Smokers' strategies across social grades to minimise the cost of smoking in a period with annual tax increases: evidence from a national survey in England.

Autor:	Kuipers MA; Department of Public Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands.; Department of Behavioural Science and Health, University College London, London, UK., Partos T; Department of Addictions, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK., McNeill A; Department of Addictions, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK., Beard E; Department of Behavioural Science and Health, University College London, London, UK.; Research Department of Clinical, Educational and Health Psychology, University College London, London, UK., Gilmore AB; Tobacco Control Research Group, Department for Health, University of Bath, Bath, UK., West R; Department of Behavioural Science and Health, University College London, London, UK., Brown J; Department of Behavioural Science and Health, University College London, London, UK.; Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2019 Jun 25; Vol. 9 (6), pp. e026320. Date of Electronic Publication: 2019 Jun 25.
DOI:	10.1136/bmjopen-2018-026320
Abstrakt:	Objectives: To assess associations between smokers' strategies to minimise how much their smoking costs and cost of smoking among smokers across three social grades during a period of annual tax increases in England. Design: Repeat cross-sectional. Setting: England, May 2012-December 2016. Participants: 16 967 adult smokers in 56 monthly surveys with nationally representative samples. Measures and Analysis: Weighted generalised additive models assessed associations between four cost-minimising strategies (factory-made and roll-your-own (RYO) cigarette consumption levels, illicit and cross-border purchases) and cost of smoking (£/week). We adjusted for inflation rate, age, gender and secular and seasonal trends. Results: Cost of smoking did not increase above the rate of inflation. Factory-made cigarette consumption decreased, while proportion of RYO and, to a much lesser extent, illicit and cross-border purchases increased. These trends were only evident in lowest social grade. Cost of smoking was 12.99% lower with consumption of 10 fewer factory-made cigarettes (95% CI -13.18 to -12.80) and 5.86% lower with consumption of 10 fewer RYO cigarettes (95% CI -5.66 to -6.06). Consumption levels accounted for 60% of variance in cost. Cross-border and illicit tobacco purchases were associated with 9.64% (95% CI -12.94 to -6.33) and 9.47% (95% CI -12.74 to -6.20) lower costs, respectively, but due to low prevalence, accounted for only 0.2% of variation. Associations were similar across social grades, although weaker for illicit and cross-border purchases and stronger for consumption in higher social grades compared with lower social grades. Conclusion: During a period of annual tax increases, the weekly cost of smoking did not increase above inflation. Cost-minimising strategies increased, especially among more disadvantaged smokers. Reducing cigarette consumption and switching to RYO tobacco explained a large part of cost variation, while use of illicit and cross-border purchasing played only a minor role. Competing Interests: Competing interests: RW undertakes consultancy and research for and receives travel funds and hospitality from manufacturers of smoking cessation medications. EB and JB have received unrestricted research funding from Pfizer. (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ.)
Databáze:	MEDLINE
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