Tobacco control policies and smoking among older adults: a longitudinal analysis of 10 European countries

Abstract

Background and Aims The impact of tobacco control on European older adults has not been studied, despite evidence that smoking cessation at old age can bring significant life expectancy gains. Our aim was to evaluate the impact of tobacco control policies on smoking among older adults in Europe from 2004 to 2013. Design We used longitudinal data from the Survey of Health, Ageing and Retirement in Europe (SHARE, aged 50+ years) from four waves from 2004 to 2013. We used logistic regression models with clustered standard errors to determine whether the implementation of tobacco control policies was associated with changes in smoking status. Furthermore, we studied whether these associations varied by socio‐demographic characteristics. Regression coefficients were converted to changes the probability of smoking [marginal effects (ME)]. Measurements Smoking status was the dependent variable, and the Tobacco Control Scale (TCS) was the explanatory variable, overall and by its main policy components (pricing and smoke‐free policies). Covariates included age, sex, education and country and wave fixed‐effects. Findings A 10‐point increase in TCS was associated with a lower probability of smoking by 1.6 percentage points [95% confidence interval (CI) = −3.208, −0.056] for those aged 50–65, but not for older Europeans. Among those with primary school or no education, the associated drop was of 1.5 percentage points (95% CI = –2.751, −0.253). By contrast, no significant relation between TCS and smoking was observed among those with high education. Higher TCS scores for pricing (ME = –0.636, 95% CI = –0.998, −0.275) and smoke‐free policies (ME = –0.243, 95% CI = –0.445, −0.041) were associated with a significantly lower probability of smoking (P = 0.001 and P = 0.018, respectively). Conclusion Increases in tobacco taxes and smoke‐free policies are significantly related with a reduction in smoking among European older adults, suggesting potential health gains for this rising share of the population. These policies may be more effective among the lowest educated.

Who Smokes in Europe? Data From 12 European Countries in the TackSHS Survey (2017–2018)

“…2 However, data from country-specific populations are poorly comparable, since they are not collected using a standardized study design-including sampling methods, mode of interviewing and questionnaires-which represents a prerequisite for valid comparisons of smoking prevalence and smoking patterns across different countries. 3,4 To the best of our knowledge, the only standardized and representative investigations that systematically monitor smoking prevalence among adults in more than one European country, are the WHO Global Adult Tobacco Survey (GATS) 5,6 ; the Survey of Health, Ageing and Retirement in Europe (SHARE) 7 ; and the European Commission (EC) Special Eurobarometers. [8][9][10] GATS covers three European Union (EU) member states (MS; ie, Greece, Poland, and Romania) 5,6 ; SHARE is a longitudinal study, conducted in five waves between 2004 and 2013, collecting information on smoking habit among individuals aged 50 years and older from 20 European countries 7 ; Eurobarometer is a representative survey conducted in all the 28 EU MS on approximately 1,000 face-to-face interviews per country, based on selected thematic studies.…”

“…3,4 To the best of our knowledge, the only standardized and representative investigations that systematically monitor smoking prevalence among adults in more than one European country, are the WHO Global Adult Tobacco Survey (GATS) 5,6 ; the Survey of Health, Ageing and Retirement in Europe (SHARE) 7 ; and the European Commission (EC) Special Eurobarometers. [8][9][10] GATS covers three European Union (EU) member states (MS; ie, Greece, Poland, and Romania) 5,6 ; SHARE is a longitudinal study, conducted in five waves between 2004 and 2013, collecting information on smoking habit among individuals aged 50 years and older from 20 European countries 7 ; Eurobarometer is a representative survey conducted in all the 28 EU MS on approximately 1,000 face-to-face interviews per country, based on selected thematic studies. The most recent Eurobarometer surveys focusing on tobacco smoking indicated that the overall smoking prevalence in the EU had slightly decreased from 29% in 2009 to 26% in 2014, and remained stable until 2017.…”

Association Between Social Isolation and Smoking in Japan and England

“…6 The World Health Organization supports the upward implementation to impose high tobacco taxes, driving up retail prices of the product, as the most effective tobacco control measure. 2,9,10 Higher retail prices have been found to reduce the prevalence of smoking in the older population at a rate of approximately 9% for every 1 USD increase. 10 However, the retail prices of tobacco across countries, especially those in Asia, have remained low.…”

Retiring from smoking: Reply to Kleykamp (2019)

“…We are grateful to Bethea Kleykamp for her interest in our study and for the highly relevant comments . We agree with her that the conclusion in the abstract of our article did not fully reflect our main findings, namely that Tobacco Control Policies (TCP) were not found to influence smoking among individuals older than 65 years. However, in the main text we described carefully how the negative relation found between TCP and smoking was driven by the reduction in smoking among those aged between 50 and 65, and not among those older than 65.…”