Reduce Tobacco Consumption Research Articles

The influence of estimated retail tobacco sale price increase on smokers' smoking habit in Jiangxi province, China: a cross-sectional study.

IntroductionChina is the biggest tobacco producer and consumer in the world. Raising cigarette taxes and increasing tobacco retail prices have been prove as effective strategies to reduce tobacco consumption and the prevalence of smoking in western countries. But in China, it is uncertain how an increase of cigarette retail price will influence the tobacco consumption.MethodsFrom April to July, 2012, we selected 4025 residents over 15 years by a three stage random sampling in four cities, Jiangxi Province, China. We conducted interviews of their current smoking habits and how they would change their smoking behavior if tobacco retail prices increase.ResultsOverall, the prevalence of smoking is 27 % (47 % for male, 3.1 % for female). 15 % of smokers have tried to quit smoking in the past but all relapsed (168/1088), and over 50 % of current smokers do not want to quit, The average cigarette price per pack is 1.1 USD (range = 0.25-5.0). If retail cigarette prices increases by 50 %, 45 % of smokers say they will smoke fewer cigarettes, 20 % will change to cheaper brands and 5 % will attempt to quit smoking. Smokers who have intention to quit smoking are more sensitive to retail cigarette price increase. With retail cigarette price increases, more smokers will attempt to quit smoking.ConclusionChinese smokers will change their smoking habits if tobacco retail prices increase. Consequently the Chinese government should enact tobacco laws which increase the retail cigarette price. The implementation of new tobacco laws could result in lowering the prevalence of smoking. Meanwhile, price increase measures need to apply to all cigarette brands to avoid smokers switching cigarettes to cheaper brands.

State-ownership of tobacco industry: a ‘fundamental conflict of interest’ or a ‘tremendous opportunity’ for tobacco control?

Despite state-owned tobacco companies (SOTCs) accounting for over 40% of global production, the significance of state-ownership for tobacco control strategies has received limited academic and policy attention. The complex interests...

Will Sin Taxes Deliver us from Disease? An initial Assessment of the Sin Tax Law

In 2012, sin taxes in the Philippines were re-structured, paving the way for high, unitary taxes by 2017. The i:estructuring was intended to discourage the consumption of tobacco and alcohol, thus, addressing the concerns of high smoking prevalence and increasing incidence of non-communicable diseases such as diseases of the heart and malignant neoplasms. I propose a framework for tracking health status improvements and then use various population-based survey data to assess one pathway from sin taxes to better health, i.e., reduced tobacco consumption. Higher sin taxes in 2013 seem to have reduced total consumption by not more than 10 percent. A larger impact on cigarette consumption can be expected beyond 2013, particularly, in 2017 with uniform and higher tax rates. Systematic and coordinated monitoring of tobacco consumption is needed to ensure maximum and sustained health gains from sin taxes.

Electronic cigarette: use and perceptions among French military nurses in 2013.

Paramedical personnel are exposed to tobacco smoking. Electronic cigarettes (e-cigarettes) may be considered as a lower-risk substitute for cigarettes. The aim of the study was to estimate the prevalence of e-cigarette use, the motives for use and the perceptions among French military nurses. A cross-sectional survey, using self-administered questionnaires, was conducted in 2013 among 300 students and instructors of the French school of military paramedical personnel. Prevalences of e-cigarette use among smokers and nonsmokers were compared using logistic regressions adjusted on age and gender. The prevalence of smoking was 40% among the 200 responders. E-cigarette current use prevalence was 25% (6% daily users), without significant difference according to gender and age. Tobacco smokers reported significantly more e-cigarette current use (51% vs7%). Motives for e-cigarette use reported by smokers were curiosity (48%), intention to reduce tobacco consumption (43%) or to quit smoking (8%). Among users of both tobacco and e-cigarettes, 48% reported a significant decrease in tobacco consumption following e-cigarette initiation (average decrease of 5-10 cigarettes smoked per day; p <0.001). Both tobacco smokers and nonsmokers (88%) estimated that e-cigarette use was potentially harmful for health, but it was perceived as less harmful than tobacco by 46%. E-cigarette use among military nurses follows the trends observed in the general population in terms of prevalence and motives. E-cigarettes, which are seen as an attractive alternative to cigarettes, may contribute to a reduction in tobacco use among healthcare workers.

The APJPH Supports “World No Tobacco Day”

Every year, on May 31, the World Health Organization (WHO) invites us all to join together to mark World No Tobacco Day.1 On this day, we highlight the health risks associated with tobacco use and we pledge to continue working together to advocate for effective policies to reduce tobacco consumption. The most important public health issue in the Asia-Pacific region continues to be tobacco use.2 Over the years, the journal has published 83 articles on smoking and no doubt this issue has been mentioned in many other articles. Because of the increase in chronic disease, 40% of the tobacco-related articles in the journal have been published in the past 3 years alone. We welcome continued submissions on tobacco; particularly papers on the ways that countries in our region are able to reduce overall smoking rates and the recruitment of teenagers into tobacco addiction. Tobacco companies remain a ruthless opponent in promoting and distributing a deadly product across our region. As they face the prospect of declining profits, they are continually inventing new ways to increase the addiction among children, ethnic groups, and existing users.3 They have consistently opposed the introduction of effective health promotion efforts such as the plain packaging legislation in Australia. They are encouraging countries with tobacco industries to sue Australia, and at the present time Indonesia is one of the countries trying to get the Australian public health legislation reversed.4 The small South American nation of Uruguay has a long history of social support and public health programs that are enshrined in its constitution. Its Congress Hall in Montevideo, itself a work of art dedicated to social values, has at its entrance a statue that includes a mother breastfeeding her infant, a strong symbol of social justice and public health. Uruguay enacted strong antitobacco legislation and because of its limited resources it was targeted by multi-national tobacco companies in the courts. With their multibillion dollar assets it looked as if Uruguay would be forced to back down on its antitobacco stance, but the Bloomberg Foundation came to its defense and is supporting the rights of Uruguayans to live a healthy life.5 The tobacco companies are heavily involved in promoting e-cigarettes despite the increasing evidence of their addictive effects on existing and new users.6,7 Recent reports by the WHO and NHMRC (National Health and Medical Research Council) have rejected claims that e-cigarettes can reduce harm from smoking.8 There is little evidence of benefit and emerging evidence that teenagers who would never have taken up smoking are beginning to use vaporizers.9 The tobacco companies have become innovative in the use of social media on the Internet to promote their deadly wares. They continue to sponsor and undertake “research” in the guise of

The association between tax structure and cigarette price variability: findings from the ITC Project

BackgroundRecent studies have shown that more opportunities exist for tax avoidance when cigarette excise tax structure departs from a uniform specific structure. However, the association between tax structure and cigarette...

Tobacco – Whose friend and who is friend with it?

Abstract Tobacco use poses immense socio-economic and health burden on the world community. World No Tobacco Day initiative is earmarked on the 31st of May each year. It is an initiative to lead the fight against tobacco highlighting health risks associated with tobacco and advocating effective policies to reduce tobacco consumption. The Framework Convention on Tobacco Control (FCTC) is an evidence-based treaty negotiated under the auspices of the World Health Organization with 168 countries including India, signatories to it. WHO FCTC reaffirms the right of all people to the highest standard of health, and proposes to develop regulatory strategies to address addictive substances stressing upon the importance of both demand reduction strategies as well as supply issues. The FCTC entered into force on 27 February, 2005. India's health warnings policy was drafted in 2006 and has undergone serial revisions. Packaging and labelling of tobacco products and tobacco advertising and promotion are a part of these strategies. Health warnings are required to be present over 40% of the front of all cigarette packages. Pictorial health warnings are considered to be a deterrent to young persons, uneducated/illiterate people and the women folk. There has been a recent debate on whether to increase the size of pictorial health warnings to 80% on both faces of tobacco product packs, and if there is a lack of Indian studies on the matter. There have been over a dozen studies from India in recent times, and the pictorial health warnings unanimously have helped in improving awareness, in helping think about tobacco cessation and also in quitting tobacco. In fact, larger pictorial health warnings and strict enforcement of laws to curb aggressive promotional strategies are the felt-need to act as a deterrent to the tobacco promotional strategies adopted by the tobacco lobby.

Mo1737 Granulo-Monocytes Apheresis Induce TGFβ1 Modulation in Neutrophils of Patients Suffering From Ulcerative Colitis: A Possible Role of Soluble HLA-I Molecules

Introduction Since their invention 14 years ago, by Chinese pharmacist Hon Lik, the electronic cigarette (e-cigarette) has known increasing success, experiencing a particular surge in popularity post 2010. Their usage has allowed for reduced tobacco consumption which can be attributed to a reduction in health concerns such as Crohn's Disease. However, it is important to clarify whether or not the e-cigarette may also present a number of health risks. Previous work carried out by our team, examining the effect of exposure to cigarette smoke on immune cells taken from patients with inflammatory bowel disease (IBD), confirmed the dual effect on IBD inflammatory response after tobacco exposure [1]. In this context, examining the toxicity of products present in the smoke from traditional cigarettes versus e-cigarettes, presented an interesting topic. The aim of this study was to compare the impact of the e-cigarette with that of tobacco on inflammatory response in an epithelial intestinal cell culture model. Materials and Methods The intestinal inflammatory response was evaluated using a human intestinal epithelial cell line model (HT29), transfected with bacterial LPS receptor, MD-2. This model presents an exaggerated inflammatory response to LPS, a characteristic which presented in Crohn's disease. Release of interleukin (IL)-8, a marker of inflammation, was measured by ELISA for control cells or those stimulated by LPS and after exposure to either traditional or e-cigarettes smoke extracted in parallel using a machine which mimics the act of smoking. The concentration of nicotine was equivalent in both extracts (traditional and e-cigarette). Controls were performed in the presence of smoke containing only the e-cigarette solvent, propylene glycol. Toxicity was evaluated by tetrazolium salt MTT toxicity test. Results Inflammatory response was greatly elevated in cells exposed to traditional cigarette (tc) smoke, as measured by IL-8 release (pg/mg protein). In contrast, cells exposed to e-cigarette smoke (ec) showed inflammatory response comparable to control cells (sol) and significantly lower than those treated with traditional cigarette (tc) smoke extracts. IL-8 release (pg/mg protein) was observed as follows: for non-LPS stimulated (control) cells; 79.6±10.1 (controls) vs 175.2±16.6 (tc) and 68.6±4 (ec) vs 77.7±10.7 (sol) and for cells treated with 10 μg/ml LPS; 1507.8 ±228.6 (controls) vs 2684.7±632.1 (tc) and 1287,5±235 (ec) vs 1570,9±224,8 (sol). Conclusion Our results suggest that the intestinal epithelium inflammatory response is not altered by exposure to smoke from e-cigarettes. Further research into the consequences of e-cigarettes on immune cells will aid to complement these encouraging results and serve to refine our current knowledge on the dual effect of tobacco in Crohn's disease and ulcerative colitis.

Electronic cigarette use and harm reversal: emerging evidence in the lung.

Electronic cigarettes (ECs) have been rapidly gaining ground on conventional cigarettes due to their efficiency in ceasing or reducing tobacco consumption, competitive prices, and the perception of them being a much less harmful smoking alternative. Direct confirmation that long-term EC use leads to reductions in smoking-related diseases is not available and it will take a few decades before the tobacco harm reduction potential of this products is firmly established. Nonetheless, it is feasible to detect early changes in airway function and respiratory symptoms in smokers switching to e-vapor. Acute investigations do not appear to support negative respiratory health outcomes in EC users and initial findings from long-term studies are supportive of a beneficial effect of EC use in relation to respiratory outcomes. The emerging evidence that EC use can reverse harm from tobacco smoking should be taken into consideration by regulatory authorities seeking to adopt proportional measures for the e-vapor category.

E-cigarettes: Are we renormalizing public smoking? Reversing five decades of tobacco control and revitalizing nicotine dependency in children and youth in Canada.

An electronic cigarette (e-cigarette) is a battery attached to a chamber containing liquid that may (or may not) contain nicotine. The battery heats the liquid and converts it into a vapour, which is inhaled, mimicking tobacco smoking. The e-cigarette does not rely on tobacco as a source of nicotine but, rather, vaporizes a liquid for inhalation. E-liquids are often flavoured and may contain nicotine in various concentrations, although actual amounts are seldom accurately reflected in container labelling. The deleterious effects of nicotine on paediatric health are well established. The use of e-cigarettes in the paediatric age group is on the rise in Canada, as are associated nicotine poisonings. E-devices generate substantial amounts of fine particulate matter, toxins and heavy metals at levels that can exceed those observed for conventional cigarettes. Children and youth are particularly susceptible to these atomized products. Action must be taken before these devices become a more established public health hazard. Policies to denormalize tobacco smoking in society and historic reductions in tobacco consumption may be undermined by this new 'gateway' product to nicotine dependency.

Current tobacco use among adults: a community-based study in urban area of Thanlyin township, Yangon region, Myanmar

Background: The identification, prevention and control of the common risk factors are the basic element in prevention and control of NCDs. However, the paucity of information on risk factors is one of the major challenges in the prevention and control of these diseases. The use of tobacco is one of the main risk factors of major NCDs. Therefore, this study was conducted to determine the prevalence, and socioeconomic and demographic determinants of current tobacco use among adults residing in urban area of Thanlyin Township, Yangon Region . Methods: A cross-sectional study was conducted among 468 adults. Multi-stage random sampling was applied. Data entry and analysis was done using Stata 11.0 statistical package. Results: The prevalence of current smoking, current use of smokeless tobacco and current tobacco use were 27.6%, 35.7% and 48.1%, respectively. Age, sex, marital status and occupation were significantly associated with both current smoking and current use of smokeless tobacco. There was a significant decreasing trend of current smokeless tobacco use across the levels of education. Besides, age, sex, education and occupation were detected as significant determinants of current tobacco use . Conclusions: There is an urgent need to curb the use of tobacco in urban area, especially among males and young adults. Tobacco control policy in Myanmar should be strengthened or reinforced to reduce tobacco consumption in the country. Education status of the population should also be improved.

Estimating cross-price elasticity of e-cigarettes using a simulated demand procedure.

Our goal was to measure the cross-price elasticity of electronic cigarettes (e-cigarettes) and simulated demand for tobacco cigarettes both in the presence and absence of e-cigarette availability. A sample of New Zealand smokers (N = 210) completed a Cigarette Purchase Task to indicate their demand for tobacco at a range of prices. They sampled an e-cigarette and rated it and their own-brand tobacco for favorability, and indicated how many e-cigarettes and regular cigarettes they would purchase at 0.5×, 1×, and 2× the current market price for regular cigarettes, assuming that the price of e-cigarettes remained constant. Cross-price elasticity for e-cigarettes was estimated as 0.16, and was significantly positive, indicating that e-cigarettes were partially substitutable for regular cigarettes. Simulated demand for regular cigarettes at current market prices decreased by 42.8% when e-cigarettes were available, and e-cigarettes were rated 81% as favorably as own-brand tobacco. However when cigarettes cost 2× the current market price, significantly more smokers said they would quit (50.2%) if e-cigarettes were not available than if they were available (30.0%). Results show that e-cigarettes are potentially substitutable for regular cigarettes and their availability will reduce tobacco consumption. However, e-cigarettes may discourage smokers from quitting entirely as cigarette price increases, so policy makers should consider maintaining a constant relative price differential between e-cigarettes and tobacco cigarettes.

Strategies for an effective tobacco harm reduction policy in Indonesia.

Tobacco consumption is a major causative agent for various deadly diseases such as coronary artery disease and cancer. It is the largest avoidable health risk in the world, causing more problems than alcohol, drug use, high blood pressure, excess body weight or high cholesterol. As countries like Indonesia prepare to develop national policy guidelines for tobacco harm reduction, the scientific community can help by providing continuous ideas and a forum for sharing and distributing information, drafting guidelines, reviewing best practices, raising funds, and establishing partnerships. We propose several strategies for reducing tobacco consumption, including advertisement interference, cigarette pricing policy, adolescent smoking prevention policy, support for smoking cessation therapy, special informed consent for smokers, smoking prohibition in public spaces, career incentives, economic incentives, and advertisement incentives. We hope that these strategies would assist people to avoid starting smoking or in smoking cessation.

Prevalence and determinants of tobacco use in India: evidence from recent Global Adult Tobacco Survey data.

BackgroundTobacco use in India is characterized by a high prevalence of smoking and smokeless tobacco use, with dual use also contributing a noticeable proportion. In the context of such a high burden of tobacco use, this study examines the regional variations, and socioeconomic, demographic and other correlates of smoking, smokeless tobacco and dual use of tobacco in India.Methods and FindingsWe analyzed a cross sectional, nationally representative sample of individuals from the Global Adult Tobacco Survey in India (2009–10), which covered 69,296 individuals aged 15 years and above. The current tobacco use in three forms, namely, smoking only, smokeless tobacco use only, and both smoking and smokeless tobacco use were considered as outcomes in this study. Descriptive statistics, cross tabulations and multinomial logistic regression analysis were adopted as analytical tools. Smokeless tobacco use was the major form of tobacco use in India followed by smoking and dual tobacco use. Tobacco use was higher among males, the less educated, the poor, and the rural population in India. Respondents lacking knowledge of health hazards of tobacco had higher prevalence of tobacco use in each form. The prevalence of different forms of tobacco use varies significantly by states. The prevalence of tobacco use increases concomitantly with age among females. Middle-aged adult males had higher prevalence of tobacco use. Age, education and region were found to be significant determinants of all forms of tobacco use. Adults from the poor household had significantly higher risk of consuming smokeless tobacco. Lack of awareness about the selected hazards of tobacco significantly affects tobacco use.ConclusionsThere is an urgent need to curb the use of tobacco among the sub-groups of population with higher prevalence. Tobacco control policies in India should adopt a targeted, population-based approach to control and reduce tobacco consumption in the country.

The Enforcement of India's Tobacco Control Legislation in the State of Haryana: A Case Study

In 2003, the Parliament of India passed the Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act, 2003 (COTPA) to counter the growing societal and health burdens of tobacco in India. The major provisions (Sections 4–7) of COTPA mandate the display of pictorial health warnings on all tobacco product packets and strictly prohibit: smoking in public places, direct and indirect forms of tobacco advertisements, promotion and sponsorship of tobacco products, sale of tobacco products to a minor, and sale within 100 yards of any educational institution. However, India continues to have a high prevalence of tobacco consumption and the provisions of COTPA are routinely flouted. The purpose of the study is to analyze the trends in and the prevalence of COTPA violations in a sample test site (Haryana) to develop informed and practical tobacco control policy recommendations. Violations in five districts of the State of Haryana were observed and recorded. The data overwhelmingly show that the most fundamental provisions (Sections 4–7) of COTPA were frequently violated in each of the five districts. All districts had a high rate of noncompliance, with Sites having at least one violation of Sections 4–7 of COTPA, with rates fluctuating between nearly 70 and 90 percent. Such violations however, were unequally distributed between Sections 4–7 within the five districts with some districts having a higher frequency of Section 4 violations (Panipat and Jhajjar) and other districts with higher violation frequency of Section 5 (Mewat and Kurukshetra). However, all five districts had relatively low numbers of Section 7 violations (i.e., the required display of pictorial health warnings on all tobacco products). The study highlights the challenges of the tobacco control policy in India including: engagement of state and district level enforcement officials for effective enforcement of existing legislation, encouragement for civil society to partner and complement governmental efforts in monitoring progress and reporting violations of COTPA, and the need for supply‐level controls on tobacco (e.g., pictorial health warnings and increased taxation) to reduce tobacco consumption.

Prevalence and determinants of secondhand smoke exposure among women in Bangladesh, 2011.

The population of Bangladesh is highly susceptible to secondhand smoke (SHS) exposure due to high smoking rates and low awareness about the harmful effects of SHS. This study aims to determine the prevalence of SHS exposure and highlight the essential determinants in developing successful strategies to prevent adverse health effects in Bangladesh. The analysis is based on the Bangladesh Demographic Health Survey 2011, in which 17,749 women in the reproductive age group (12-49 years) were included. The information regarding SHS exposure at home was derived from the question: "How often does anyone smoke inside your house?" The variable was recoded into 3 groups: daily exposure, low exposure (exposed weekly, monthly, or less than monthly), and no SHS exposure. We performed descriptive and bivariable analyses and multinomial logistic regression. A total of 46.7% of the women reported high exposure to SHS at home. According to the multinomial logistic regression model, relatively lower education and lower wealth index were significantly associated with daily SHS exposure at home. The exposure differed significantly between the divisions of Bangladesh. Having children at home (vs. not) and being Islamic (compared to other religious affiliations) were protective factors. The study indicates that women from socioeconomically disadvantaged households are more likely to experience daily exposure to SHS at home. Therefore, especially these groups have to be targeted to reduce tobacco consumption. In addition to aspects of legislation, future strategies need to focus educational aspects to improve the population's health status in Bangladesh.

Public health leadership and electronic cigarette users.

The recent study by Goniewicz and colleagues1 points to the increasing popularity of electronic cigarettes among people who want to quit smoking, adds to the growing scientific evidence about their real-world use and in turn raises questions about their potential to reduce smoking-related disease. Smoking is the leading cause of preventable death and disease globally, associated with nearly 6 million deaths annually; in the European Union smoking rates average 29% of the adult population, with 700 000 premature deaths each year. Most smokers want to quit smoking but find it hard to give up nicotine. Progress with reducing smoking continues, but the pace is slow. It is hard to see how the current non-communicable disease burden can be met without a drastic reduction in smoking prevalence. It is also hard to see how that can come about with current anti-smoking measures. The package of interventions in the European Tobacco Products Directive, including large health warnings and bans on small packs, is on the evidence of the European Commission’s own impact assessment likely to reduce tobacco consumption only by ∼2% over 5 years, which translates into ∼0.5% decline in prevalence in that time. Elsewhere, similarly modest historical gains have …

Demographic characteristics, nicotine dependence, and motivation to quit as possible determinants of smoking behaviors and acceptability of shocking warnings in Italy.

Introduction. This paper presents the final results of a cross-sectional study started in 2010. It compares the perceived efficacy of different types of tobacco health warning (texts versus shocking pictures) to quit or reduce tobacco use. Methods. The study conducted between 2010 and 2012 in Italy enrolled adults smokers. Administering a questionnaire demographic data, smokers behaviors were collected. Showing text and graphic warnings (the corpse of a smoker, diseased lungs, etc.) the most perceived efficacy to reduce tobacco consumption or to encourage was quit. Results. 666 subjects were interviewed; 6% of responders referred that they stopped smoking at least one month due to the textual warnings. The 81% of the smokers perceived that the warnings with shocking pictures are more effective in reducing/quitting tobacco consumption than text-only warnings. The younger group (<45 years), who are more motivated to quit (Mondor's score ≥ 12), and females showed a higher effectiveness of shocking warnings to reduce tobacco consumption of, 76%, 78%, and 43%, respectively with P < 0.05. Conclusions. This study suggests that pictorial warnings on cigarette packages are more likely to be noticed and rated as effective by Italian smokers. Female and younger smokers appear to be more involved by shock images. The jarring warnings also appear to be supporting those who want to quit smoking. This type of supportive information in Italy may become increasingly important for helping smokers to change their behavior.

Paying the price: A cross‐sectional survey of Australian socioeconomically disadvantaged smokers' responses to hypothetical cigarette price rises

Increases in tobacco taxation can lead to reductions in tobacco consumption and prevalence of use across social groups. However, use of price-minimisation strategies to manage current and future tobacco use and the role of financial stress is less understood. This study aimed to measure the effect of cigarette price increases on price-minimisation strategy endorsement and financial stress among socioeconomically disadvantaged smokers. Community service organisation welfare recipients in NSW, Australia completed a touchscreen survey. Smoking history, financial stress, highest price to quit and responses to hypothetical cigarette price increases were assessed. Participants were 354 smokers (response rate = 79%). Most participants received income from a government pension (95%), earned <A$300/week (55%), had not completed secondary schooling (64%), were moderately or heavily nicotine-dependent (60%), reported high financial stress (66%) and spent A$56/week on tobacco. In response to 10% and 20% hypothetical price rises, significantly more participants endorsed trying to quit in response to the larger increase scenario (P < 0.001), and fewer selected no change to their smoking (P < 0.001). Numerous price-minimisation strategies (e.g. switching to cheaper brands/products) were endorsed, but remained constant across hypothetical scenarios; level of financial stress appeared to have little influence. Smokers indicating they would not change their smoking in response to price rises had higher levels of nicotine dependence. Socially disadvantaged smokers endorsed numerous price-minimising strategies to maintain smoking at hypothetically increased costs. Larger cigarette price rises motivated more smokers to consider quitting, while price-resistant smokers appeared to have a more entrenched smoker status.

A novel approach to estimating the prevalence of untaxed cigarettes in the USA: findings from the 2009 and 2010 international tobacco control surveys

BackgroundIncreases in tobacco taxes are effective in reducing tobacco consumption, but because of the addictive nature of cigarettes, smokers often seek out less expensive sources of cigarettes. The objective of...