•  
  •  
 

Abstract

Background: Price affects the demand for cigarettes, but its direct impact on smoking behaviors remains unclear. This study evaluated the effects of cigarette price increases and non-pricing tobacco control policies on adult smoking behaviors in Taiwan, using data from national annual survey during 2004~2015 with 166,325 valid respondents.

Methods: We established mixed-effects models of logistic regression for each of the three dependent variables, “smoking,” “quit attempts,” and “cessation maintenance,” to characterize smoking behaviors. Socioeconomic and sociodemographic factors were also included in the models.

Results: Non-pricing tobacco control policies had no significant effects on smoking behaviors. Conversely, cigarette price increases were highly associated with changes in smoking behavior. A 1% increase in the price of cigarettes reduced the odds ratio of smoking (ORs) by −1.361% ± 0.114%, increased the OR of quit attempts (ORq) by 0.982% ± 0.129%, and increased the OR of maintaining smoking cessation (ORm) by 5.027% ± 1.758%. We found that: (1) men were generally more sensitive to changes in cigarette prices than women (2) middle-aged adults were not sensitive to changes in cigarette prices.

Conclusions: Anti-tobacco pricing measures had a significant effect on smoking behavior. Price-insensitive groups were also identified, such as employment, marriage, and middle-aged women. Specific selective anti-tobacco measures should be implemented for these groups.

Keywords: Cigarettes price, Tobacco control, Price sensitivity, Cessation,Taxation

References

[1] International Agency for Research on Cancer [IARC]. Tobacco Smoke and Involuntary Smoking. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans: Volume 83. Lyon: IARC; 2004.

[2] Taiwan, Ministry of Health and Welfare, Health Promotion Administration. Taiwan Tobacco Control Annual Report 2018. Taipei: Ministry of Health and Welfare; 2018.

[3] Yeh CY, Schafferer C, Lee JM, Ho LM, Hsieh CJ. The effects of a rise in cigarette price on cigarette consumption, tobacco taxation revenues, and of smoking-related deaths in 28 EU countries-- applying threshold regression modelling. BMC Public Health. 2017; 17(1): 676. doi: 10.1186/s12889-017-4685-x

[4] Lee JM, Hwang TC, Ye CY, Chen SH. The effect of cigarette price increase on the cigarette consumption in Taiwan: evidence from the National Health Interview Surveys on cigarette consumption. BMC Public Health. 2004; 4(1): 61. doi: 10.1186/1471-2458-4-61

[5] Lee JM, Liao DS, Ye CY, Liao WZ. Effect of cigarette tax increase on cigarette consumption in Taiwan. Tob Control. 2005; 14(Suppl 1): i71-5. doi: 10.1136/tc.2004.008177

[6] Huang WH, Hsu HY, Chang BC, Chang FC. Factors Correlated with Success Rate of Outpatient Smoking Cessation Services in Taiwan. Int J Environ Res Public Health. 2018; 15(6). doi: 10.3390/ijerph15061218

[7] Lienemann BA, Rose SW, Unger JB, Meissner HI, Byron MJ, Baezconde-Garbanati L, et al. Tobacco Advertisement Liking, Vulnerability Factors, and Tobacco Use Among Young Adults. Nicotine Tob Res. 2019; 21(3): 300-8. doi: 10.1093/ntr/nty220

[8] Tsai LT, Lo FE, Yang CC, Lo WM, Keller JJ, Hwang CW, et al. Influence of Socioeconomic Factors, Gender and Indigenous Status on Smoking in Taiwan. Int J Environ Res Public Health. 2016; 13(11): 1044. doi: 10.3390/ijerph13111044

[9] Tsai YW, Tsai TI, Yang CL, Kuo KN. Gender differences in smoking behaviors in an Asian population. J Womens Health (Larchmt). 2008; 17(6): 971-8. doi: 10.1089/jwh.2007.0621

[10] Ghani WM, Razak IA, Yang YH, Talib NA, Ikeda N, Axell T, et al. Factors affecting commencement and cessation of smoking behaviour in Malaysian adults. BMC Public Health. 2012; 12(1): 207. doi: 10.1186/1471-2458-12-207

[11] Bossé R, Rose CL. Age and interpersonal factors in smoking cessation. J Health Soc Behav. 1973; 14(4): 381-7. doi: 10.2307/2136783

[12] Kouvonen A, Kivimaki M, Virtanen M, Pentti J, Vahtera J. Work stress, smoking status, and smoking intensity: an observational study of 46,190 employees. J Epidemiol Community Health. 2005; 59(1): 63-9. doi: 10.1136/jech.2004.019752

[13] Perelman J, Alves J, Pfoertner TK, Moor I, Federico B, Kuipers MAG, et al. The association between personal income and smoking among adolescents: a study in six European cities. Addiction. 2017; 112(12): 2248-56. doi: 10.1111/add.13930

[14] Viscusi WK. Age Variations in Risk Perceptions and Smoking Decisions. Rev Econ Stat. 1991; 73(4): 577-88. doi: 10.2307/2109396

[15] Hu SS, Homa DM, Wang T, Gomez Y, Walton K, Lu H, et al. State-Specific Patterns of Cigarette Smoking, Smokeless Tobacco Use, and E-Cigarette Use Among Adults - United States, 2016. Prev Chronic Dis. 2019; 16: E17. doi: 10.5888/pcd16.180362

[16] Bottorff JL, Haines-Saah R, Kelly MT, Oliffe JL, Torchalla I, Poole N, et al. Gender, smoking and tobacco reduction and cessation: a scoping review. Int J Equity Health. 2014; 13(1): 114. doi: 10.1186/s12939-014-0114-2

[17] Allen AM, Scheuermann TS, Nollen N, Hatsukami D, Ahluwalia JS. Gender Differences in Smoking Behavior and Dependence Motives Among Daily and Nondaily Smokers. Nicotine Tob Res. 2016; 18(6): 1408-13. doi: 10.1093/ntr/ntv138

[18] Becker GS, Grossman M, Murphy KM. Rational Addiction and the Effect of Price on Consumption. Am Econ Rev. 1991; 81(2): 237-41.

[19] Franz GA. Price effects on the smoking behaviour of adult age groups. Public Health. 2008; 122(12): 1343-8. doi: 10.1016/j.puhe.2008.05.019

[20] Lee JE, Park EC, Chun SY, Park HK, Kim TH. Socio-demographic and clinical factors contributing to smoking cessation among men: a four-year follow up study of the Korean Health Panel Survey. BMC Public Health. 2016; 16(1): 908. doi: 10.1186/s12889-016-3583-y

[21] Zhu BP, Giovino GA, Mowery PD, Eriksen MP. The relationship between cigarette smoking and education revisited: implications for categorizing persons' educational status. Am J Public Health. 1996; 86(11): 1582-9. doi: 10.2105/ajph.86.11.1582

[22] Lewit EM, Hyland A, Kerrebrock N, Cummings KM. Price, public policy, and smoking in young people. Tob Control. 1997; 6(Suppl 2): S17-24. doi: 10.1136/tc.6.suppl_2.s17

[23] Hsieh CR, Hu TW, Lin CFJ. The Demand for Cigarettes in Taiwan: Domestic Versus Imported Cigarettes. Contemp Econ Policy. 1999; 17(2): 223-34.

[24] Kenkel D, Schmeiser M, Urban C. Is Smoking Inferior?: Evidence from Variation in the Earned Income Tax Credit. J Hum Resour. 2014; 49(4): 1094-120.

[25] Yang JJ, Yu D, Wen W, Shu XO, Saito E, Rahman S, et al. Tobacco Smoking and Mortality in Asia: A Pooled Meta-analysis. JAMA Netw Open. 2019; 2(3): e191474. doi: 10.1001/jamanetworkopen.2019.1474

[26] Sreeramareddy CT, Pradhan PM, Mir IA, Sin S. Smoking and smokeless tobacco use in nine South and Southeast Asian countries: prevalence estimates and social determinants from Demographic and Health Surveys. Popul Health Metr. 2014; 12(1): 22. doi: 10.1186/s12963-014-0022-0

[27] Tsai YW, Sung HY, Yang CL, Shih SF. The behaviour of purchasing smuggled cigarettes in Taiwan. Tob Control. 2003; 12(1): 28-33. doi: 10.1136/tc.12.1.28

Share

COinS