Article Text

Weight control belief and its impact on the effectiveness of tobacco control policies on quit attempts: findings from the ITC 4 Country Survey
  1. Ce Shang1,
  2. Frank J Chaloupka1,2,3,
  3. Geoffrey T Fong4,5,6,
  4. Mary Thompson7,
  5. Mohammad Siahpush8,
  6. William Ridgeway2
  1. 1Health Policy Center, Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois, USA
  2. 2Department of Economics, University of Illinois at Chicago, Chicago, Illinois, USA
  3. 3WHO Collaborating Centre on the Economics of Tobacco and Tobacco Control
  4. 4Department of Psychology, University of Waterloo, Waterloo, Canada
  5. 5Ontario Institute for Cancer Research, Toronto, Ontario, Canada
  6. 6School of Public Health and Health Systems, University of Waterloo, Ontario, Canada
  7. 7Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, Ontario, Canada
  8. 8College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA
  1. Correspondence to Dr Ce Shang, Visiting Senior Research Specialist, Health Policy Center, Institute for Health Research and Policy, University of Illinois at Chicago, 1747 W. Roosevelt Rd, Chicago, IL 60608, USA; cshang{at}


Background Weight concerns are widely documented as one of the major barriers for girls and young adult women to quit smoking. Therefore, it is important to investigate whether smokers who have weight concerns respond to tobacco control policies differently than smokers who do not in terms of quit attempts, and how this difference varies by gender and country.

Objective This study aims to investigate, by gender and country, whether smokers who believe that smoking helps control weight are less responsive to tobacco control policies with regards to quit attempts than those who do not.

Methods We use longitudinal data from the International Tobacco Control Policy Evaluation Project in the USA, Canada, the UK and Australia to conduct the analysis. We first constructed a dichotomous indicator for smokers who have the weight control belief and then examined the disparity in policy responsiveness in terms of quit attempts by directly estimating the interaction terms of policies and the weight control belief indicator using generalised estimating equations.

Findings We find that weight control belief significantly attenuates the policy impact of tobacco control measures on quit attempts among US female smokers and among UK smokers. This pattern was not found among smokers in Canada and Australia.

Conclusions Although our results vary by gender and country, the findings suggest that weight concerns do alter policy responsiveness in quit attempts in certain populations. Policy makers should take this into account and alleviate weight concerns to enhance the effectiveness of existing tobacco control policies on promoting quitting smoking.

  • Cessation
  • Economics
  • Price
  • Public policy

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