High tobacco prices, typically achieved through taxation, are an evidence-based strategy to reduce tobacco use. However, the presence of inexpensive contraband tobacco could undermine this effective intervention by providing an accessible alternative to quitting. We assessed whether the use of contraband tobacco negatively affects smoking cessation outcomes.
We evaluated data from 2786 people who smoked, aged 18 years or older, who participated in the population-based longitudinal Ontario Tobacco Survey. We analyzed associations between use of contraband tobacco and smoking cessation outcomes (attempting to quit, 30-d cessation and long-term cessation at 1 yr follow-up).
Compared with people who smoked premium or discount cigarettes, people who reported usually smoking contraband cigarettes at baseline were heavier smokers, perceived greater addiction, identified more barriers to quitting and were more likely to have used pharmacotherapy for smoking cessation. People who smoked contraband cigarettes were less likely to report a period of 30-day cessation during the subsequent 6 months (adjusted relative risk [RR] 0.23, 95% confidence interval [CI] 0.09-0.61) and 1 year (adjusted RR 0.30, 95% CI 0.14-0.61), but they did not differ significantly from other people who smoked regarding attempts to quit (at 6 mo, adjusted RR 0.74, 95% CI 0.43-1.20) or long-term cessation (adjusted RR 0.24, 95% CI 0.04-1.34).
Smoking contraband cigarettes was negatively associated with short-term smoking cessation. Access to contraband tobacco may therefore undermine public health efforts to reduce the use of tobacco at the population level.
Cites: Am J Public Health. 2005 Jun;95(6):994-515914821
Cites: Can J Public Health. 2005 Nov-Dec;96(6):451-316350872
Recent studies suggest an ambiguous relationship between obesity and cigarette taxes. We employ Canadian data to evaluate the effects of cigarette taxes on smoking and obesity.
We use a simple reduced form approach and exploit the significant cross-province differences that exist between Eastern and Western Canada to estimate the effects of higher cigarette taxes using aggregate health region and individual level data from the 2003 and 2005 waves of the Canadian Community Health Surveys (CCHS).
OLS estimates based on health regions data suggest that a 10% increase in cigarette taxes is significantly correlated with a 4-5% increase in the percentage of obese population. We also find cigarette tax elasticities of between -0.2 and -0.4 with respect to the percentage of smokers. Estimates from individual level data are similar.
In tandem, these results offer support to the possibility that health benefits from higher cigarette taxes and lower smoking, might be partially offset by a corresponding increase in obesity levels.
From 1980 to 1994, the Canadian government enacted major tax increases on tobacco products. These actions initiated significant tobacco smuggling from the United States into Canada through a few U.S. Native American reservations to undercut the price of Canadian tobacco products. The tobacco industry blamed rampant smuggling on excessive taxation; however, research shows that the tobacco industry had actually promoted smuggling schemes to both increase profits and provide an argument for tobacco taxation reduction. Although the smuggling has resulted in numerous U.S. and Canadian criminal convictions of tobacco industry officials and partners, significant smuggling continues throughout the world. For the few Native Americans involved, the smuggling was lucrative and they were able to avoid criminal prosecution through tribal sovereignty. Industry-supported tobacco smuggling has had a profoundly negative effect on Canadian public health that must be brought to light to prevent future similar occurrences.
BACKGROUND: There are no studies of the relative significance in Norway of registered sales, tax-free import, border trade or smuggling of tobacco. MATERIAL AND METHODS: The estimated registered sales of tobacco are based on data from the Norwegian customs and excise authorities. The border trade and tax-free import estimates were based on nation-wide, representative surveys of daily smokers aged 16-74 carried out by Statistics Norway for the years 1990-1993 and 1997-2001. There are no detailed data on the scale of smuggling other than confiscation statistics compiled by the customs and excise authorities. It is assumed that confiscations amount to about a tenth of the total amount smuggled into the country. RESULTS: The unregistered consumption of cigarettes and tobacco has been on the rise since the early 1990s; in the years 1997-2001 it accounted for about a quarter of total consumption. Broken down, the figures are as follows: 11% was purchased in Sweden, 5% in Denmark, 9% in other foreign countries; 1% was smuggled into the country. INTERPRETATION: The rise in unregistered tobacco consumption is putting further pressure on the high Norwegian taxes on tobacco. But if taxes were cut, domestic demand would rise, and hence have little or even negative impact on revenue flowing to the government from the legal tobacco market and probably little impact on the levels of imported tobacco through tax-free arrangements or cross-border trade. Hence, although the price gap between Norway and neighbouring countries narrows, we must assume that the motivation to acquire tobacco will remain unaffected while Norwegians continue to travel to Sweden to stock up on inexpensive meat produce.
A battle to introduce new antitobacco legislation in Canada has caused political battles within the Liberal Party. While one side is worried about the need to protect people's health, another is worried about the potential loss of jobs within the tobacco industry--many of which are located in politically volatile Quebec. Charlotte Gray writes about the machinations that led to the introduction of new smoking legislation in the House of Commons in November.