Youth Preferences for Roll-Your-Own Versus Factory-Made Cigarettes: Trends and Associations in Repeated National Surveys (2006-2013) and Implications for Policy.

Abstract

We investigated trends in roll-your-own (RYO) and factory-made (FM) cigarette use over time among youth in New Zealand (NZ), a high RYO use country. We also explored factors associated with RYO use. We analyzed data from an annual survey of NZ students (14-15 years old) from 2006-2013. Smokers were asked whether they usually smoked RYO or FM cigarettes, and provided details of their source of supply. We estimated prevalences and developed a binary logistic regression model to explore determinants of RYO use. Between 6663 (2006) and 3143 (2013) current smokers responded. Each year, around 80% reported usually smoking RYO or FM cigarettes. The proportion reporting usual RYO use was 45% (95% confidence interval [CI] ±3%) in 2006, reducing to 40% (95% CI ±3%) in 2013 (trend test: P < .001). By contrast, the proportions reporting usual FM use increased slightly over time from 36% (95% CI ±3%) in 2006 to 38% (95% CI ±3%) in 2013 (trend test: P < .001). Usual RYO use was more common amongst regular smokers, those who initiated smoking younger, who belonged to low or medium socioeconomic status groups, and whose friends and family both smoked. RYO use is very high among NZ youth who smoke. Preference for RYO cigarettes amongst longer-term, regular smokers suggests RYO tobacco supports and maintains youth smoking. There was some initial evidence that a 2010 differential tax increase on RYO tobacco was associated with a shift away from usual RYO use amongst those who sourced tobacco from caregivers or friends. Additional measures such as further differential excise tax increases appear warranted.