title: The relation between cigarette price and hand-rolling tobacco consumption in the UK: an ecological study.
abstract: OBJECTIVE
  Cigarette price increases reduce smoking prevalence but as a tobacco control policy are undermined by the availability of lower cost alternatives such as hand-rolling tobacco. The aim of this descriptive study is to explore time trends in the price of manufactured cigarettes and hand-rolling tobacco, and in the numbers of people who smoke these products, over recent years in the UK.
  
  
  METHODS
  UK.
  
  
  METHODS
  Trends in the most popular price category (MPPC) data for cigarettes and hand-rolling tobacco from 1983 to 2012 adjusted for inflation using the Retail Price Index, and trends in smoking prevalence and the proportion of smokers using hand-rolling tobacco from 1974 to 2010.
  
  
  RESULTS
  After adjustment for inflation, there was an increase in prices of manufactured cigarettes and hand-rolling tobacco between 1983 and 2012. Between 1974 and 2010, the prevalence of smoking fell from 45% to 20%, and the estimated total number of smokers from 25.3 to 12.4 million. However the number of people smoking hand-rolling tobacco increased from 1.4 to 3.2 million, and MPPC cigarette price was strongly correlated with number of people smoking hand-rolling tobacco.
  
  
  CONCLUSIONS
  Although the ecological study design precludes conclusions on causality, the association between increases in manufactured cigarette price and the number of people smoking hand-rolling tobacco suggests that the lower cost of smoking hand-rolling tobacco encourages downtrading when cigarette prices rise. The magnitude of this association indicates that the lower cost of hand-rolling tobacco seriously undermines the use of price as a tobacco control measure.
authors.affiliation: University of Nottingham, Nottingham, UK.
authors.forename: Lucas
authors.initials: L
authors.lastname: Rothwell
authors.affiliation: Division of Epidemiology and Public Health, UK Centre for Tobacco and Alcohol Studies, University of Nottingham, Nottingham, UK.
authors.forename: John
authors.initials: J
authors.lastname: Britton
authors.affiliation: Division of Epidemiology and Public Health, UK Centre for Tobacco and Alcohol Studies, University of Nottingham, Nottingham, UK.
authors.forename: Ilze
authors.initials: I
authors.lastname: Bogdanovica
mesh_terms: D003132:Commerce / Q000639:trends*; D005260:Female; D006801:Humans; D008297:Male; D010209:Paper; D015995:Prevalence; D011640:Public Policy; D012907:Smoking / Q000453:epidemiology* / Q000639:trends*; D013660:Taxes; D062789:Tobacco Products / Q000191:economics*; D006113:United Kingdom / Q000453:epidemiology
keywords: cigarette prices; hand rolling tobacco prices; smoking prevalence