This study evaluates the impact of cigarette prices on smoking initiation and cessation among adults in two pooled samples of 6 low- to lower-middle income countries (LMICs) and 8 upper-middle income countries (UMICs). We find that, while higher prices reduce smoking across the board, this reduction occurs through different behavioral mechanisms in lower versus higher income countries. Specifically, cigarette prices reduce smoking rates by deterring initiation in LMICs while in UMICs they act primarily by promoting cessation. Because current smoking rates are relatively lower in LMICs and relatively higher in UMICs, this differential mechanism underscores the adaptability of tobacco prices as a tool for regulating tobacco use across countries at different levels of development; it shows that prices can be used to sustain the relatively low rates of smoking in LMICs by preventing entry of new smokers, and can reduce the relatively high rates of smoking in UMICs by encouraging exit of existing smokers. Using split-population duration models and controlling for fixed and time-varying unobserved country characteristics, we estimate that the price elasticity of initiation in LMICs is −0.74 and the price elasticity of cessation in UMICs is 0.51.
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Though Poland is currently classified as a high-income country, it was in the upper-middle income range during most of the analysis period.
We are not able to observe all subjects in this sample from the age of 15 due to unavailability of price data extending that far back in time for some individuals. Those individuals for whom price data are not available from age 15 are instead observed from the earliest year when price data become available for their country. Thus, the median age of start of observation is 17 years old.
Mathers, C. D., Loncar, D.: Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med. 3, e442 (2006)
Baltagi, B.H., Levin, D.: Estimating dynamic demand for cigarettes using panel data: the effects of bootlegging, taxation and advertising reconsidered. Rev. Econ. Stat. 68(1), 148–155 (1986)
Chapman, S., Richardson, J.: Tobacco excise and declining consumption: the case of Papua New Guinea. Am. J. Public Health 80, 537–540 (1990)
Carpenter, C., Cook, P.: Cigarette taxes and youth smoking; new evidence from national, state, and local youth risk behavior surveys. J. Health Econ. 27, 287–299 (2008)
Chaloupka, F.J., Wechsler, H.: Price, tobacco control policies and smoking among young adults. J. Health Econ. 16, 359–373 (1997)
Chaloupka, F.J.: Rational addictive behavior and cigarette smoking. J. Polit. Econ. 99, 722–742 (1991)
Decicca, P., Kenkel, D., Mathios, A., Shin, Y., Lim, J.: Youth smoking, cigarette prices, and anti-smoking sentiment. Health Econ. 17(6), 733–749 (2008)
Decicca, P., Kenkel, D., Mathios, A.: Putting out the fires: will higher taxes reduce the onset of youth smoking? J. Polit. Econ. 110(1), 144–169 (2002)
Kostova, D., Ross, H., Blecher, E., Markowitz, S.: Is youth smoking responsive to cigarette prices? Evidence from low- and middle-income countries. Tob. Control 20, 419–424 (2011)
Lewit, E.M., Coate, D.: The potential for using excise taxes to reduce smoking. J. Health Econ. 1, 121–145 (1982)
Wasserman, J., Manning, W.G., Newhouse, J.P., Winkler, J.D.: The effects of excise taxes and regulations on cigarette smoking. J. Health Econ. 10(1), 43–64 (1991)
Forster, M., Jones, A.M.: The role of tobacco taxes in starting and quitting smoking: duration analysis of British data. J. R. Stat. Soc. Ser. A 164, 517–547 (2001)
Nicolas, A.L.: How important are tobacco prices in the propensity to start and quit smoking? An analysis of smoking histories from the Spanish National Health Survey. Health Econ. 11(6), 521–535 (2002)
Cawley, J., Markowitz, S., Tauras, J.: Obesity, cigarette prices, youth access laws and adolescent smoking initiation. East. Econ. J. 32(1), 149–170 (2006)
Cawley, J., Markowitz, S., Tauras, J.: Lighting up and slimming down: the effects of body weight and cigarette prices on adolescent smoking initiation. J. Health Econ. 23, 293–311 (2004)
Douglas, S.: The duration of the smoking habit. Econ. Inq. 36, 49–64 (1998)
Douglas, S., Hariharan, G.: The hazard of starting smoking: estimates form a split population duration model. J. Health Econ. 13, 213–230 (1994)
Madden, D.: Tobacco taxes and starting and quitting smoking: does the effect differ by education? Appl. Econ. 39, 613–627 (2007)
Lillard, D.R., Molloy, E., Sfekas, A.: Smoking initiation and the iron law of demand. J. Health Econ. 32, 114–127 (2013)
Kostova, D.: A (nearly) global look at the dynamics of youth smoking initiation and cessation: the role of cigarette prices. Appl. Econ. 45, 3943–3951 (2013)
Bertrand, M., Duflo, E., Mullainathan, S.: How much should we trust difference-in-differences estimates? Q. J. Econ. 119(1), 249–275 (2004)
Meyer, B.: Natural and quasi-experiments in economics. J. Bus. Econ. Stat. 13(2), 151–161 (1995)
Schmidt, P., Witte, A.D.: Predicting criminal recidivism using “split population” survival time models. J. Econ. 40, 141–159 (1989)
International Agency for Research on Cancer (2011) IARC Handbooks of cancer prevention, tobacco control, volume 14: effectiveness of tax and price policies in tobacco control. Lyon, France
Kenkel, D.S., Lillard, D.R., Mathios, A.D.: Accounting for misclassification error in retrospective smoking data. Health Econ. 13, 1031–1044 (2004)
Kenkel, D.S., LeCates, J., Liu, F.: Errors in retrospective data on smoking: comparing maximum likelihood and ad hoc approaches. In: Working paper (2011)
Chaloupka, F.J., Kostova, D., Shang, C.: Cigarette tax structure and cigarette prices in low and middle-income countries: evidence from GATS and ITC. Nicot Tob Res 16(Suppl 1), S3–S9 (2014)
The authors wish to thank Don Kenkel for valuable comments on previous versions of this study. The findings and conclusions in this article are those of the authors and do not necessarily represent the views of the US Centers for Disease Control and Prevention or the University of Illinois at Chicago.
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Kostova, D., Chaloupka, F.J. & Shang, C. A duration analysis of the role of cigarette prices on smoking initiation and cessation in developing countries. Eur J Health Econ 16, 279–288 (2015). https://doi.org/10.1007/s10198-014-0573-9
- Cigarette prices
- Tobacco use
- Smoking initiation
- Smoking cessation
- Duration analysis