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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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Guindon GE, Abbas U, Trivedi R, Garasia S, Johnson S, John RM. Socioeconomic differences in the impact of prices and taxes on tobacco use in low- and middle-income countries-A systematic review. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002342. [PMID: 37756265 PMCID: PMC10529577 DOI: 10.1371/journal.pgph.0002342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 08/07/2023] [Indexed: 09/29/2023]
Abstract
There is indisputable evidence that increases in taxes that raise tobacco prices reduce tobacco use. Consumption taxes on manufactured tobacco products, however, can be regressive in socioeconomic status (e.g., when the ratio of tax paid to income is lower for higher-income groups than for lower-income groups). Nevertheless, if the poor or less educated are more price responsive, a change in tobacco tax may be progressive in socioeconomic status. Existing reviews clearly indicate that populations with lower income or education are more responsive to tobacco tax and price changes than higher-income and more educated populations in high-income countries. Research pertaining to low- and middle-income countries was, however, limited and inconclusive. We conducted a review of quantitative studies that examined if socioeconomic status modified the association between prices and taxes and tobacco use in low- and middle-income countries. We searched two electronic databases, two search engines, and two working paper repositories. At least two reviewers independently screened articles for inclusion, extracted detailed characteristics, and assessed the risk of bias of each included study. Thirty-two studies met our inclusion criteria. Overall, we found that the evidence in low- and middle-income countries was too limited and methodologically weak to make any conclusive statements. Our review highlights a number of data and methodological limitations in existing studies. The most important limitation was the lack of formal assessment of socioeconomic differences in price responsiveness. Only seven of 32 studies assessed statistically whether own-price effects were modified by socioeconomic status. Many modelling studies have examined the distributional effect of a tax increase on tobacco use, while assuming a strong own-price elasticity gradient in income. The poor were generally assumed to be more responsive to price by a factor of two to five, relative to the wealthy. Although there are theoretical reasons to expect poorer individuals to be more responsive to monetary prices than wealthy ones in low- and middle-income countries, our review provides little empirical support.
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Affiliation(s)
- G. Emmanuel Guindon
- Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Economics, McMaster University, Hamilton, Ontario, Canada
| | - Umaima Abbas
- Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada
| | - Riya Trivedi
- Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada
| | - Sophiya Garasia
- Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Sydney Johnson
- Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada
| | - Rijo M. John
- Rajagiri College of Social Sciences, Rajagiri PO, Kochi, Kerala, India
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Chen-Sankey J, Unger JB, Bernat E, Niederdeppe J, Bansal-Travers M, Choi K. Price promotion receipt and use progression of any tobacco, cigarettes, e-cigarettes and cigars among US youth between 2016 and 2018. Tob Control 2023; 32:225-232. [PMID: 34301838 PMCID: PMC8782922 DOI: 10.1136/tobaccocontrol-2021-056667] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 07/07/2021] [Indexed: 01/24/2023]
Abstract
BACKGROUND Tobacco price promotions may prompt tobacco trials among youth. We assessed whether receiving price promotions for any tobacco, cigarettes, e-cigarettes and cigars was associated with product use progression. METHODS The analysis included a nationally representative sample of youth never tobacco users (aged 12-16; n=9405) from wave 4 (2016-2018) of the Population Assessment of Tobacco and Health Study. We assessed past-year receipt of price promotions and use progression (initiation, current use and ever regular use) for any tobacco, cigarettes, e-cigarettes and cigars 1 year later at wave 4.5 (2017-2018). Multivariable logistic regressions were used to examine the associations between receiving price promotions and use progression by product type, controlling for covariates. RESULTS At wave 4.5, 9.4% of youth initiated any tobacco (1.8%, 7.8% and 0.9% for cigarettes, e-cigarettes and cigars), and 5.4% received any price promotions (3.8%, 3.1% and 0.9% for cigarettes, e-cigarettes and cigars). Receiving any tobacco price promotions was associated with any tobacco initiation (adjusted OR (AOR)=1.77; 95% CI 1.30 to 2.41), current use (AOR=1.54; 95% CI 1.06 to 2.23) and ever regular use (AOR=1.76; 95% CI 1.04 to 3.10). Receiving e-cigarette price promotions was associated with e-cigarette initiation (AOR=1.78; 95% CI 1.18 to 2.26), current use (AOR=1.88; 95% CI 1.17 to 3.02) and ever regular use (AOR=2.10; 95% CI 1.02 to 4.40). The associations specific to cigarettes and cigars were only found for product initiation. DISCUSSION Receiving price promotions for any tobacco and e-cigarettes was respectively associated with the use progression of any tobacco and e-cigarettes. Continuous monitoring of tobacco marketing activities is needed to identify youth-appealing price promotion tactics.
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Affiliation(s)
- Julia Chen-Sankey
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, Maryland, USA
| | - Jennifer B Unger
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Edward Bernat
- Department of Psychology, University of Maryland, College Park, Maryland, USA
| | - Jeff Niederdeppe
- Department of Communication, Cornell University, Ithaca, New York, USA
| | | | - Kelvin Choi
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, Maryland, USA
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Anderson DM, Matsuzawa K, Sabia JJ. CIGARETTE TAXES AND TEEN MARIJUANA USE. NATIONAL TAX JOURNAL 2020; 73:475-510. [PMID: 33888919 PMCID: PMC8059644 DOI: 10.17310/ntj.2020.2.06] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
The spillover effect of cigarette taxes on youth marijuana use has been the subject of intense public debate. Opponents of cigarette taxes warn that tax hikes will cause youths to substitute toward marijuana. On the other hand, public health experts often claim that because tobacco is a "gateway" drug, higher cigarette taxes will deter youth marijuana use. Using data from the National and State Youth Risk Behavior Surveys (YRBS) for the period 1991-2017, we explore the relationship between state excise taxes on cigarettes and teen marijuana use. In general, our results fail to support either of the above hypotheses. Rather, we find little evidence to suggest that teen marijuana use is sensitive to changes in the state cigarette tax. This null result holds for the sample period where cigarette taxes are observed to have the largest effect on teen cigarette use and across a number of demographic groups in the data. Finally, we find preliminary evidence that the recent adoption of state e-cigarette taxes is associated with a reduction in youth marijuana use.
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Affiliation(s)
- D Mark Anderson
- Department of Agricultural Economics and Economics, Montana State University, Bozeman, MT, USA, Institute of Labor Economics, Bonn, Germany, and National Bureau of Economic Research, Cambridge, MA, USA
| | - Kyutaro Matsuzawa
- Center for Health Economics and Policy Studies, San Diego State University, San Diego, CA, USA
| | - Joseph J Sabia
- Center for Health Economics and Policy Studies, Department of Economics, San Diego State University, San Diego, CA, USA, and Institute of Labor Economics, Bonn, Germany
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Kwon DS, Kim TH, Byun MK, Kim HJ, Lee HS, Park HJ. Positive Effects of the National Cigarette Price Increase Policy on Smoking Cessation in South Korea. Tuberc Respir Dis (Seoul) 2020; 83:71-80. [PMID: 31905434 PMCID: PMC6953490 DOI: 10.4046/trd.2019.0011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 06/10/2019] [Accepted: 08/30/2019] [Indexed: 01/15/2023] Open
Abstract
Background In January 2015, South Korea's government raised the cigarette tax, and the retail price of cigarettes abruptly increased by 80% compared to the previous year. This research aimed to determine the effect of this increase on smoking cessation among South Korean smokers. Methods We analyzed data collected by the 2013–2015 South Korea National Health and Nutrition Examination Survey of 15,203 South Koreans over 19 years old using regression analysis. We examined the recent non-smoking period of nonsmoking people, prepared according to the survey, and analyzed the recent smoking cessation ratio. Results Among smokers, from 2013 to 2014, the smoking cessation rate was 7.2%, and it increased to 9.9% in 2015 after the increase in the cigarette tax. In 2015, the recent smoking cessation rate was higher among people over the age of 60 (odds ratio [OR], 2.67) compared to those between the ages of 40 and 49. The recent smoking cessation rate was higher among people with below elementary education (OR, 2.28) and above university education (OR, 1.94) compared to high school, higher for those with apartments (OR, 1.74) compared to general type residences, and higher among those with a household income in the low-middle quartile (Q2) (OR, 2.32) compared to the highest quartile (Q4). Conclusion This innovative policy including increase in cigarette prices affected smoking cessation, and its impact varied by sub-group of smokers in South Korea.
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Affiliation(s)
- Do Sun Kwon
- Department of Internal Medicine, Gangnam Severance Hospital, Seoul, Korea
| | - Tae Hee Kim
- Department of Internal Medicine, Gangnam Severance Hospital, Seoul, Korea
| | - Min Kwang Byun
- Department of Internal Medicine, Gangnam Severance Hospital, Seoul, Korea
| | - Hyung Jung Kim
- Department of Internal Medicine, Gangnam Severance Hospital, Seoul, Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Korea
| | - Hye Jung Park
- Department of Internal Medicine, Gangnam Severance Hospital, Seoul, Korea.
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Asare S, Stoklosa M, Drope J, Larsen A. Effects of Prices on Youth Cigarette Smoking and Tobacco Use Initiation in Ghana and Nigeria. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3114. [PMID: 31461885 PMCID: PMC6747324 DOI: 10.3390/ijerph16173114] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 08/20/2019] [Accepted: 08/23/2019] [Indexed: 11/16/2022]
Abstract
Background: Population growth in the African region is set to outpace the rate of decline in smoking prevalence, leading to a projected increase in the total number of smokers. As most tobacco users initiate during their adolescent years, tobacco prevention strategies targeting youth will be particularly important. Methods: This study estimated the impact of cigarette prices on youth cigarette smoking and tobacco use initiation in Ghana and Nigeria using the Global Youth Tobacco Survey data. First, we used cross-section data and logit models to estimate the effects of prices on youth cigarette smoking. Second, we created pseudo longitudinal data and used continuous-time hazard models to evaluate the impact of cigarette prices on tobacco use initiation. Results: We found that higher cigarette prices decreased both 30-day cigarette smoking and tobacco use onset significantly in both Ghana and Nigeria. Additionally, the price elasticity of cigarette smoking and tobacco use initiation ranged from -0.44 to -1.13, and -1.04 to -3.66, respectively. Conclusions: As one of the first studies on youth tobacco consumption in Sub-Saharan Africa, this study strongly suggests that policies that increase real cigarette prices can lower both cigarette smoking and tobacco use initiation among youth in Ghana and Nigeria.
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Affiliation(s)
- Samuel Asare
- Department of Economics, Andrew Young School of Policy Studies, Georgia State University, Atlanta, GA 30303, USA.
| | - Michal Stoklosa
- Economic and Health Policy Research, American Cancer Society, Atlanta, GA 30303, USA
| | - Jeffrey Drope
- Economic and Health Policy Research, American Cancer Society, Atlanta, GA 30303, USA
| | - Aidan Larsen
- Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
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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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Guindon GE, Paraje GR, Chaloupka FJ. El impacto de los precios e impuestos sobre el consumo de productos de tabaco en América Latina y el Caribe. Am J Public Health 2018. [DOI: 10.2105/ajph.2014.302396s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- G. Emmanuel Guindon
- Centro de Economía de la Salud y Análisis de Políticas y al Departamento de Epidemiología y Bioestadística Clínica, Universidad McMaster, Hamilton (Canadá)
- Escuela de Negocios, Universidad Adolfo Ibáñez, Santiago (Chile)
- Departamento de Economía y al Instituto de Investigación y Políticas de Salud, Universidad de Illinois, Chicago, y la Oficina Nacional de Investigaciones Económicas de los Estados Unidos, Cambridge, Massachusetts La correspondencia se debe dirigir a G. Emmanuel Guindon: Correo electrónico:
| | - Guillermo R. Paraje
- Centro de Economía de la Salud y Análisis de Políticas y al Departamento de Epidemiología y Bioestadística Clínica, Universidad McMaster, Hamilton (Canadá)
- Escuela de Negocios, Universidad Adolfo Ibáñez, Santiago (Chile)
- Departamento de Economía y al Instituto de Investigación y Políticas de Salud, Universidad de Illinois, Chicago, y la Oficina Nacional de Investigaciones Económicas de los Estados Unidos, Cambridge, Massachusetts La correspondencia se debe dirigir a G. Emmanuel Guindon: Correo electrónico:
| | - Frank J. Chaloupka
- Centro de Economía de la Salud y Análisis de Políticas y al Departamento de Epidemiología y Bioestadística Clínica, Universidad McMaster, Hamilton (Canadá)
- Escuela de Negocios, Universidad Adolfo Ibáñez, Santiago (Chile)
- Departamento de Economía y al Instituto de Investigación y Políticas de Salud, Universidad de Illinois, Chicago, y la Oficina Nacional de Investigaciones Económicas de los Estados Unidos, Cambridge, Massachusetts La correspondencia se debe dirigir a G. Emmanuel Guindon: Correo electrónico:
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Guindon GE, Paraje GR, Chaloupka FJ. The Impact of Prices and Taxes on the Use of Tobacco Products in Latin America and the Caribbean. Am J Public Health 2018. [DOI: 10.2105/ajph.2014.302396r] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- G. Emmanuel Guindon
- G. Emmanuel Guindon is with the Centre for Health Economics and Policy Analysis and the Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton. Guillermo R. Paraje is with the Escuela de Negocios, Universidad Adolfo Ibáñez, Santiago, Chile. Frank J. Chaloupka is with the Department of Economics and the Institute for Health Research and Policy, University of Illinois, Chicago, and the US National Bureau of Economic Research, Cambridge, MA
| | - Guillermo R. Paraje
- G. Emmanuel Guindon is with the Centre for Health Economics and Policy Analysis and the Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton. Guillermo R. Paraje is with the Escuela de Negocios, Universidad Adolfo Ibáñez, Santiago, Chile. Frank J. Chaloupka is with the Department of Economics and the Institute for Health Research and Policy, University of Illinois, Chicago, and the US National Bureau of Economic Research, Cambridge, MA
| | - Frank J. Chaloupka
- G. Emmanuel Guindon is with the Centre for Health Economics and Policy Analysis and the Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton. Guillermo R. Paraje is with the Escuela de Negocios, Universidad Adolfo Ibáñez, Santiago, Chile. Frank J. Chaloupka is with the Department of Economics and the Institute for Health Research and Policy, University of Illinois, Chicago, and the US National Bureau of Economic Research, Cambridge, MA
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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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11
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Pesko MF, Huang J, Johnston LD, Chaloupka FJ. E-cigarette price sensitivity among middle- and high-school students: evidence from monitoring the future. Addiction 2018; 113:896-906. [PMID: 29193537 PMCID: PMC5895490 DOI: 10.1111/add.14119] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 07/17/2017] [Accepted: 11/21/2017] [Indexed: 11/27/2022]
Abstract
AIMS We estimated associations between e-cigarette prices (both disposable and refill) and e-cigarette use among middle and high-school students in the United States. We also estimated associations between cigarette prices and e-cigarette use. DESIGN We used regression models to estimate the associations between e-cigarette and cigarette prices and e-cigarette use. In our regression models, we exploited changes in e-cigarette and cigarette prices across four periods of time and across 50 markets. We report the associations as price elasticities. In our primary model, we controlled for socio-demographic characteristics, cigarette prices, tobacco control policies, market fixed effects and year-quarter fixed effects. SETTING United States of America. PARTICIPANTS A total of 24 370 middle- and high-school students participating in the Monitoring the Future Survey in years 2014 and 2015. MEASUREMENTS Self-reported e-cigarette use over the last 30 days. Average quarterly cigarette prices, e-cigarette disposable prices and e-cigarette refill prices were constructed from Nielsen retail data (inclusive of excise taxes) for 50 US markets. FINDINGS In a model with market fixed effects, we estimated that a 10% increase in e-cigarette disposable prices is associated with a reduction in the number of days vaping among e-cigarette users by approximately 9.7% [95% confidence interval (CI) = -17.7 to 1.8%; P = 0.02] and is associated with a reduction in the number of days vaping by the full sample by approximately 17.9% (95% CI = -31.5 to -4.2%; P = 0.01). Refill e-cigarette prices were not statistically significant predictors of vaping. Cigarette prices were not associated significantly with e-cigarette use regardless of the e-cigarette price used. However, in a model without market fixed effects, cigarette prices were a statistically significant positive predictor of total e-cigarette use. CONCLUSIONS Higher e-cigarette disposable prices appear to be associated with reduced e-cigarette use among adolescents in the US.
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Affiliation(s)
| | - Jidong Huang
- School of Public Health, Georgia State University, Atlanta, GA
| | - Lloyd D. Johnston
- Institute for Social Research, University of Michigan, Ann Arbor, MI
| | - Frank J. Chaloupka
- Health Policy Center, Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL
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Tolstrup JS, Pisinger VSC, Egan KK, Christensen AI. Trends in smoking and smokeless tobacco use among Danish Adolescents, 1997-2014. Tob Prev Cessat 2018; 4:10. [PMID: 32411838 PMCID: PMC7205043 DOI: 10.18332/tpc/86331] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 03/05/2018] [Accepted: 03/06/2018] [Indexed: 01/23/2023]
Abstract
INTRODUCTION High rates of smoking among adolescents remain a public health concern. This study investigates smoking behavior and use of smokeless tobacco among Danish high-school students and assesses how smoking and use of smokeless tobacco cluster in schools and school classes. We estimate the trend in cigarette smoking from 1997 to 2014. METHODS We used data on 70 243 students, from 3 214 school classes in 119 high schools, who participated in the Danish National Youth Study from 2014. We had information on 87% of all Danish high schools and 85% of eligible students. We also used data from 1997 on 26 644 high-school students from a similar data set to assess the chronological trend in smoking. We calculated prevalences and intraclass correlation coefficients (ICCs) to estimate between-school and between-school class clustering in smoking and use of smokeless tobacco. RESULTS In all, 14% of boys and 11% of girls were daily smokers. A large fraction of the variation in smoking and the use of smokeless tobacco was attributable to the school and school-class level (ICC of 0.19, 0.12, 0.16 and 0.27, for daily smoking, waterpipe smoking, use of electronic cigarettes and snuff/chewing tobacco, respectively). Daily smoking decreased from 15% in 1997 to 12% in 2014, while more students were occasional smokers in 2014 than in 1997 (30% vs 18%). CONCLUSIONS The prevalence of smoking was high among Danish high-school students and had changed little since 1997. The school and class environment accounted for a large part of the variation in smoking behavior.
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Affiliation(s)
- Janne S Tolstrup
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Veronica S C Pisinger
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Kia K Egan
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Anne I Christensen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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Bollard T, Maubach N, Walker N, Ni Mhurchu C. Effects of plain packaging, warning labels, and taxes on young people's predicted sugar-sweetened beverage preferences: an experimental study. Int J Behav Nutr Phys Act 2016; 13:95. [PMID: 27580589 PMCID: PMC5007687 DOI: 10.1186/s12966-016-0421-7] [Citation(s) in RCA: 89] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Accepted: 08/09/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Consumption of sugar-sweetened beverages (SSBs) is associated with increased risk of obesity, diabetes, heart disease and dental caries. Our aim was to assess the effects of plain packaging, warning labels, and a 20 % tax on predicted SSB preferences, beliefs and purchase probabilities amongst young people. METHODS A 2 × 3 × 2 between-group experimental study was conducted over a one-week period in August 2014. Intervention scenarios were delivered, and outcome data collected, via an anonymous online survey. Participants were 604 New Zealand young people aged 13-24 years who consumed soft drinks regularly. Participants were randomly allocated using a computer-generated algorithm to view one of 12 experimental conditions, specifically images of branded versus plain packaged SSBs, with either no warning, a text warning, or a graphic warning, and with or without a 20 % tax. Participant perceptions of the allocated SSB product and of those who might consume the product were measured using seven-point Likert scales. Purchase probabilities were measured using 11-point Juster scales. RESULTS Six hundred and four young people completed the survey (51 % female, mean age 18 (SD 3.4) years). All three intervention scenarios had a significant negative effect on preferences for SSBs (plain packaging: F (6, 587) = 54.4, p <0.001; warning label: F (6, 588) = 19.8, p <0.001; 20 % tax: F (6, 587) = 11.3, p <0.001). Plain packaging and warning labels also had a significant negative impact on reported likelihood of purchasing SSB's (p = <0.001). A 20 % tax reduced participants' purchase probability but the difference was not statistically significant (p = 0.2). CONCLUSIONS Plain packaging and warning labels significantly reduce young people's predicted preferences for, and reported probability of purchasing, SSBs.
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Affiliation(s)
- Tessa Bollard
- Auckland District Health Board, Auckland City Hospital Nutrition, Auckland, New Zealand
| | - Ninya Maubach
- Department of Marketing, University of Otago, Dunedin, New Zealand
| | - Natalie Walker
- National Institute for Health Innovation, University of Auckland, Private Bag 92019, Auckland, New Zealand
| | - Cliona Ni Mhurchu
- National Institute for Health Innovation, University of Auckland, Private Bag 92019, Auckland, New Zealand
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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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15
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Kalant H. A critique of cannabis legalization proposals in Canada. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2016; 34:5-10. [PMID: 27292414 DOI: 10.1016/j.drugpo.2016.05.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 04/27/2016] [Accepted: 05/09/2016] [Indexed: 10/21/2022]
Abstract
An editorial in this issue describes a cannabis policy framework document issued by a major Canadian research centre, calling for legalization of non-medical use under strict controls to prevent increase in use, especially by adolescents and young adults who are most vulnerable to adverse effects of cannabis. It claims that such a system would eliminate the severe personal, social and monetary costs of prohibition, diminish the illicit market, and provide more humane management of cannabis use disorders. It claims that experience with regulation of alcohol and tobacco will enable a system based on public health principles to control access of youth to cannabis without the harm caused by prohibition. The present critique argues that the claims made against decriminalization and for legalization are unsupported, or even contradicted, by solid evidence. Early experience in other jurisdictions suggests that legalization increases use by adolescents and its attendant harms. Regulation of alcohol use does not provide a good model for cannabis controls because there is widespread alcohol use and harm among adolescents and young adults. Government monopolies of alcohol sale have been used primarily as sources of revenue rather than for guarding public health, and no reason has been offered to believe they would act differently with respect to cannabis. Good policy decisions require extensive unbiased information about the individual and social benefits and costs of both drug use and proposed control measures, and value judgments about the benefit/harm balance of each option. Important parts of the necessary knowledge about cannabis are not yet available, so that the value judgments are not yet possible. Therefore, a better case can be made for eliminating some of the harms of prohibition by decriminalization of cannabis possession and deferring decision about legalization until the necessary knowledge has been acquired.
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Affiliation(s)
- Harold Kalant
- Department of Pharmacology & Toxicology, University of Toronto Medical Sciences Building, 1 King's College Circle Toronto, ON, Canada M5S 1A8.
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16
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Hoffman SJ, Tan C. Overview of systematic reviews on the health-related effects of government tobacco control policies. BMC Public Health 2015; 15:744. [PMID: 26242915 PMCID: PMC4526291 DOI: 10.1186/s12889-015-2041-6] [Citation(s) in RCA: 103] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Accepted: 07/08/2015] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Government interventions are critical to addressing the global tobacco epidemic, a major public health problem that continues to deepen. We systematically synthesize research evidence on the effectiveness of government tobacco control policies promoted by the Framework Convention on Tobacco Control (FCTC), supporting the implementation of this international treaty on the tenth anniversary of it entering into force. METHODS An overview of systematic reviews was prepared through systematic searches of five electronic databases, published up to March 2014. Additional reviews were retrieved from monthly updates until August 2014, consultations with tobacco control experts and a targeted search for reviews on mass media interventions. Reviews were assessed according to predefined inclusion criteria, and ratings of methodological quality were either extracted from source databases or independently scored. RESULTS Of 612 reviews retrieved, 45 reviews met the inclusion criteria and 14 more were identified from monthly updates, expert consultations and a targeted search, resulting in 59 included reviews summarizing over 1150 primary studies. The 38 strong and moderate quality reviews published since 2000 were prioritized in the qualitative synthesis. Protecting people from tobacco smoke was the most strongly supported government intervention, with smoke-free policies associated with decreased smoking behaviour, secondhand smoke exposure and adverse health outcomes. Raising taxes on tobacco products also consistently demonstrated reductions in smoking behaviour. Tobacco product packaging interventions and anti-tobacco mass media campaigns may decrease smoking behaviour, with the latter likely an important part of larger multicomponent programs. Financial interventions for smoking cessation are most effective when targeted at smokers to reduce the cost of cessation products, but incentivizing quitting may be effective as well. Although the findings for bans on tobacco advertising were inconclusive, other evidence suggests they remain an important intervention. CONCLUSION When designing and implementing tobacco control programs, governments should prioritize smoking bans and price increases of tobacco products followed by other interventions. Additional studies are needed on the various factors that can influence a policy's effectiveness and feasibility such as cost, local context, political barriers and implementation strategies.
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Affiliation(s)
- Steven J Hoffman
- Global Strategy Lab, Faculty of Law, University of Ottawa, 57 Louis Pasteur Street, Ottawa, K1N 6N5, ON, Canada.
- Department of Clinical Epidemiology & Biostatistics and McMaster Health Forum, McMaster University, Hamilton, ON, Canada.
- Department of Global Health & Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.
| | - Charlie Tan
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada.
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Guindon GE, Paraje GR, Chaloupka FJ. The impact of prices and taxes on the use of tobacco products in Latin America and the Caribbean. Am J Public Health 2015; 105:e9-19. [PMID: 25602902 PMCID: PMC4330839 DOI: 10.2105/ajph.2014.302396] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2014] [Indexed: 01/08/2023]
Abstract
We examined the impact of tobacco prices or taxes on tobacco use in Latin America and Caribbean countries. We searched MEDLINE, EconLit, LILACS, unpublished literature, 6 specialty journals, and reviewed references. We calculated pooled price elasticities using random-effects models. The 32 studies we examined found that cigarette prices have a negative and statistically significant effect on cigarette consumption. A change in price is associated with a less than proportional change in the quantity of cigarettes demanded. In most Latin American countries, own-price elasticity for cigarettes is likely below -0.5 (pooled elasticities, short-run: -0.31; 95% confidence interval=-0.39, -0.24; long-run: -0.43; 95% CI=-0.51, -0.35). Tax increases effectively reduce cigarette use. Lack of studies using household- or individual-level data limits research's policy relevance.
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Affiliation(s)
- G Emmanuel Guindon
- G. Emmanuel Guindon is with the Centre for Health Economics and Policy Analysis and the Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton. Guillermo R. Paraje is with the Escuela de Negocios, Universidad Adolfo Ibáñez, Santiago, Chile. Frank J. Chaloupka is with the Department of Economics and the Institute for Health Research and Policy, University of Illinois, Chicago, and the US National Bureau of Economic Research, Cambridge, MA
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18
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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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Guindon GE. The impact of tobacco prices on smoking onset in Vietnam: duration analyses of retrospective data. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2014; 15:19-39. [PMID: 23471691 DOI: 10.1007/s10198-012-0444-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2012] [Accepted: 11/16/2012] [Indexed: 06/01/2023]
Abstract
The benefits of preventing smoking onset are well known, and even just delaying smoking onset conveys benefits. Tobacco control policies are of critical importance to low-income countries with high smoking rates such as Vietnam where smoking prevalence is greater than 55 % in young men between the ages of 25 and 45. Using a survey of teens and young adults, I conducted duration analyses to explore the impact of tobacco price on smoking onset. The results suggest that tobacco prices in Vietnam have a statistically significant and fairly substantial effect on the onset of smoking. Increases in average tobacco prices, measured by an index of tobacco prices and by the prices of two popular brands, are found to delay smoking onset. Of particular interest is the finding that Vietnamese youth are more sensitive to changes in prices of a popular international brand that has had favourable tax treatment since the late 1990s.
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Affiliation(s)
- G Emmanuel Guindon
- Faculté de Médecine, Département d'administration de la santé, Université de Montréal, C.P.6128, Succursale Centre-ville, Montreal, QC, H3C 3J7, Canada,
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