5.12 Affordability of tobacco products
Tobacco pricing may not be a major concern for those very young smokers who are only experimenting with smoking in a one-off or occasional way.1 However, as smoking behaviour becomes more established and adolescents increasingly finance their own tobacco purchases, affordability of cigarettes becomes a far more important consideration. As noted in Section 5.11, many young smokers do not purchase their own cigarettes directly, rather they obtain them through their social network and from other informal sources. Australian research indicated that in 2017, the most common way to access cigarettes among high school current smokers was through friends (48%).2 About 18% of current smokers aged 12–17 reported that they purchased their own cigarettes.2 The likelihood of adolescents themselves buying cigarettes over the counter increased with age2 and with frequency of smoking.3
Research exploring smoking among adolescents has shown that those with greater personal income are more likely to try smoking, smoke daily and/or weekly, and smoke with greater intensity.4 In contrast, adults are more likely to smoke at lower levels of income (see Section 9.1).4 While greater disposable income has been associated with smoking among young people, a substantial body of evidence demonstrates that young smokers are particularly sensitive to rises in tobacco prices and increasing the price of tobacco has a greater impact on smoking rates among young people than among older adults.5 For example, one Canadian study found that a 10% increase in cigarette prices reduced smoking initiation among adolescents by 11.3%.6 Higher cigarette prices are associated with a reduced probability of smoking among young people,7 including reduced current prevalence and consumption.7,8 Research also suggests that cigarette price rises may foster cessation-related behaviours among high school smokers such as ‘Want[ing] to quit smoking’, ‘Non-continuation of smoking’, and ‘Discontinuation of smoking’.8
Results from the 2017 Australian Secondary Students’ Use of Tobacco, Alcohol, Over-the-counter Drugs, and Illicit Substances (ASSAD) showed a large increase in students reporting use of roll-your-own (RYO) cigarettes.2 In 2014, 24% of past-month smokers aged 12–17 years old reported having used RYO tobacco twenty or more times, while in 2017 that percentage rose to 29%.2 Furthermore, 73% of past-month smokers aged 12–17 reported having used RYO cigarettes at some time.2 Research shows RYO tobacco is perceived by many as an affordable option when compared to factory made cigarettes.9 The Australian RYO market, from 2001 to 2016, introduced progressively smaller pouch sizes resulting in products with lower up-front purchase costs.10 In a review of tobacco industry documents, researchers have shown how ‘starters, new users and younger users’ are targeted by the tobacco industry through small pack size offerings, based on young and new smokers’ lower consumption rates and their preference for cheaper per-pack prices.11 In 2017, the most common cigarette pack size used by current Australian smokers aged 12–17 was packs of 20 (34%)—the smallest size available—followed by roll-your-own (21%) and then packs of 25 (12%).2 See Chapter 13, Section 13.3 and Chapter 10, Section 10.9.5 for further details.
Fiscal policy and pricing of cigarettes is an integral component of comprehensive tobacco-control policy12,13 for reducing prevalence and encouraging cessation among adults, and as discussed in this section, is just as important for smoking prevention efforts geared towards young people. The effects of tax increases on consumption are discussed briefly in Section 5.22 and in detail in Chapter 13, Section 13.1.3.
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References for Section 5.12
1. Liang L and Chaloupka FJ. Differential effects of cigarette price on youth smoking intensity. Nicotine and Tobacco Research, 2002; 4(1):109-14. Available from: https://www.ncbi.nlm.nih.gov/pubmed/11906687
2. Guerin NW, V. ASSAD 2017 statistics & trends: Australian secondary students’ use of Tobacco, alcohol, over-the-counter drugs, and illicit substances. Melbourne: Cancer Council Victoria, 2018. Available from: https://www.health.gov.au/resources/collections/australian-secondary-school-students-alcohol-and-drug-assad-survey-2017.
3. White V and Hayman J. Smoking behaviours of Australian secondary students in 2005. National Drug Strategy Monograph series no. 59, Canberra: Drug Strategy Branch, Australian Government Department of Health and Ageing, 2006. Available from: http://www.nationaldrugstrategy.gov.au/internet/drugstrategy/publishing.nsf/Content/mono59.
4. Perelman J, Alves J, Pfoertner TK, Moor I, Federico B, et al. The association between personal income and smoking among adolescents: A study in six European cities. Addiction, 2017; 112(12):2248-56. Available from: https://www.ncbi.nlm.nih.gov/pubmed/28667824
5. U.S. National Cancer Institute. Socioecological approach to addressing Tobacco-related health disparities. Bethesda, MD: National Cancer Institute Tobacco Control Monograph 22. NIH Publication No. 17-CA-8035A, U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute, 2017. Available from: https://cancercontrol.cancer.gov/brp/tcrb/monographs/22/docs/m22_complete.pdf.
6. Cui Y, Forget EL, Zhu Y, Torabi M, and Oguzoglu U. The effects of cigarette price and the amount of pocket money on youth smoking initiation and intensity in Canada. Canadian Journal of Public Health, 2019; 110(1):93-102. Available from: https://www.ncbi.nlm.nih.gov/pubmed/30168041
7. Ross H and Chaloupka FJ. The effect of cigarette prices on youth smoking. Health Economics, 2003; 12(3):217-30. Available from: https://www.ncbi.nlm.nih.gov/pubmed/12605466
8. Tworek C, Yamaguchi R, Kloska DD, Emery S, Barker DC, et al. State-level tobacco control policies and youth smoking cessation measures. Health Policy, 2010; 97(2-3):136-44. Available from: https://www.ncbi.nlm.nih.gov/pubmed/20483500
9. Hoek J, Ferguson S, Court E, and Gallopel-Morvan K. Qualitative exploration of young adult RYO smokers' practices. Tobacco Control, 2016; 26(5):563-8. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27625410
10. Bayly M, Scollo MM, and Wakefield MA. Who uses rollies? Trends in product offerings, price and use of roll-your-own tobacco in Australia. Tobacco Control, 2019; 28(3):317-24. Available from: https://www.ncbi.nlm.nih.gov/pubmed/30030409
11. Persoskie A, Donaldson EA, and Ryant C. How tobacco companies have used package quantity for consumer targeting. Tobacco Control, 2018. Available from: https://www.ncbi.nlm.nih.gov/pubmed/29853560
12. US Department of Health and Human Services. Reducing tobacco use: A report of the Surgeon General. Atlanta, Georgia: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2000. Available from: https://www.cdc.gov/tobacco/data_statistics/sgr/2000/index.htm.
13. Liang L, Clayton R, and Nichter M. Prices, policies and youth smoking, May 2001. Addiction, 2003; 98(suppl.1):i105–22. Available from: http://www.ingentaconnect.com/content/bsc/add/2003/00000098/A00101s1/art00007;jsessionid=gehufx0tx8bb.alice