Abstract

BackgroundAppropriate increases in tobacco taxes and prices are an essential component of comprehensive tobacco control strategies. This study investigates factors related to the use, sale, and distribution of cigarettes in Iran, focusing on the relationship between cigarette price and its consumption.MethodsThis interview-based qualitative study was conducted among 20 participants, including cigarette smokers, retail shop owners, large-scale distributors, and an expert in tobacco control research.ResultsSeven themes were extracted from participant interviews, including the type and price of cigarette, the best time to sell cigarettes, profits from the sale of cigarette, affordability, rise in cigarette price and smokers’ reaction to it, lobbying and black-market sales of cigarettes, and the sale and distribution of cigarettes across the country. Although the price of cigarettes in Iran has shown some increases in the past decade, the timing of these increases are not predictable and the limited amount of these increases has not reduced the use of cigarettes. Following a price increase, consumers are more likely to switch from buying packets to single cigarettes, or buy a less expensive brand, then to quit. Moreover, increases in prices may encourage smokers and sellers to buy a large number of cigarettes and store them for a rainy day. Another adverse effect may be increased smuggling of illicit cigarettes to balance the pressure caused by rising prices.ConclusionsOur findings highlight two important aspects concerning cigarette pricing in Iran. First is the change in the type of purchase from the whole box of cigarettes to the single stick cigarette or swapping to less expensive cigarettes. Second, increase in cigarette price (either through taxing or regular increases) could be offset by flooding smuggled cigarettes into the market. Therefore, in addition to raising cigarette prices, reducing cigarette consumption rates in Iran requires the development and effective implementation of regulatory policies to control cigarette smuggling, reduce purchasing, and subsequently curb the use of this leading cause of premature morbidity and mortality.

Highlights

  • Appropriate increases in tobacco taxes and prices are an essential component of comprehensive tobacco control strategies

  • Smokers with low incomes are more responsive to price change than those with higher income [10], and on a population level, economic downturns are associated with decreases in cigarette consumption [11, 12], which shows that affordability may affect the purchase and consumption of cigarettes in addition to the absolute price of cigarettes

  • Participants who were tobacco traders and the tobacco control expert were asked about socio-environmental factors related to cigarette consumption, sale, and distribution of cigarettes, as well as laws related to cigarette pricing, selling

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Summary

Introduction

Appropriate increases in tobacco taxes and prices are an essential component of comprehensive tobacco control strategies. Cigarette smoking is a leading cause of preventable morbidity and mortality and is responsible for more than 8 million deaths worldwide annually, mostly from lowand-middle-income countries [1]. Cigarettes are the most popular form of tobacco in Iran and a 2013 meta-analysis of 17 studies revealed that one-fifth of Iranian men and 2–3% of women smoke cigarettes daily [3]. Increasing taxes and prices are effective at reducing overall tobacco consumption [4, 5] by preventing initiation––especially among youth [2] and reducing the level of consumption among established smokers [6], leading to increased tax revenue [7, 8] and long-term reductions in tobacco-related morbidity and mortality [7, 9]. Smokers with low incomes are more responsive to price change than those with higher income [10], and on a population level, economic downturns are associated with decreases in cigarette consumption [11, 12], which shows that affordability may affect the purchase and consumption of cigarettes in addition to the absolute price of cigarettes

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