How smokers may react to cigarette taxes and price increases in Brazil: data from a national survey.
BACKGROUND
Despite being the third largest tobacco producer in the world, Brazil has developed a comprehensive tobacco control policy that includes a broad restriction on both advertising and smoking in indoor public places, compulsory pictorial warning labels, and a menthol cigarette ban. However, tax and pricing policies have been developed slowly and only very recently were stronger measures implemented. This study investigated the expected responses of smokers to hypothetical price increases in Brazil.


METHODS
We analyzed smokers' responses to hypothetical future price increases according to sociodemographic characteristics and smoking conditions in a multistage sample of Brazilian current cigarette smokers aged≥14 years (n=500). Logistic regression analysis was used to examine the relationship between possible responses and different predictors.


RESULTS
In most subgroups investigated, smokers most frequently said they would react to a hypothetical price increase by taking up alternatives that might have a positive impact on health, i.e., they would "try to stop smoking" (52.3%) or "smoke fewer cigarettes" (46.8%). However, a considerable percentage responded that they would use alternatives that would reduce the effect of price increases, such as the same brand with lower cost (48.1%). After controlling for sex age group (14-19, 20-39, 40-59, and ≥60 years), schooling level (≥9 versus ≤9 years), number of cigarettes per day (>20 versus ≤20), and stage of change for smoking cessation (precontemplation, contemplation, and preparation), lower levels of dependence were positively associated with the response "I would try to stop smoking" (odds ratio [OR], 2.19). Young age was associated with "I would decrease the number of cigarettes" (OR, 3.44). A low schooling level was strongly associated with all responses.


CONCLUSIONS
Taxes and prices increases have great potential to stimulate cessation or reduction of cigarette consumption further among two important vulnerable populations of smokers in Brazil: young smokers and those of low educational level. The results from the present study also suggest that seeking illegal products may reduce the impact of increased taxes, but does not eliminate it.
National Institute for Alcohol and Drug Policies (INPAD), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil. analicegigliotti@gmail.com.
Analice
A
Gigliotti
Valeska C
VC
Figueiredo
Clarice S
CS
Madruga
Ana C P R
AC
Marques
Ilana
I
Pinsky
Raul
R
Caetano
Vera Luiza
VL
da Costa e Silva
Martin
M
Raw
Ronaldo
R
Laranjeira
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001290:Attitude; D001938:Brazil; D003132:Commerce; D003365:Costs and Cost Analysis; D004522:Educational Status; D005260:Female; D006291:Health Policy; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011634:Public Health / Q000331:legislation & jurisprudence*; D012907:Smoking / Q000191:economics / Q000331:legislation & jurisprudence; D016540:Smoking Cessation / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D000074606:Smoking Prevention; D013660:Taxes / Q000191:economics*; D062789:Tobacco Products / Q000191:economics*; D014029:Tobacco Use Disorder / Q000191:economics; D035862:Vulnerable Populations; D055815:Young Adult