Background The price of tobacco products in relation to the income of tobacco users—affordability—is recognised as a key determinant of tobacco use behaviour. The effectiveness of a price increase as a deterrent to tobacco use depends on how much price increases in relation to the income of the potential users. The aim of this paper is to examine the distribution of and trends in the affordability of tobacco products in Bangladesh.
Method Using four waves of International Tobacco Control Survey data on Bangladesh, this study measures affordability of tobacco products at the individual level as the ratio of self-reported price and self-reported income. The trends in affordability by brand categories of cigarettes and of bidi and smokeless tobacco are estimated using multivariate linear regression analysis.
Results Despite significant increase in price, the affordability of cigarettes increased between 2009 and 2014–2015 due to income growth outpacing price increase. The increase was disproportionately larger for more expensive brands. The affordability of bidis increased over this period as well. The affordability of smokeless tobacco products remained unchanged between 2011–2012 and 2014–2015.
Conclusion The tax increases that were implemented during 2009–2015 were not enough to increase tobacco product prices sufficiently to outweigh the effect of income growth, and to reduce tobacco consumption. The findings from this research inform policymakers that in countries experiencing rapid economic growth, significant tax increases are needed to counteract the effect of income growth, in order for the tax increases to be effective in reducing tobacco use.
Statistics from Altmetric.com
Contributors NN, MS, JD, AKMGH and GTF contributed to the study design. NN conducted the quantitative analysis and wrote the first draft of the manuscript. All authors contributed to interpretation of results and to writing, revising and editing of the final manuscript.
Funding The ITC Bangladesh Survey was supported by the International Development Research Centre (IDRC Grant 104831-002) and Canadian Institutes of Health Research (MOP 79551 and MOP 115016), and the US National Cancer Institute (P01 CA138389). Additional support was provided to GTF from a Senior Investigator Award from the Ontario Institute for Cancer Research and a Prevention Scientist Award from the Canadian Cancer Society Research Institute. CS is funded by 1K99AA024810 (NIAAA). Additional support in preparing this paper was provided to University of Waterloo by the Canadian Institutes of Health Research (FDN-148477).
Disclaimer The authors alone are responsible for the views expressed in this article, and they do not necessarily represent the views, decisions or policies of the institutions with which they are affiliated.
Competing interests None declared.
Patient consent Obtained.
Ethics approval Office of Research Ethics, University of Waterloo, Canada and Bangladesh Medical Research Council.
Provenance and peer review Not commissioned; externally peer reviewed.
Correction notice This paper has been corrected since it was published Online First. Funding information for CS has been added to the ’Funding' section. Details of additional support have also been added.
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.