title: The effect of the market opening on trends in smoking rates in Taiwan.
abstract: OBJECTIVE
  To examine smoking rates before and after the opening of the market to foreign imports.
  
  
  METHODS
  Consumer surveys of Monopoly Bureau, National Health Interview Survey and official tobacco consumption, production and import data were used to calculate smoking rates, cigarette consumption, and the market share of imports. Age-adjusted smoking rates were used to compare trends before and after the market opening.
  
  
  RESULTS
  The market share of the imports reached half in 2001 from 2% before opening. Compared to projected rates, smoking rates in 2001 for all and younger males, and all and younger females were increased by 12, 6, 202, and 249%, respectively, over and above the projected trends. The ratio of smoking rates between younger and older adults became larger, from 0.62 to 0.74 in males and from 0.32 to 0.98 in females. Per capita consumption increased after the market opening, particularly when large increases in smuggled cigarettes were considered.
  
  
  CONCLUSIONS
  The finding that the market opening triggered an increase in smoking rates is contrary to the assertion by U.S. cigarette producers that importation would only make smokers switch brands. Younger adults and females were more affected, reflecting their higher sensitivity to the appeal from foreign cigarettes. Because of the marketing strategy of imports, more young people smoked, at an earlier age. Experience from Taiwan revealed that after the initial increase in smoking rates, the opening had galvanized the anti-smoking sentiments, legitimized and strengthened tobacco control policies and tempered the severity of the adverse impact.
authors.affiliation: Division of Health Policy Research, National Health Research Institutes, Taipei, Taiwan.
authors.forename: Chih Cheng
authors.initials: CC
authors.lastname: Hsu
authors.forename: David Theodore
authors.initials: DT
authors.lastname: Levy
authors.forename: Chi Pang
authors.initials: CP
authors.lastname: Wen
authors.forename: Ting Yuan
authors.initials: TY
authors.lastname: Cheng
authors.forename: Shan Pou
authors.initials: SP
authors.lastname: Tsai
authors.forename: Ted
authors.initials: T
authors.lastname: Chen
authors.forename: Michael P
authors.initials: MP
authors.lastname: Eriksen
authors.forename: Chen Chun
authors.initials: CC
authors.lastname: Shu
mesh_terms: D000293:Adolescent; D000328:Adult; D006801:Humans; D038622:Internationality; D008297:Male; D040541:Marketing; D012907:Smoking / Q000453:epidemiology*; D013624:Taiwan / Q000453:epidemiology; D019460:Tobacco Industry