Abstract
Objectives To assess associations between smokers' strategies to minimise how much their smoking costs and cost of smoking among smokers across three social grades during a period of annual tax increases in England. Design Repeat cross-sectional. Setting England, May 2012-December 2016. Participants 16 967 adult smokers in 56 monthly surveys with nationally representative samples. Measures and analysis Weighted generalised additive models assessed associations between four cost-minimising strategies (factory-made and roll-your-own (RYO) cigarette consumption levels, illicit and cross-border purchases) and cost of smoking (£/week). We adjusted for inflation rate, age, gender and secular and seasonal trends. Results Cost of smoking did not increase above the rate of inflation. Factory-made cigarette consumption decreased, while proportion of RYO and, to a much lesser extent, illicit and cross-border purchases increased. These trends were only evident in lowest social grade. Cost of smoking was 12.99% lower with consumption of 10 fewer factory-made cigarettes (95% CI -13.18 to -12.80) and 5.86% lower with consumption of 10 fewer RYO cigarettes (95% CI -5.66 to -6.06). Consumption levels accounted for 60% of variance in cost. Cross-border and illicit tobacco purchases were associated with 9.64% (95% CI -12.94 to -6.33) and 9.47% (95% CI -12.74 to -6.20) lower costs, respectively, but due to low prevalence, accounted for only 0.2% of variation. Associations were similar across social grades, although weaker for illicit and cross-border purchases and stronger for consumption in higher social grades compared with lower social grades. Conclusion During a period of annual tax increases, the weekly cost of smoking did not increase above inflation. Cost-minimising strategies increased, especially among more disadvantaged smokers. Reducing cigarette consumption and switching to RYO tobacco explained a large part of cost variation, while use of illicit and cross-border purchasing played only a minor role.
Original language | English |
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Article number | e026320 |
Pages (from-to) | e026320 |
Journal | BMJ Open |
Volume | 9 |
Issue number | 6 |
Early online date | 25 Jun 2019 |
DOIs | |
Publication status | Published - 25 Jun 2019 |
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Anna Gilmore
- Department for Health - Professor
- Tobacco Control Research Group (TCRG)
- Centre for 21st Century Public Health - Co-Director
- Centre for Governance, Regulation and Industrial Strategy
- Centre for the Analysis of Social Policy and Society (CASPS)
Person: Research & Teaching, Core staff