Australian smokers' and recent quitters' responses to the increasing price of cigarettes in the context of a tobacco tax increase
ABSTRACT To track smokers' responses to the increasing price of cigarettes after a tax increase, and assess socio-demographic differences in responses.
The Cancer Institute NSW's Tobacco Tracking Survey (CITTS) is a continuous tracking telephone survey. Weekly data were collected between May and September 2010.
New South Wales, Australia.
A total of 834 smokers and 163 recent quitters (quit in last 12 months).
Responses to the price increase included smoking-related changes (tried to quit, cut down) and product-related changes (changed to lower priced brands, started using loose tobacco, bought in bulk). Recent quitters were asked how much the increasing price of cigarettes influenced them to quit.
Overall, 47.5% of smokers made smoking-related changes and 11.4% made product-related changes without making smoking-related changes. Multinomial logistic regressions showed that younger smokers (versus older) were more likely to make product-related changes and smoking-related changes in comparison to no changes. Low- or moderate-income smokers (versus high-income) were more likely to make smoking-related changes compared to no changes. Highly addicted smokers (versus low addicted) were more likely to make product-related changes and less likely to make smoking-related changes. The proportion of smokers making only product-related changes decreased with time, while smoking-related changes increased. Recent quitters who quit after the tax increase (versus before) were more likely to report that price influenced them.
The effect of increasing cigarette prices on smoking does not appear to be mitigated by using cheaper cigarette products or sources. These results support the use of higher cigarette prices to encourage smoking cessation.
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ABSTRACT: Introduction One population-level solution to smoking cessation are Quitlines, telephone-based services to aid quitting. Monitoring the profile of Quitline callers in a changing tobacco policy environment is important for informing future policy strategies and identifying target groups to improve the reach and impact of Quitline services. Methods De-identified data from 43618 new callers to the NSW Quitline, Australia between January 2008 and October 2011 (inclusive) were extracted from he Quitline database. Regression analyses explored the effect of year of first call on the distribution of demographic and smoking-related variables. Results Men calling the Quitline increased proportionately (PR=1.05, 95%CI:1.03-1.08) but callers from non-major city areas fell (PR=0.90, 95%CI:0.87-0.93) in 2011 versus 2008. The proportion of callers not working demonstrated a significant increasing linear trend (PR=1.08, p<.001), although area-level socioeconomic status did not change. The proportions of new Quitline callers who had stopped smoking (relative to still smoking) (RRR: 1.29, 95%CI: 1.14-1.46) and who were classified as low nicotine dependent (versus high nicotine dependent, RRR: 1.60, 95%CI:1.39-1.83), were higher in 2011 versus 2008. Proportionately more callers nominated 'money' as a motivation to quit in 2010 (PR=1.58, 95%CI:1.49-1.66) and 2011 (PR=1.70, 95%CI:1.62-1.79) compared with 2008. Conclusions Quitline callers showed decreasing tobacco consumption and dependence 2008 to 2011, but remained more addicted than average. Clear effects of tobacco policy were shown, as money as a motivator increased dramatically in conjunction with increased tobacco taxation, highlighting the importance of promoting cessation services concurrent with policy change to capitalise on increased motivation to quit.Nicotine & Tobacco Research 09/2014; 17(5). DOI:10.1093/ntr/ntu198 · 2.81 Impact Factor
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ABSTRACT: Background and Aims There is strong evidence about which tobacco control policies reduce smoking. However, their equity impact is uncertain. The aim was to assess the effectiveness of population-level interventions/policies to reduce socioeconomic inequalities in adult smoking. Methods Systematic review of studies of population-level interventions/policies reporting smoking-related outcomes in adults of lower compared to higher socioeconomic status (SES). References were screened and independently checked. Studies were quality assessed. Results are presented in a narrative synthesis. Equity impact was assessed as: positive (reduced inequality), neutral (no difference by SES), negative (increased inequality), mixed (equity impact varied) or unclear. Results 117 studies of 130 interventions/policies were included: smokefree (44); price/tax (27); mass media campaigns (30); advertising controls (9); cessation support (9); settings-based interventions (7); multiple policies (4). The distribution of equity effects was: 33 positive, 36 neutral, 38 negative, 6 mixed, 17 unclear. Most neutral equity studies benefited all SES groups. Fourteen price/tax studies were equity positive. Voluntary, regional and partial smokefree policies were more likely to be equity negative than national, comprehensive smokefree policies. Mass media campaigns had inconsistent equity effects. Cigarette marketing controls were equity positive or neutral. Targeted national smoking cessation services can be equity positive by achieving higher reach among low SES, compensating for lower quit rates. Conclusions Few studies have assessed the equity impact of tobacco control policy/interventions. Price/tax increases had the most consistent positive equity impact. More research is needed to strengthen the evidence-base for reducing smoking inequalities and to develop effective equity-orientated tobacco control strategies.Drug and alcohol dependence 05/2014; 138. DOI:10.1016/j.drugalcdep.2014.03.001 · 3.28 Impact Factor
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ABSTRACT: Health informatics systems are a proven tool for tobacco control interventions. To address the needs of low-income groups, the Tobacco Control Initiative was established in partnership with the Louisiana State University Health Care Services Division to provide cost-effective tobacco use cessation services through the health informatics system in the state public hospital system. In this study we used a Web-based, result-reporting application to monitor and assess the effect of the 2009 federal cigarette tax increase. We assessed readiness to quit tobacco use before and after a cigarette tax increase among low-income tobacco users who were outpatients in a public hospital system. Overall, there was an increase in readiness to quit, from 22% during the first week of February to 33% during the first week of April, when the tax went into effect. Smokers who were female, 31 or older, African American, and assessed at a clinic visit in April were more likely to report readiness to quit than were men, those aged 30 or younger, those who were white, and those who were assessed at a clinic visit in February. A health informatics system that efficiently tracks trends in readiness to quit can be used in combination with other strategies and thus optimize efforts to control tobacco use. Our data suggest that a cigarette tax increase affects smokers' readiness to quit and provides an opportunity to intervene at the most beneficial time.Preventing chronic disease 04/2014; 11:E52. DOI:10.5888/pcd11.130203 · 1.96 Impact Factor