title: Increasing availability and consumption of single cigarettes: trends and implications for smoking cessation from the ITC Mexico Survey.
abstract: OBJECTIVE
  Determine (1) trends in single cigarette availability and purchasing in Mexico and (2) the association between neighbourhood access to singles and cessation behaviour among adult Mexican smokers.
  
  
  METHODS
  We analysed data from Wave 4 (2010), Wave 5 (2011) and Wave 6 (2012) of the Mexican International Tobacco Control Policy Evaluation Survey. We used data from all three waves to examine time trends in singles availability and purchasing. To explore the association between neighbourhood access to singles and cessation behaviour, we used data from participants who were smokers at Wave 5 and followed up at Wave 6 (n=1272).
  
  
  RESULTS
  The percentage of participants who saw singles sold daily (45.2% in 2010; 51.4% in 2011; 64.9% in 2012), who bought singles at least once a week (22.3% in 2010; 29.1% in 2011; 29.1% in 2012) and whose last cigarette purchase was a single (16.6% in 2010; 20.7% in 2011; 25.8% in 2012) increased significantly from 2010 to 2012 (all p<0.001). The average percentage of residents who reported seeing singles sold daily in their neighbourhood in 2012 was 60% (SD=25%). In adjusted analyses, smokers living in neighbourhoods with higher access to singles were less likely to make a quit attempt (risk ratio (RR)=0.72; 95% CI 0.46 to 1.12), and more likely to relapse (RR=1.30; CI 0.94 to 1.82), but these results were not statistically significant.
  
  
  CONCLUSIONS
  Single cigarettes appear widely accessible in Mexico and growing in availability. Future research should explore potential explanations, consequences and effective methods for reducing the availability of single cigarettes.
authors.affiliation: Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA.
authors.forename: Marissa G
authors.initials: MG
authors.lastname: Hall
authors.affiliation: Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Fleischer
authors.affiliation: Tobacco Control Research Department, National Institute of Public Health Mexico, Cuernavaca, Mexico.
authors.forename: Luz Myriam
authors.initials: LM
authors.lastname: Reynales-Shigematsu
authors.affiliation: Tobacco Control Research Department, National Institute of Public Health Mexico, Cuernavaca, Mexico.
authors.forename: Edna
authors.initials: E
authors.lastname: Arillo-Santillán
authors.affiliation: Tobacco Control Research Department, National Institute of Public Health Mexico, Cuernavaca, Mexico Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina.
authors.forename: James F
authors.initials: JF
authors.lastname: Thrasher
mesh_terms: D000328:Adult; D003132:Commerce / Q000191:economics / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D012008:Recurrence; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012907:Smoking / Q000191:economics / Q000453:epidemiology*; D016540:Smoking Cessation / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D062789:Tobacco Products / Q000191:economics / Q000706:statistics & numerical data*
keywords: Cessation; Global health; Illegal tobacco products; Low/Middle income country; Public policy