Abstract
BackgroundDespite being the third largest tobacco producer in the world, Brazil has developed a comprehensive tobacco control policy that includes a broad restriction on both advertising and smoking in indoor public places, compulsory pictorial warning labels, and a menthol cigarette ban. However, tax and pricing policies have been developed slowly and only very recently were stronger measures implemented. This study investigated the expected responses of smokers to hypothetical price increases in Brazil.MethodsWe analyzed smokers’ responses to hypothetical future price increases according to sociodemographic characteristics and smoking conditions in a multistage sample of Brazilian current cigarette smokers aged ≥14 years (n = 500). Logistic regression analysis was used to examine the relationship between possible responses and different predictors.ResultsIn most subgroups investigated, smokers most frequently said they would react to a hypothetical price increase by taking up alternatives that might have a positive impact on health, i.e., they would “try to stop smoking” (52.3%) or “smoke fewer cigarettes” (46.8%). However, a considerable percentage responded that they would use alternatives that would reduce the effect of price increases, such as the same brand with lower cost (48.1%). After controlling for sex age group (14–19, 20–39, 40–59, and ≥60 years), schooling level (≥9 versus ≤9 years), number of cigarettes per day (>20 versus ≤20), and stage of change for smoking cessation (precontemplation, contemplation, and preparation), lower levels of dependence were positively associated with the response “I would try to stop smoking” (odds ratio [OR], 2.19). Young age was associated with “I would decrease the number of cigarettes” (OR, 3.44). A low schooling level was strongly associated with all responses.ConclusionsTaxes and prices increases have great potential to stimulate cessation or reduction of cigarette consumption further among two important vulnerable populations of smokers in Brazil: young smokers and those of low educational level. The results from the present study also suggest that seeking illegal products may reduce the impact of increased taxes, but does not eliminate it.
Highlights
Despite being the third largest tobacco producer in the world, Brazil has developed a comprehensive tobacco control policy that includes a broad restriction on both advertising and smoking in indoor public places, compulsory pictorial warning labels, and a menthol cigarette ban
Tax increases and price increases for tobacco products are addressed in article 6 of The World Health Organization (WHO) Framework Convention on Tobacco Control and are considered to be one of the best policies in reducing the demand for tobacco products [1]
The present study investigated how smokers in Brazil react to new price increases by focusing on expected responses to a future hypothetical price increase that has a positive impact on health such as quitting smoking or reducing the demand for cigarettes instead of smokers adopting alternative behaviors such as switching to cheaper brands or buying from the illegal market
Summary
Despite being the third largest tobacco producer in the world, Brazil has developed a comprehensive tobacco control policy that includes a broad restriction on both advertising and smoking in indoor public places, compulsory pictorial warning labels, and a menthol cigarette ban. In addition to smokers’ strategies of limiting consumption to cope with higher prices, studies have shown that they take up alternatives aimed at reducing costs, which may limit the beneficial impact of price and taxes policies [8,9]. They may change their brand of cigarettes for a cheaper one or they may look for places where their preferred brand, even if illicit products, is sold at lower prices. They are less likely to make successful attempts to quit
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