Price minimizing behaviours by smokers in Europe (2006–20): evidence from the International Tobacco Control Project

Geboers, Cloé; Nagelhout, Gera E.; Vries, Hein de; Candel, Math J. J. M.; Driezen, Pete; Mons, Ute; Andler, Raphaël; Fong, Geoffrey T.; Willemsen, Marc C.

doi:10.1093/eurpub/ckac115

Cited by 5 publications

(4 citation statements)

References 26 publications

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“…It is not surprising that this is the least popular strategy, since it is the one which requires the most effort: low-taxed sales outlets are uncommon in the Netherlands, and require time and money to travel to. In contrast, bulk buying and switching to a cheaper product can be done at almost every point of sale [29].…”

Section: Discussionmentioning

confidence: 99%

“…Both nicotine dependence and having made a previous quit attempt are associated with smoking cessation [24][25][26][27]. Nicotine dependence is also associated with other behaviours such as smoking less or use of price-minimising strategies as prices increase [28,29]. Nicotine dependence was measured by the heaviness of smoking index (HSI), a six-point scale that cumulates a categorised measure of cigarettes per day (1-10 cigarettes = 0 points, 11-20 = 1 point, 21-30 = 2 points, 31 or more = 3 points) and time to first cigarette (within 5 min = 3 points, 6-30 min = 2 points, 31 min or later = 1 point) [30].…”

Section: Independent Variablesmentioning

confidence: 99%

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Smokers’ strategies to reduce tobacco spending: self-reported use and differences across subgroups. Findings from the International Tobacco Control (ITC) Netherlands Survey

et al. 2023

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Background The cost of tobacco is one of the most reported reasons for smoking cessation. Rather than quitting, smokers can use also strategies to reduce tobacco expenditure while continuing smoking, such as smoking less or using price-minimising strategies. The Netherlands announced to increase the price of a pack cigarettes from seven (2018) to ten euros (2023), to reduce tobacco prevalence and consumption. This study explores the self-reported strategies to reduce tobacco spending among Dutch smokers, and whether this differed per age, income, and education. Additionally, we analysed among quitters in these subgroups whether price played a role in their decision to quit. Methods Cross-sectional survey data from the International Tobacco Control (ITC) Netherlands Wave 2 (September–November 2020, N = 1915) was used. Strategies to reduce spending among smokers (N = 1790) were: reducing consumption, bulk buying, switching to cheaper products or buying from low-taxed sources. These were collapsed into: reducing consumption (solely or in combination with other behaviours), solely price-minimising behaviours (such as buying cheaper brands), or no strategies to reduce spending. Associations between strategies and characteristics were analysed through multinomial and binary logistic regression models. Second, we explored which subgroups were more likely to report that price played a role in their decision to quit among quitters (N = 125). Results The majority of smokers used strategies to reduce tobacco spending: 35.6% reduced consumption and 19.3% used solely price-minimising strategies. 82.1% of quitters reported that price played a role in their decision to quit. Low-income individuals were more likely to report price as a reason for quitting and reduce consumption, but also to buy cheaper products. Highly nicotine dependent smokers were more likely to use price-minimising behaviours, and less likely to reduce consumption. Conclusions The majority reported using strategies to reduce spending or that price played a role in their decision to quit. Reducing consumption was the most reported strategy. Low-income smokers were more likely to reportedly reduce consumption, buy cheaper products, or quit. Price policies have the potential to reduce socioeconomic inequalities in smoking. To discourage price-minimising behaviours, such as switching to cheaper products, reducing price differences between products should be prioritized.

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Section: Discussionmentioning

confidence: 99%

Section: Independent Variablesmentioning

confidence: 99%

Smokers’ strategies to reduce tobacco spending: self-reported use and differences across subgroups. Findings from the International Tobacco Control (ITC) Netherlands Survey

et al. 2023

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“…Existing research has identified demographic groups who are at greater risk for persistent tobacco use. These include individuals who are socioeconomically disadvantaged, have lower levels of education, experience poorer mental health, identify as sexual and/or gender minorities or belong to racial and/or ethnic minorities (19)(20)(21)(22)(23). In the sociomedical context, these can be interpreted as expressions of health inequity.…”

Section: Discussionmentioning

confidence: 99%

Smoking trends and health equity in Switzerland between 1992 and 2017: dependence of smoking prevalence on educational level and social determinants

Wehrli,

Gilljam,

Koh

et al. 2023

Front. Psychiatry

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BackgroundSwitzerland ranks among the top three healthcare systems in the world with regards to healthcare access, suggesting a high degree of health equity. However, Switzerland has few preventive strategies against smoking abuse. The aim of this study is to clarify whether educational level and citizenship status have an influence on the prevalence of smoking in Switzerland and whether there is health inequity related to a lack of preventive strategies.MethodsWe based our analysis on publicly available health data published in the Swiss government's Swiss health survey (1992–2017). We compared the prevalence of smoking across the years and correlated these data with levels of educational attainment, citizenship status and age.ResultsA continuous significant decline in smokers is observed in the highest education group (TERT). Over time, prevalence was reduced from 29% in 1992 to 23% in 2017 (p < 0.001). The intermediate-level educational group (SEK 2) showed smaller but also significant decline on a 0.05 sigificance level over the same period, from 31% to 29% (p = 0.003). The lowest educational group showed a nonsignificant decline from 28% to 27% (p = 0.6). The population who holds Swiss citizenship showed a decrease in smoking from 28% to 26% within the time frame (p < 0.001). People without Swiss citizenship had a much higher prevalence of smokers, at 38% in 1992 and declining to 32% in 2017 (p < 0.001). All cohorts from age 15 to age 64 have a far higher prevalence of smokers than cohorts at an older age, with the highest prevalence in the 25–34 age group.ConclusionIn Switzerland, individuals with lower levels of education and non-Swiss populations are more susceptible to health risk of smoking. This is despite the existence of a high-quality healthcare system that has nevertheless failed to negated health inequities.

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“… 18 Another study examined trends in price-minimizing behaviors between 2006 and 2020, and found that the use of these behaviors by Dutch FM smokers ranged from 7.4% to 26.4%—depending on per year and type of price-minimizing behavior. 26 …”

Section: Discussionmentioning

confidence: 99%

Trends in Individualized Affordability of Factory-Made Cigarettes: Findings of the 2008–2020 International Tobacco Control Netherlands Surveys

Geboers

Candel

Chaloupka

et al. 2022

Nicotine &Amp; Tobacco Research

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Introduction Cigarette affordability, the price of tobacco relative to consumer income, is a key determinant of tobacco consumption. This study examined trends over 12 years in individualised factory-made cigarette affordability in the Netherlands, and whether these trends differed by sex, age, and education. Methods Data from 10 waves (2008-2020) of the International Tobacco Control (ITC) Netherlands Surveys were used to estimate individualised affordability, measured as the percentage of income required to buy 100 cigarette packs (Relative Income Price, RIP), using self-reported prices and income. The higher the RIP, the less affordable cigarettes are. Generalised estimating equation regression models assessed trends in individualised affordability over time and by sex, age, and education. Results Affordability decreased significantly between 2008 and 2020, with RIP increasing from 1.89% (2008) to 2.64% (2020) (p≤.001), Except for 2008-2010, no significant year-on-year changes in affordability were found. Lower affordability was found among subgroups who have a lower income level: females (versus males), 18-24 and 25-39 year olds (versus 55 and over) and low or moderate educated individuals (versus high educated). Interactions between wave and education (p=.007) were found, but not with sex (p=.653) or age (p=.295). A decreasing linear trend in affordability was found for moderately (p=.041) and high-educated (p=.025), but not for low-educated individuals (p=.149). Conclusions Cigarettes in the Netherlands have become less affordable between 2008 and 2020, yet this was mostly due to the decrease in affordability between 2008 and 2010. There is a need for more significant increases in tax to further decrease affordability. IMPLICATIONS Our findings suggest that cigarettes have become less affordable in the Netherlands between 2008 and 2020. But, this appears to be the result of a steep decrease in affordability between 2008 and 2010. Affordability was lower among groups who have on average lower incomes (females, young adults, low- and moderate educated individuals), and differences in trends across education levels could be explained by per capita income changes. Our individualised measure indicated lower affordability than published aggregate affordability estimations. Future tax increases should be large enough to result in a lower affordability.

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Price minimizing behaviours by smokers in Europe (2006–20): evidence from the International Tobacco Control Project

Cited by 5 publications

References 26 publications

Smokers’ strategies to reduce tobacco spending: self-reported use and differences across subgroups. Findings from the International Tobacco Control (ITC) Netherlands Survey

Smokers’ strategies to reduce tobacco spending: self-reported use and differences across subgroups. Findings from the International Tobacco Control (ITC) Netherlands Survey

Smoking trends and health equity in Switzerland between 1992 and 2017: dependence of smoking prevalence on educational level and social determinants

Trends in Individualized Affordability of Factory-Made Cigarettes: Findings of the 2008–2020 International Tobacco Control Netherlands Surveys

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