Abstract

China is in the midst of an epidemic of non-communicable diseases (NCDs), which has increasingly accounted for a growing share of disease burden, due in part to China’s ongoing rapid socioeconomic changes and population aging. Smoking, the second leading health risk factors associated with NCDs in China, disproportionately affects the old population more than their younger counterparts. Using survey data from the China Health and Retirement Longitudinal Study (CHARLS), this study evaluated the impact of changes in cigarette affordability on smoking behavior among middle-aged and elderly (age 45 and older) smokers. Self-reported cigarette price and disposable income were used to calculate cigarette affordability. Cigarette consumption was measured using the number of cigarettes smoked per day reported by the survey respondents. The correlation between cigarette affordability and cigarette consumption was estimated using generalized estimating equations adjusting for demographics, socioeconomic status, geolocations, and cigarette price tiers, as well as year fixed effects. The estimated overall conditional cigarette affordability elasticity of demand was –0.165, implying a 10% decrease in cigarette affordability would result in a reduction in cigarette consumption by 1.65%. The cigarette affordability responsiveness differs by demographics, socioeconomic status, geolocations, and cigarette price tiers. This study provides evidence that tax/price policies that reduce cigarette affordability could lead to a decrease in cigarette consumption among middle-aged and elderly smokers in China. Smoke-free laws, as well as minimum price regulations, may be needed to compliment excise tax policy to target specific smoking subgroups whose cigarette consumption is less sensitive to changes in cigarette affordability.

Highlights

  • The Chinese population is ageing dramatically, average life expectancy at birth has risen from44.6 years in 1950 to 75.3 years in 2015, and is expected to reach 80 years by 2050

  • This paper aims to fill this critical gap by estimating the affordability elasticity of demand for cigarettes using individual level data obtained from a national representative survey in China

  • We examined the associations between cigarette affordability and cigarette consumption and the potential differential responsiveness of cigarette consumption to changes in cigarette affordability by employing the individual-level survey data—the China Health and Retirement Longitudinal Study (CHARLS)—in China. It focuses on how daily cigarette consumption responds to changes in cigarette affordability among middle-aged and elderly Chinese smokers, a group known to be more likely to be affected by non-communicable diseases (NCDs) compared to their younger counterparts [17]

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Summary

Introduction

The Chinese population is ageing dramatically, average life expectancy at birth has risen from. 44.6 years in 1950 to 75.3 years in 2015, and is expected to reach 80 years by 2050. The pace of population ageing is much faster in China than many other countries, both high-income and low/middle-income ones. In the 30 years, the percentage of people in China aged 60 years or older is expected to more than double, growing from 15.0% (211 million people) in 2015 to 31.9%. (422 million) in 2050 [1,2]. The rapid aging population in China exerts a heavy burden on the country’s workforce and poses substantial challenges for China’s healthcare systems. The total expenditures for elderly care in China as a share of its gross domestic product (GDP) are projected to increase from.

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