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Price elasticity of demand of non-cigarette tobacco products: a systematic review and meta-analysis
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  • Published on:
    Jawad et al.'s Policy Recommendations Need Refinement
    • Eric N. Lindblom, Director, Tobacco Control and Food & Drug Law O'Neill Institute for National & Global Health Law, Georgetown Law

    NOT PEER REVIEWED
    This paper’s core findings are quite helpful: (1) Tax/price increases for non-cigarette tobacco products can effectively reduce their use; and (2) Tax/price increases for non-cigarette tobacco products could prompt some users to increase their cigarette smoking if comparable tax/price increases for cigarettes are not done at the same time. But the paper’s related analysis is incomplete, producing misleading conclusions, largely because the paper focuses on cigarettes versus non-cigarette tobacco products without also considering the more important distinction for health-directed tobacco tax strategies between smoked tobacco products and non-combustible tobacco products.

    In its abstract, the paper concludes that the “positive substitutability between cigarettes and non-cigarette tobacco products suggest that tax and price increases need to be simultaneous and comparable across all tobacco products.” But the paper does not appear to consider that the only substitutions that could significantly increase public health harms would be if the tax increases prompted some non-combusted tobacco product users to move to more-harmful smoking or prompted some smokers who would otherwise do so not to move to less-harmful non-combusted tobacco products. As a result, the paper fails to acknowledge that significant tax/price increases for only combusted tobacco products would not prompt any harm-increasing substitution and would directly secure desirable...

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    Conflict of Interest:
    None declared.
  • Published on:
    A critique of Jawad et al, Price elasticity of demand of non-cigarette tobacco products: a systematic review and meta-analysis
    • Joe G. Gitchell, President PinneyAssociates, Inc.
    • Other Contributors:
      • Robyn E. Gougelet, Senior Associate
      • David T Sweanor, Chair of the Advisory Committee
      • Mark A. R. Kleiman, Professor of Public Policy

    NOT PEER REVIEWED The Jawad et al systematic review and meta-analysis examining price effects for non-cigarette tobacco and nicotine products appears methodologically sound and was a registered analysis. It provides information that could be used productively by advocates and policymakers seeking to reduce harm. The cross-elasticities reported in this paper can be used to the advantage of public health by increasing the impact of policies that seek to drive down smoking.

    However, this work does not take into account the fact that not all tobacco and nicotine products cause the same level of health harms as combustible cigarettes. The paper examines own- and cross-price elasticity across a wide array of products – from combustible tobacco products such as kreteks and little cigars to nicotine-only products such as e-cigarettes and nicotine patches – and then discusses consumption patterns in terms of an undifferentiated aggregate of nicotine use. Jawad and colleagues do not consider the health implications of policies to move nicotine users from more-harmful to less-harmful means of administration (see, for example, Chaloupka, Warner and Sweanor, 2015, recommending differential taxation according to differential risk).

    From a public health perspective, any analysis of nicotine-use patterns should consider differential harm levels. A focus on nicotine use as the sole outcome variable can be seriously misleading and detrimental to the goal of reducing smoking....

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    Conflict of Interest:
    Disclosures
    The employer of JGG and REG, PinneyAssociates, provides consulting services on tobacco harm minimization (including nicotine replacement therapy and vapor products) to Niconovum USA, RJ Reynolds Vapor Company, and RAI Services Company, all subsidiaries of Reynolds American Inc. Reynolds American Inc. was purchased by British American Tobacco in July 2017. JGG also owns an interest in intellectual property for a novel nicotine medication that has not been developed or commercialized.

    MK’s firm BOTEC Analysis receives funding for tobacco-related research from both Altria and PMI.