title: Impact of cigarette price differences across the entire European Union on cross-border purchase of tobacco products among adult cigarette smokers.
abstract: BACKGROUND
  We investigated the impact of cigarette price differences across the European Union (EU) on cross-border tobacco purchasing because of cheaper price among current cigarette smokers.
  
  
  METHODS
  Individual-level tobacco-related data (including cross-border tobacco purchasing behavior) were from the Special Eurobarometer 385 (V.77.1), a cross-sectional survey of persons aged ≥15 years from 27 EU Member States during 2012. Country-specific weighted average prices (WAP) per 1000 cigarettes (as of 1 July 2012) were obtained from the European Commission, and divided by 50 to yield WAP per cigarette pack. The dispersion in EU cigarette prices was measured with the coefficient of variation. Multivariate logistic regression was applied to measure the relationship between EU-wide cigarette price differential and cross-border tobacco purchasing because of cheaper price among current cigarette smokers (n=6896).
  
  
  RESULTS
  The coefficient of variation for cigarette WAP within the EU was 0.39 (mean price=€3.99/pack). Of all current cigarette smokers in the EU, 26.2% (27.5 million persons) engaged in a cross-border tobacco purchase within the past 12 months, of which 56.3% did so because of cheaper price in another country. EU-wide cigarette price differential was significantly associated with making a cross-border tobacco purchase because of cheaper price (adjusted OR=1.34; 95% CI 1.22 to 1.47).
  
  
  CONCLUSIONS
  Reducing differences in cigarette tax and price within the EU, coupled with a stricter limitation on the quantity of cigarettes that it is possible to carry from one Member State to another, may help reduce cross-border tax avoidance strategies.
authors: Department of Social and Behavioral Sciences, Center for Global Tobacco Control, Harvard School of Public Health, Boston, Massachusetts, USA.
authors: Israel T
authors: IT
authors: Agaku
authors: Economic and Health Policy Research, American Cancer Society, Atlanta, Georgia, USA.
authors: Evan
authors: E
authors: Blecher
authors: Department of Social and Behavioral Sciences, Center for Global Tobacco Control, Harvard School of Public Health, Boston, Massachusetts, USA School of Public Health, Imperial College London, London, UK.
authors: Filippos T
authors: FT
authors: Filippidis
authors: Department of Medicine, University of Ibadan, Ibadan, Nigeria.
authors: Uyoyo T
authors: UT
authors: Omaduvie
authors: Economics Department, University of Piraeus, Piraeus, Greece.
authors: Athanassios
authors: A
authors: Vozikis
authors: Department of Social and Behavioral Sciences, Center for Global Tobacco Control, Harvard School of Public Health, Boston, Massachusetts, USA Clinic of Social and Family Medicine, Department of Social Medicine, School of Medicine, University of Crete, Heraklion, Greece.
authors: Constantine I
authors: CI
authors: Vardavas
mesh_terms: D000293:Adolescent; D000328:Adult; D003132:Commerce / Q000191:economics*; D017046:Cost Savings; D003430:Cross-Sectional Studies; D005060:Europe; D005062:European Union; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D018803:Models, Economic; D015999:Multivariate Analysis; D012907:Smoking / Q000191:economics*; D013660:Taxes / Q000191:economics*; D019460:Tobacco Industry / Q000191:economics*; D062789:Tobacco Products / Q000191:economics*; D055815:Young Adult
keywords: Economics; Global health; Prevention; Price; Taxation