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Original research
Own-price and cross-price elasticities of demand for cigarettes and waterpipe tobacco in three Eastern Mediterranean countries: a volumetric choice experiment
  1. Ali Chalak1,
  2. Rima Nakkash2,
  3. Niveen M E Abu-Rmeileh3,
  4. Yousef S Khader4,
  5. Mohammed Jawad5,
  6. Aya Mostafa6,
  7. Ruba Abla2,
  8. Jordan Louviere7,
  9. Ramzi G Salloum2,8
  1. 1 Department of Agriculture, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
  2. 2 Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
  3. 3 Institute of Community and Public Health, Birzeit University, Birzeit, Palestine
  4. 4 Department of Community Medicine, Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
  5. 5 Public Health Policy Evaluation Unit, Imperial College London, London, UK
  6. 6 Department of Community, Environmental, and Occupational Medicine, Faculty of Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
  7. 7 Choiceflows, LLC, Chapel Hill, North Carolina, USA
  8. 8 Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida, USA
  1. Correspondence to Dr Ramzi G Salloum, Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida, USA; rsalloum{at}ufl.edu

Abstract

Background Waterpipe tobacco smoking rates in the Eastern Mediterranean region are among the highest worldwide, yet little evidence exists on its economics. Estimates of demand elasticities for tobacco products are largely limited to cigarettes. This study aimed to estimate own-price and cross-price elasticities of demand for cigarettes and waterpipe tobacco products in Lebanon, Jordan and Palestine.

Methods A volumetric choice experiment was conducted using nationally representative household surveys. The choice experiment elicited respondents’ stated purchases of eight cigarette and waterpipe tobacco product varieties by hypothetically varying prices. Data were analysed using zero-inflated Poisson models that yielded demand elasticity estimates of cigarette and waterpipe tobacco consumption.

Results The study included 1680 participants in Lebanon (50% female), 1925 in Jordan (44.6% female) and 1679 in Palestine (50% female). We found the demand for premium cigarettes to be price elastic (range, −1.0 to −1.2) across all three countries, whereas the demand for discount cigarettes was less elastic than premium cigarettes in Lebanon (−0.6) and Jordan (−0.7) and more elastic in Palestine (−1.2). The demand for premium waterpipe tobacco was highly elastic in Lebanon (−1.9), moderately elastic in Jordan (−0.6) and inelastic in Palestine (0.2). The cross-price elasticity between cigarettes and waterpipe tobacco was near zero, suggesting that the two products are not considered to be close substitutes by consumers.

Conclusions These results serve as a strong evidence base for developing and implementing fiscal policies for tobacco control in the Eastern Mediterranean region that address cigarettes and waterpipe tobacco products.

  • economics
  • taxation
  • low/middle income country
  • global health
  • non-cigarette tobacco products

Data availability statement

Data are available upon reasonable request.

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

http://dx.doi.org/10.1136/tobaccocontrol-2021-056616

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    Data availability statement

    Data are available upon reasonable request.

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    Footnotes

    • Twitter @AliChalak3, @rimanakkash, @mojawad606

    • Contributors RTN, RGS and AC conceptualised the study. AC, RGS and JL contributed to the design of the experiment. RTN, YSK and NMEA-R supervised data collection. AC was responsible for data analysis reported in this paper. AC and RGS wrote the first draft. All authors contributed to successive drafts, and approved the final manuscript.

    • Funding This research is funded by a grant from the International Development Research Centre (Grant number 108821).

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.