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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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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).
Footnotes
X @Ara_JCho, @CoralGartner
Contributors AC and CEG developed the initial research concept and design. AC had the lead role in drafting the manuscript with the help of MS and CEG and conducted all statistical analyses with the support of GC and PD. MS, PD, AH and CS commented on advanced drafts. All authors contributed to data interpretation, reviewed and edited the text and have approved the final version of the manuscript. AC is the guarantor.
Funding The data collection for the Australia arm of the ITC Four Country Survey is supported by National Health and Medical Research Council of Australia (GNT265903, GNT450110, GNT1005922 and GNT1198301) and partially supported by the Canadian Institutes of Health Research (MOP-79551 and MPO-115016). The data collection for the Australia arm of the ITC Four Country Smoking and Vaping Survey is supported by National Health and Medical Research Council of Australia (GNT1106451) and partially supported by the Canadian Institutes of Health Research Foundation Grant (FDN-148477). PD is supported by the Canadian Institutes of Health Research Foundation Grant (FDN-148477) and the US National Institute of Health (P01 CA200512). AH is supported by the US National Institute of Health (P01 CA200512). AC holds a University of Queensland Research Training Scholarship. GC is supported by the National Health and Medical Research Council Investigator Grant (NHMRC Grant GNT1176137). CEG is supported by an Australian Research Council Future Fellowship (FT220100186). AC, MS, GC and CEG are researchers associated with the National Health and Medical Research Council Centre of Research Excellence on Achieving the Tobacco Endgame (NHMRC Grant GNT1198301).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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