result of multifactorial influences of demographic and health behaviours and status. Demographic background (older youths, male, unmarried youths, and youths having informal work) and health behaviours and status (youths who had smoking family members and/or smoking close friends, and had harmful drinking) were more likely to initiate smoking and more difficult to quit smoking. Among these variables, youths who had smoking close-friends had the highest likelihood of both initiating smoking and failed quitting. Our results could represent the similar health problems among youths in peri-urban areas in Vietnam. Further, our findings suggested that anti-smoking interventions should involve peer intervention, integrated with the reduction of other unhealthy behaviours such as alcohol consumption, and to focus on adolescents in their very early age (10–14 years old).
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Affiliation(s)
- Duong Minh Duc
- Hanoi School of Public Health, 138 Giang Vo Street, Ba Dinh District, Ha Noi, Vietnam.,International Maternal and Child Health (IMCH), Department of Women's and Children's Health, Uppsala University, SE-751 85 Uppsala, Sweden
| | - Le Thi Vui
- Hanoi School of Public Health, 138 Giang Vo Street, Ba Dinh District, Ha Noi, Vietnam
| | - Hoang Ngoc Son
- Department of General Surgery, Viet Duc University Hospital, 40 Trang Thi Street, Hoan Kiem District, Ha Noi, Vietnam
| | - Hoang Van Minh
- Hanoi School of Public Health, 138 Giang Vo Street, Ba Dinh District, Ha Noi, Vietnam
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Vellios N, van Walbeek C. Determinants of regular smoking onset in South Africa using duration analysis. BMJ Open 2016; 6:e011076. [PMID: 27431900 PMCID: PMC4964680 DOI: 10.1136/bmjopen-2016-011076] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Revised: 06/24/2016] [Accepted: 06/28/2016] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES South Africa has achieved significant success with its tobacco control policy. Between 1994 and 2012, the real price of cigarettes increased by 229%, while regular smoking prevalence decreased from about 31% to 18.2%. METHODS Cigarette prices and socioeconomic variables are used to examine the determinants of regular smoking onset. We apply duration analysis techniques to the National Income Dynamics Study, a nationally representative survey of South Africa. RESULTS We find that an increase in cigarette prices significantly reduces regular smoking initiation among males, but not among females. Regular smoking among parents is positively correlated with smoking initiation among children. Children with more educated parents are less likely to initiate regular smoking than those with less educated parents. Africans initiate later and at lower rates than other race groups. CONCLUSIONS As the tobacco epidemic is shifting towards low-income and middle-income countries, there is an increasing urgency to perform studies in these countries to influence policy. Higher cigarette excise taxes, which lead to higher retail prices, reduce smoking prevalence by encouraging smokers to quit and by discouraging young people from starting smoking.
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Affiliation(s)
- Nicole Vellios
- School of Economics, University of Cape Town, Cape Town, Western Cape, South Africa
| | - Corné van Walbeek
- School of Economics, University of Cape Town, Cape Town, Western Cape, South Africa
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12
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Tanihara S, Momose Y. Reasons for smoking cessation attempts among Japanese male smokers vary by nicotine dependence level: a cross-sectional study after the 2010 tobacco tax increase. BMJ Open 2015; 5:e006658. [PMID: 25795690 PMCID: PMC4368926 DOI: 10.1136/bmjopen-2014-006658] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 02/14/2015] [Accepted: 02/16/2015] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To examine the association between smoking cessation attempts during the previous 12 months, motivators to quit smoking and nicotine dependence levels among current male smokers after Japan's massive 2010 tobacco tax increase. DESIGN Cross-sectional study. SETTING A self-reported questionnaire about smoking habits, nicotine dependence levels and factors identified as motivators to quit smoking was administered to 9378 employees working at a company located in Fukuoka Prefecture in Japan (as of 1 October 2011). PARTICIPANTS A total of 2251 male current smokers 20-69 years old. PRIMARY AND SECONDARY OUTCOME MEASURES Nicotine dependence level assessed by Fagerström Test for Cigarette Dependence (FTCD), smoking cessation attempts during the previous 12 months and motivators for smoking cessation. RESULTS The proportion of current smokers who had attempted to quit smoking within the previous 12 months was 40.6%. Nicotine dependence level of current smokers was negatively associated with cessation attempts during the previous 12 months. Motivators for smoking cessation differed by nicotine dependence levels. 'The rise in cigarette prices since October 2010' as a smoking cessation motivator increased significantly at the medium nicotine dependence level (OR 1.44, 95% CI 1.09 to 1.90); however, this association was not statistically significant for individuals with high nicotine dependence (OR 1.24, 95% CI 0.80 to 1.92). 'Feeling unhealthy' was significantly negatively associated for medium (OR 0.42, 95% CI 0.27 to 0.65) and high (OR 0.31, 95% CI 0.14 to 0.71) nicotine dependence levels. Trend associations assessed by assigning ordinal numbers to total FTCD score for those two motivators were statistically significant. CONCLUSIONS The efficacy of smoking cessation strategies can be improved by considering the target group's nicotine dependence level. For smokers with medium and high nicotine dependence levels, more effective strategies aimed at encouraging smoking cessation, such as policy interventions including increasing tobacco taxes, are needed.
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Affiliation(s)
- Shinichi Tanihara
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Yoshito Momose
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
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13
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Shang C. The effect of smoke-free air law in bars on smoking initiation and relapse among teenagers and young adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:504-20. [PMID: 25584419 PMCID: PMC4306876 DOI: 10.3390/ijerph120100504] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Accepted: 12/23/2014] [Indexed: 11/16/2022]
Abstract
BACKGROUND Existing evidence has shown that most smoking uptake and escalation occurs while smokers are teenagers or young adults. Effective policies that reduce smoking uptake and escalation will play an important role in curbing cigarette smoking. This study aims to investigate the effect of smoke-free air (SFA) laws in bars on smoking initiation/relapse while controlling for other confounders. METHODS The national longitudinal Survey of Youth 1997 (NLSY97) from 1997-2009 was linked to state-level scores for the strength of SFA laws in order to carry out the analysis. RESULTS AND CONCLUSION We find that SFA laws in bars with exemptions significantly reduce (p ≤ 0.01) the probability of smoking initiation (one-puff, daily, and heavy smoking initiation). The 100% SFA law in bars without exemption significantly deters smoking relapse from abstinence into daily smoking (p ≤ 0.05) or relapse from abstinence into heavy smoking (p ≤ 0.01) among people age 21 or older. The reduction of one-puff and daily smoking initiation is larger among ages 20 or younger than ages 21 or older, while the reduction in relapse does not differ by whether respondents reach the drinking age. Results also indicate that higher cigarette taxes significantly reduce daily smoking initiation and relapse into nondaily and light smoking.
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Affiliation(s)
- Ce Shang
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL 60608, USA.
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14
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Morton J, Song Y, Fouad H, Awa FE, Abou El Naga R, Zhao L, Palipudi K, Asma S. Cross-country comparison of waterpipe use: nationally representative data from 13 low and middle-income countries from the Global Adult Tobacco Survey (GATS). Tob Control 2013; 23:419-27. [PMID: 23760609 PMCID: PMC4145417 DOI: 10.1136/tobaccocontrol-2012-050841] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE Evidence shows that smoking tobacco using a waterpipe is significantly associated with diseases. Despite this, waterpipe use seems to be increasing worldwide, though nationally representative data are not widely available. The Global Adult Tobacco Survey (GATS) provides an opportunity to measure various indicators of waterpipe use from nationally representative surveys. METHODS Data were obtained for adults 15 years of age or older from 13 countries (Bangladesh, Brazil, China, Egypt, India, Mexico, Philippines, Russia, Thailand, Turkey, Ukraine, Uruguay and Vietnam) who completed GATS from 2008-2010. The GATS questionnaire collected data on current waterpipe use, including daily/less than daily prevalence and number of sessions per day/week. An optional waterpipe module measured former use, age of initiation, and level of consumption during a session. RESULTS GATS was successful in producing nationally representative data on waterpipe use from 13 countries, many of which for the first time. The prevalence of waterpipe use among men was highest in Vietnam (13.0%) and Egypt (6.2%); among women, waterpipe use was highest in Russia (3.2%) and Ukraine (1.1%). While over 90% of adults in Ukraine thought smoking tobacco causes serious illness, only 31.4% thought smoking tobacco using a waterpipe causes serious illness. CONCLUSIONS GATS data provide the ability to analyse waterpipe use within a country and across countries. Monitoring of waterpipe use at a national level will better enable countries to target tobacco control interventions such as education campaigns about the negative health effects of waterpipe use.
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Affiliation(s)
- Jeremy Morton
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Yang Song
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Heba Fouad
- World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Fatimah El Awa
- World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Randa Abou El Naga
- World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Luhua Zhao
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Krishna Palipudi
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Samira Asma
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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