Population cigarette consumption in Great Britain: novel insights using retail sales data

Geographical differences in the financial impacts of different forms of tobacco licence fees on small retailers in Scotland

OBJECTIVE

Retailer licencing fees are a promising avenue to regulate tobacco availability. However, they face strong opposition from retailers and the tobacco industry, who argue significant financial impacts. This study compares the impacts of different forms of tobacco licence schemes on retailers' profits in Scotland.

METHODS

We calculated gross profits from tobacco sales in 179 convenience stores across Scotland using 1 099 697 electronic point-of-sale records from 16 weeks between 2019 and 2022. We estimated different fees using universal, volumetric and separate urban/rural schemes. We identified the point at which 50% of retailers would no longer make a gross profit on tobacco sales for each scheme and modelled the financial impact of 10 incremental fee levels. The financial impact was assessed based on changes in retailers' tobacco gross profits. Differences by neighbourhood deprivation and urban/rural status were examined.

RESULTS

The gross profit from tobacco per convenience store averaged £15 859/year. Profits were 2.29 times higher in urban (vs rural) areas and 1.59 times higher in high-deprivation (vs low-deprivation) areas, attributable to higher sales volumes. Tobacco gross profit decreased proportionally with increasing fee levels. Universal and urban/rural fees had greater gross profit reductions in rural and/or less deprived areas, where profits were lower, compared with volumetric fees.

CONCLUSION

The introduction of tobacco licence fees offers a potential opportunity for reducing the availability of tobacco retailers. The likely impact of a tobacco licence fee is sensitive to the type of licence scheme implemented, the level at which fees are set and the retailers' location in relation to neighbourhood deprivation and rurality.

Is tobacco a driver of footfall among small retailers? A geographical analysis of tobacco purchasing using electronic point of sale data

OBJECTIVE

Opponents of policies designed to reduce tobacco retail availability argue that tobacco products are a vital driver of 'footfall' in small retailers. This study considers the changing contribution of tobacco to footfall and revenue among convenience stores across Britain, compares tobacco to other 'footfall driver' products and assesses whether tobacco's importance varies by neighbourhood deprivation and urban/rural status.

METHODS

We conducted an analysis of electronic point of sale systems data from 1253 convenience stores in Britain in 4 weeks in 2016 and 2019. We calculated the number and value of purchased basket types (Tobacco Only, Non-Tobacco, Mixed) in each year and by neighbourhood characteristics.

RESULTS

The mean numbers of baskets per store containing tobacco fell by 47% during 2016-2019, a greater decline than any other footfall driver product. The sales value of tobacco products rose sharply over this time period due to increasing unit price. However, the proportion of store turnover accounted for by tobacco transactions declined. There were marked falls in the turnover from non-tobacco products in Mixed tobacco baskets. The proportion of baskets containing tobacco and the value of turnover from these baskets was greater in more deprived and urban areas but these places also experienced larger reductions over time, narrowing differences between areas.

CONCLUSION

Tobacco's importance as a driver of footfall and related turnover among convenience retailers has reduced significantly in Britain in recent years, particularly in deprived and urban areas, undermining industry claims that tobacco is essential to the viability of these businesses.

Anticipated responses to a hypothetical minimum price for cigarettes and roll-your-own tobacco: an online cross-sectional survey with cigarette smokers and ex-smokers in the UK

OBJECTIVES

As tobacco companies can circumvent tax increases, a minimum retail price per-cigarette/per-gram of roll-your-own tobacco presents an additional mechanism for governments to reduce smoking. We examined (1) anticipated responses to a hypothetical minimum price-per-cigarette/per-gram among smokers in the UK; (2) what demographic and smoker characteristics are associated with anticipated responses; and (3) whether minimum pricing may help ex-smokers stay quit.

DESIGN

Cross-sectional survey (May-July 2019).

SETTING

UK.

PARTICIPANTS

Adult cigarette smokers (n=2412) and ex-smokers (n=700).

MAIN OUTCOME MEASUREMENTS

Anticipated responses to a hypothetical minimum price of £10.00 for 20 cigarettes (£0.50 per-cigarette) and £13.50 for 30 grams of roll-your-own tobacco (£0.45 per-gram); approximately £0.10 per-cigarette/per-gram increases on the cheapest prices in leading UK supermarkets (January 2019). Smokers were presented with ten options (eg, 'Try to quit') and asked which they would do (Yes/No) and then which they would most likely do. Ex-smokers were asked to what extent the minimum prices would help them stay quit (A lot vs Lesser agreement).

RESULTS

Among smokers, 55.6% said they would most likely smoke the same amount, 10.7% they would smoke less, 9.5% they would try to quit and 5.8% they would use e-cigarettes more often. Anticipated reactions were associated with demography and smoker characteristics, for example, C2DE (lower social grade) smokers were less likely than ABC1 (higher social grade) smokers to say they would smoke the same as they do now (ORAdj=0.74, 95% CI 0.62 to 0.88). Among ex-smokers, 38.5% said the minimum prices would help them stay quit 'A lot', more so among C2DE than ABC1 participants (ORAdj=1.80, 95% CI 1.30 to 2.49).

CONCLUSIONS

In response to a hypothetical minimum price for cigarettes and roll-your-own tobacco, approximately a fifth of smokers in the UK indicated they would smoke less or quit and almost two-fifths of ex-smokers indicated the prices would help them stay quit.

Using point-of-sale data to examine tobacco pricing across neighbourhoods in Scotland

OBJECTIVES

To assess the geographical variation in tobacco price (cigarettes and roll-your-own (RYO) tobacco) in convenience stores across Scotland and how this relates to neighbourhood income deprivation, tobacco retail outlet density and urban/rural status.

METHODS

Tobacco price data from 124 566 shopping baskets purchased in 274 convenience stores during 1 week in April 2018 were obtained through an electronic point-of-sale system. These data were combined with neighbourhood-level measures of income deprivation, tobacco retail outlet density and urban/rural status. We examined brand price for 12 of the most popular cigarette brands and 3 RYO brands and variations in purchases by price segment; multivariable regression analysis assessed associations between area variables and tobacco price.

RESULTS

Most stores sold tobacco in all price segments. The lowest priced subvalue brands were the most popular in all neighbourhoods but were most dominant in shops in more deprived neighbourhoods. When total sales were assessed, overall purchase price varied significantly by neighbourhood income deprivation; packets of 20 cigarettes were 50 pence (5.6%) lower and RYO 34 pence (2.7%) lower among shops in the two highest income deprivation quintiles relative to the lowest. Analysis of individual brands showed that for 3 of the 12 cigarette brands considered, average prices were 12-17 pence lower in more deprived neighbourhoods with the most popular RYO brand 15 pence lower. There was limited evidence of a relationship with tobacco retail outlet density.

CONCLUSION

Across Scottish convenience stores, the purchase price of cigarettes and RYO was lower in more income-deprived neighbourhoods. The lower prices primarily reflect greater sales of cheap brands in these areas, rather than retailers reducing the prices of individual brands.

Cigarette smoking and heavy coffee consumption affecting response to olanzapine: The role of genetic polymorphism

Objectives: To evaluate the effect of cigarette smoking and heavy coffee consumption on efficacy and safety of olanzapine treatment in schizophrenia patients, in relation to genetic polymorphism.Methods: The study involved 120 patients with schizophrenia, treated with olanzapine for 30 days. Therapy efficacy was determined using three different psychiatric scales, and safety by assessing metabolic adverse effects and extrapyramidal symptoms. Genotyping included CYP1A2*1C, CYP1A2*1F and CYP1A1/1A2 intergenic polymorphism, as well as CYP2D6*3, CYP2D6*4 and CYP2D6*6.Results: Cigarette smoking and heavy coffee consumption decreased the efficacy and increased the safety of olanzapine treatment (P < 0.001). Although the effect was detected only in carriers of CYP1A2*1F allele, covariate analysis revealed that it is independent of CYP1A2 genotype. Olanzapine dose was inversely correlated with the drug efficacy (P ≤ 0.002) and LDL level (P = 0.004). Women and older subjects responded better to therapy (P < 0.026), but had more certain adverse effects (P ≤ 0.049). When controlling for other relevant factors, CYP2D6 metabolizer status affects olanzapine efficacy (P = 0.032).Conclusions: We confirm the effect of cigarette smoking and heavy coffee consumption on olanzapine efficacy and safety. The relevance of CYP1A2 genotype for the described effect needs further investigation. Olanzapine treatment outcome is also affected by dose, sex, age and CYP2D6 metabolizer status.

Comparison of Trends in Self-reported Cigarette Consumption and Sales in England, 2011 to 2018

Importance

Population cigarette consumption is declining in many countries. Accurate estimates of long- and short-term changes are vital for policy evaluation and planning. Survey data and sales data that are used to make these estimates each have important potential biases, so triangulation using different methods is required for robust estimation.

Objectives

To compare monthly estimates of cigarette consumption in England from a nationally representative survey and recorded cigarette sales and to triangulate an accurate estimate of changes in cigarette consumption since 2011.

Design, Setting, and Participants

This study used time series analyses based on survey data and recorded cigarette sales to estimate and compare trends in population cigarette consumption in England from 2011 to 2018. Survey participants were representative samples of 1700 people aged 16 years or older each month in England.

Main Outcomes and Measures

Monthly cigarette retail sales data from August 2011 through February 2018 were obtained from a data agency. Monthly self-reports of cigarette consumption were collected over the same period using the Smoking Toolkit Study.

Results

A total of 136 677 individuals (51.1% female; mean [SD] age, 46.7 [18.8] years) were surveyed. Over the study period, mean monthly cigarette consumption in England was 2.85 billion (95% CI, 2.78 billion to 2.93 billion) cigarettes based on survey data compared with 3.08 billion (95% CI, 3.03 billion to 3.13 billion) estimated from sales data. Over the whole period, cigarette consumption declined by 24.4% based on survey data and 24.1% based on sales data. This equated to 118.4 million and 117.4 million fewer cigarettes consumed per month (or approximately 1.4 billion per year) based on survey data and sales data, respectively. After adjusting for underlying trends, month-by-month changes in cigarette consumption were closely aligned: a 1% change in survey-estimated cigarette consumption was associated with a 0.98% (95% CI, 0.53%-1.44%) change in sales estimates.

Conclusions and Relevance

Survey data and sales data were closely aligned in showing that overall cigarette sales in England have declined by almost a quarter since 2011, amounting to more than 1 billion fewer cigarettes smoked each year. The alignment between the 2 methods provides increased confidence in the accuracy of parameters provided by the Smoking Toolkit Study and sales data. It indicates that estimated changes in cigarette consumption are robust and provide a meaningful basis for policy evaluation and planning.

Difference between recommended retail price and sales price for tobacco products in independent and convenience (small) retailers before and after the introduction of standardised tobacco packaging in the UK

AIM

Recommended retail price (RRP) is a marketing strategy used by tobacco companies to maintain competitiveness, communicate product positioning and drive sales. We explored small retailer adherence to RRP before and after the introduction of the Standardised Packaging of Tobacco Products Regulations in the UK (fully implemented on 20 May 2017) which mandated standardised packaging of cigarettes and rolling tobacco, set minimum pack/pouch sizes and prohibited price-marking.

METHOD

Monthly electronic point of sale data from 500 small retailers in England, Scotland and Wales were analysed. From May 2016 to October 2017, we monitored 20 of the best-selling fully branded tobacco products (15 factory-made cigarettes, 5 rolling tobacco) and their standardised equivalents. Adherence to RRP was measured as the average difference (%) between monthly RRPs and sales prices by pack type (fully branded vs standardised), price-marking on packaging and price segment.

RESULTS

The average difference between RRP and sales price increased from +0.36% above RRP (SD=0.72) in May 2016, when only fully branded packs were sold, to +1.37% in October 2017 (SD=0.30), when standardised packs were mandatory. Increases above RRP for fully branded packs increased as they were phased out, with deviation greater for non-price-marked packs and premium products.

DISCUSSION

Despite tobacco companies emphasising the importance of RRP, small retailers implemented small increases above RRP as standardised packaging was introduced. Consequently, any intended price changes by tobacco companies in response to the legislation (ie, to increase affordability or brand positioning) may be confounded by retailer behaviour, and such deviation may increase consumer price sensitivity.