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The impact of tobacco tax increases on cost-minimising behaviours and subsequent smoking cessation in Australia: an analysis of the International Tobacco Control Policy Evaluation Project

Abstract

Objective We examined the relationship in Australia from 2007 to 2020 between tobacco tax increases and use of cost-minimising behaviours (CMBs) when purchasing tobacco and: (1) tobacco expenditure and (2) smoking cessation attempts and quit success.

Methods We used data collected from adults who smoked factory-made and/or roll-your-own (RYO) cigarettes in nine waves (2007–2020) of the International Tobacco Control Policy Evaluation Project Australia Survey (Nsample=4975, Nobservations=10 474). CMBs included buying RYO tobacco, cartons, large-sized packs, economy packs, or tax avoidance/evasion, smoking reduction and e-cigarette use. Logistic regression, fit using generalised estimating equations, estimated the CMB-outcome association for quit attempts and quit success at the next wave follow-up (Nsubsample=2984, Nobservations=6843).

Results Over half of respondents used a CMB for tobacco purchase (P-CMB) at baseline (57.1% in 2007–2008), increasing to 76.8% (2018) post-tax increases. Participating in any P-CMB was associated with having higher weekly tobacco expenditure. Engaging in any P-CMB was negatively associated with attempting to quit (aOR=0.82, 95% CI 0.69–0.98). Purchasing RYO tobacco or cartons was associated with making no quit attempts (aOR=0.66, 95% CI 0.52–0.83; aOR=0.72, 95% CI 0.59–0.89, respectively). Among respondents smoking cigarettes who made quit attempts, there were no significant associations between all P-CMBs and quit success. Neither smoking reduction nor vaping were significantly associated with quit attempts.

Conclusion P-CMBs are associated with reduced smoking cessation. Reducing opportunities for industry to promote purchasing-related CMB options, such as by standardising pack sizes and reducing the price differential between RYO and manufactured cigarettes could increase the effectiveness of tax increases.

  • Cessation
  • Addiction
  • Price
  • Taxation
  • Hand-rolled/RYO tobacco

Data availability statement

Data are available upon reasonable request. Data from the International Tobacco Control (ITC) Policy Evaluation Project are available to eligible researchers 2 years after the ITC Data Management Centre issues cleaned data sets. Researchers who want to use ITC data must first seek for permission by completing an International Tobacco Control Data Repository (ITCDR) request application and then sign an ITCDR Data Usage Agreement. To avoid any real, potential or perceived conflict of interest between researchers who use ITC data and tobacco-related entities, no ITCDR data will be provided directly or indirectly to any researcher, institution or consultant who is currently receiving grant funds or in-kind contributions from any tobacco manufacturer, distributor or other tobacco-related entity. The data usage approval criteria and the contents of the Data Usage Agreement are described online (http://www.itcproject.org).

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