Effect of relative income price on smoking initiation among adolescents in Ghana: evidence from pseudo-longitudinal data

Abstract

ObjectiveMany smokers initiate smoking during adolescence. Making tobacco products less affordable is one of the best ways to control tobacco use. Studies on the effect of relative income price (RIP (ie, affordability)) of cigarettes on smoking initiation are scarce in low-income and middle-income countries, especially in Sub-Saharan Africa where data are limited. The goal of this study is to examine the effect of cigarette RIP on adolescent smoking initiation in Ghana.SettingThe study uses a pseudo-longitudinal data set constructed from the Global Youth Tobacco Surveys (GYTS (2000–2009 and 2017)) and RIP for the most sold cigarette brand in Ghana.ParticipantsThe GYTS is a national survey on adolescents.Primary and secondary outcomeEffect of RIP on adolescent smoking initiation in Ghana.ResultsUsing the GYTS 2000–2009 data, we find that the probability of smoking initiation falls significantly in response to a higher RIP, with an elasticity of −0.372 (95% CI −0.701 to −0.042) for the unmatched sample and −0.490 (95% CI −0.818 to −0.161) for the matched sample. The RIP elasticity for women ((−0.888) (95% CI −1.384 to −0.392) and (−0.928) (95% CI −1.434 to −0.422)) is statistically significant at 1% in both the unmatched and the matched samples, respectively, while the RIP elasticity for men is statistically insignificant in the 2000–2009 surveys. Analysis of the 2017 GYTS shows a similar outcome: a negative relationship between RIP and smoking initiation, and the results are statistically significant for both men and women, and for both matched and unmatched samples.ConclusionThe affordability (RIP) of cigarettes is negatively related to the probability of smoking initiation among adolescents in Ghana. Raising tobacco taxes in line with income growth would make cigarettes less affordable and dissuade adolescents from initiating smoking.

Effect of price on the decision to experiment with cigarette smoking among Gambian children: a survival analysis using the Gambia 2017 Global Youth Tobacco Survey data

“…It does not follow individuals over time, but provides a snapshot on their smoking patterns. The sample is drawn using a two-stage cluster-sampling design 35 36. Schools are selected with probability proportional to school enrolment size during the first stage, and then classes within participating schools are selected as a systematic equal probability sample with a random start during the second stage 36.…”

“…The sample is drawn using a two-stage cluster-sampling design 35 36. Schools are selected with probability proportional to school enrolment size during the first stage, and then classes within participating schools are selected as a systematic equal probability sample with a random start during the second stage 36. All students in the selected classes are eligible to participate in the survey 34 36…”

Effect of cigarette prices on cigarette consumption in Ghana

“…Indeed, evidence from both developed and developing countries shows that people respond to price changes and that raising the retail price of tobacco products, through increases in taxes, negatively affects consumption ( Bader et al., 2011 ; Farrelly et al., 2012 ; Chaloupka et al., 2012b ; Chelwa and van Walbeek, 2019 ; Dare et al., 2021 ) and also prevalence rates ( Immurana et al., 2021 ). Although some studies find no evidence that tobacco taxation prevents initiation, or encourages cessation among young people ( Liu, 2010 ), substantial evidence suggests that higher retail prices (resulting from increased taxes) are effective as it encourages cessation by people with tobacco use disorder ( Dauchy and Ross, 2019 ), especially at older ages ( Liu, 2010 ); prevents initiation by potential consumers ( Vellios and Van Walbeek, 2016 ; Dauchy and Ross, 2019 ; Asare et al., 2019 ; Boachie et al., 2022b ) and reduces the number of relapses ( Liu, 2010 ; IARC, 2011 ). Those who are unable to quit tobacco use completely also reduce their daily consumption ( Boachie and Ross, 2020 ).…”

“…Although previous studies have analyzed the determinants of smoking (participation and/or intensity) in Ghana ( Nketiah-Amponsah et al., 2018 ; Asare et al., 2019 ; Boachie et al., 2022b ), it is only Asare et al. (2019) and Boachie et al.…”

“…Although previous studies have analyzed the determinants of smoking (participation and/or intensity) in Ghana ( Nketiah-Amponsah et al., 2018 ; Asare et al., 2019 ; Boachie et al., 2022b ), it is only Asare et al. (2019) and Boachie et al. (2022b) who, respectively, estimate the effect of retail prices and relative income price (RIP) on smoking participation.…”