Impact of Tobacco Control Interventions on Smoking Initiation, Cessation, and Prevalence: A Systematic Review

Table 3

Effects of taxation/price on smoking initiation, cessation, and prevalence.

Author, year	Country; (data source)	Study design	Dates of data collection	Population (n)	Intervention (currency)	Smoking measure	Effect on smoking initiation, cessation, or prevalence
Smoking initiation
Nonnemaker and Farrelly, 2011 [7]	US (NLSY97)	Longitudinal	1997–2006	Youths, age 12–17 (8984); mean age = 15; 51% male	Change in real state-level taxes* (1996 US$)	Ever smoked a cigarette	Overall; OR (se): 0.88 (0.06), 𝑃=0.06; Elasticity: −0.09; Males; OR (se): 0.93 (0.08), 𝑃=0.41; Elasticity: −0.05; Females; OR (se): 0.81 (0.06), 𝑃=0.001; Elasticity: −0.15
Sen and Wirjanto, 2010 [8]	Canada (Waterloo Smoking Prevention Project)	Longitudinal	1993–1996	Youths, grade 9 (2364)	Change in real excise and sales taxes (C$)	Smoked in past month	Elasticity: −0.5, 𝑃<0.1
Tauras, 2005 [10]	US (MTF)	Longitudinal study	1976–1995	Youths, high school seniors (5,383)	Changes in real price* (1982–1984 US$)	Progression from nondaily to daily smoking	Coeff. (z-statistic): −0.46 (−2.27), 𝑃<0.05; Elasticity: −0.65
Cawley et al., 2004 [9]	US (NLSY97)	Longitudinal study	1997–2000	Youths, ages 12–16 (12,282)	Changes in real price* (NR)	Smoking any positive quantity of cigarettes	Coeff. (z-statistic): −0.15 (−1.45), 𝑃<0.1; Males; coeff. (z-statistic): −0.28 (−2.03), 𝑃<0.05; Females; coeff. (z-statistic): −0.03 (−0.17), 𝑃>0.05
DeCicca et al., 2002 [11]	US (NELS:88)	Longitudinal study	1988–1992	Youths, 8th grade (12,089)	Changes in nominal tax* (1988 US$)	Daily smoking	Coeff. (t value): −0.003 (−1.31), 𝑃>0.05
Smoking cessation
Ross et al., 2010 [22]	US and Canada (ITC)	Longitudinal	2002–2004	Adults (1990): mean age = 41; 41% male	(1) change in real price (US$); (2) change in province-level cigarette tax (US$)	Quit smoking	(1) coeff. (se): 0.0064 (0.0038), 𝑃<0.1; (2) coeff. (se): 0.0036 (0.0046)
Saenz-de-Miera et al., 2010 [23]	Mexico (ITC-Mexico)	Longitudinal	2006-2007	Adults, age 18+ (728): mean age = 39; 61% male	SPST tax increased from 110% of price to retailers to 140% in 2007	Quit smoking for at least 30 days	Quit rate: 13.1% (95% CI, 9.7 to 16.5%)
Hanewinkel and Isensee, 2007 [24]	Germany (NA)	Longitudinal study	01/2002–09/2005	Adults, age 14+; mean age 46.5	Before and after each of 5 tax increases (Euros)	Quit rates 1–4 months after tax increase	Quit rates ranged from 4% to 7.9%; OR = 1.58, 𝑃<0.05
Tauras and Chaloupka, 1999 [12]	US (MTF)	Longitudinal study	NR	Youths, high school seniors	Changes in real price* (1982–1984 US$)	30-day abstinence	Males; Coeff.: 0.746; 𝑃<0.05; Price elasticity: 1.15; Females; Coeff.: 0.742; 𝑃<0.01; Elasticity: 1.17
Franz, 2008 [25]	US (BRFSS)	Before/after w/o comparison	1993–2000	Adults, age 18+	Changes in real price* (1995 US$)	Quit daily smoking within previous year	Baseline: 13.8%; Final: 14.3%; Coeff.: 0.023, 𝑃<0.001; Elasticity: 0.375
Reed et al., 2008 [26]	US (CTS)	Before/after w/o comparison	1995–1999	Adults, age 25+	Before and after Proposition 10 and MSA, which raised price by US$ 0.95 (NA)	Quit smoking entirely within previous year	OR = 1.04; 𝑃=0.76
Smoking prevalence among youth
Grossman, 2005 [13]	US (MTF)	Time series	1975–2003	Youths, high school seniors	Changes in real price* (1975 US$)	Smoked in past 30 days	Coeff. (t-statistic): −0.12 (−5.23); 𝑃<0.05
Tauras and Chaloupka, 1999 [14]	US (MTF)	Longitudinal study	1976–1993	Youths, high school seniors	Changes in real price* (1982–1984 US$)	Smoked in past 30 days	Coeff (t-ratio): −0.03 (−2.38); 𝑃<0.05; Elasticity: −0.10
Kostova et al., 2011 [15]	17 LMIC (GYTS)	Before/after w/comparison	1999–2006	Youths, age 13–15	Change in real price (2000 US$)	Smoked in the past month	Elasticity for local brands: −0.74; Elasticity for foreign brands: −1.09
White et al., 2011 [16]	Australia (cross-sectional surveys of secondary schools)	Before/after w/comparison	1990–2005	Youths, age 12-17	Change in state-specific cigarette prices (2005 AU$)	Smoked in the past month	aOR = 0.98 (95% CI: 0.97; 0.99) (1 cent increase in change in price per stick)
Carpenter and Cook, 2008 [17]	US (YRBS)	Before/after w/o comparison	1991–2005	Youths, grades 9–12	Changes in real price* (2005 US$)	Smoked in past 30 days	Coeff. (se): −0.286 (0.101); 𝑃<0.01; Elasticity: −0.56
Ding, 2003 [18]	US (MTF)	Before/after w/o comparison	1976–1998	Youths, high school seniors	Changes in real price* (US$)	Smoked in past 30 days	Elasticity (se): −1.41 (0.83); 𝑃=0.10; Males; Elasticity (se): 0.29 (1.03), 𝑃=0.78; Females; elasticity (se): −2.98 (0.69); 𝑃<0.05
Waller et al., 2003 [19]	Canada (OSDUS)	Before/after w/o comparison	1977–2001	Youths, grades 7, 9, 11, and 13	Before and after a decrease of C$10 in taxes (C$)	Smoked > 1 cigarette in past 12 months	Overall results for smoking prevalence showed a significant discontinuity effect with a negative slope until 1993 and upward jump at the discontinuity point and leveling off after 1993
Gruber, 2000 [20]	US (MTF)	Before/after w/o comparison	1991–1997	Youths, grades 8, 10 and 12	Changes in real price* (1982 US$)	Smoked in past 30 days	Coeff. (se): −0.955 (0.034); 𝑃>0.05; Elasticity: −0.31; 8th and 10th graders; Coeff. (se): −0.03 (0.035); 𝑃>0.05; Elasticity: −0.21; 12th graders; Coeff. (se): −0.148 (0.078); 𝑃<0.05; Elasticity: −0.67
Chaloupka and Pacula, 1998 [21]	US (MTF)	Before/after w/o comparison	1975–1994	Youths, grades 8, 10 and 12; mean age = 16.3	Changes in real price* (1982–1984 US$)	Smoked in past 30 days	Coeff. (t-ratio): −0.004 (−2.62); 𝑃<0.05; Elasticity: −0.62
Smoking prevalence among adults
Wakefield et al., 2008 [27]	Australia (Roy Morgan Single Source)	Time series	1995–2006	Adults, age 18+	Cigarette costliness^‡ (NR)	Smoke factory-made cigarettes	Coeff. (se): −8.802 (2.891); 𝑃<0.003
Azagba and Sharaf, 2011 [28]	Canada (National Population Health Survey)	Longitudinal	1999–2009	Adults, ages 12–65 (56,770); mean age = 38; 50% male	Changes in real tax (2000 C$)	Daily and occasional smokers	Elasticity: −0.23; Males; elasticity: −0.32; 𝑃<0.01; Females; elasticity: −0.12; 𝑃>0.1
Lance et al., 2004 [29]	China (CHNS); Russia (RLMS)	Longitudinal study	China: 1993–1997; Russia: 1996–2000	Adults, age 13+; 100% male	Change in nominal price (China: yuan; Russia: ruble)	NR	China; coeff. (se): −0.123 (0.165); 𝑃>0.05; Elasticity = −0.045; Russia; coeff. (se): −0.011 (0.003); 𝑃<0.01; Elasticity = −0.101
Bogdanovica et al., 2011 [38]	European Union (Euro-barometer Surveys)	Before/after w/o comparison	2006–2009	Adults, age 15+	Change in cigarette affordability	Smoking prevalence	Correlation: −0.06; 𝑃=0.77
Siahpush et al., 2009 [30]	Australia (Roy Morgan Single Source)	Before/after w/o comparison	1991–2006	Adults, age 18+; ages 18–29: 21%; ages 30–49: 41%; ages 50+: 38%; 48% male	Changes in real price^‡ (2006 AU$)	Do you now smoke factory-made cigarettes? In the last month, have you smoked any roll-your-own cigarettes?	aRR (95% CI) = 0.974 (0.951 to 0.997); Price × income; Price × medium income: 1.024 (1.015 to 1.023); Price × high income: 1.025 (1.016 to 1.035)
Gospodinov and Irvine, 2009 [144]	Canada (CTUMS)	Before/after w/o comparison	2000–2005	Adults, age 20+	Changes in real price, based on Canadian Socioeconomic Information Management system (2001 C$)	Occasional or daily smoker	Coeff.: −0.0008 (se = 0.0006); 𝑃>0.05; Elasticity: −0.299 (se = 0.224) (95% CI: 0.133–−0.760)
DeCicca and McLeod, 2008 [31]	US (BRFSS)	Before/after w/o comparison	2000–2005	Adults, aged 45–65	Several state cigarette tax increases* (2001 US$)	Daily smoker	Daily smoking; Coeff.: −0.0098 (se = 0.0036); 𝑃<0.05; Elasticity: −0.21: smoked on some days; Coeff.: −0.0110 (se = 0.0032); 𝑃<0.05; Elasticity: −0.20
Jimenez-Ruiz et al., 2008 [39]	Mexico (ENIGH)	Before/after w/o comparison	1994–2005	Adults, age 15+	Until 1999, 40% for filter and 15% for unfiltered; in 2005, 45.5% for both filtered and unfiltered (NR)	Household spent money on cigarettes	Coeff. (t-statistic): −0.0019 (1.77); 𝑃<0.10; Elasticity = −0.06
Franz, 2008 [25]	US (BRFSS)	Before/after w/o comparison	1993–2000	Adults, age 18+	Changes in real price* (1995 US$)	Current smoker and smoked more than 100 cigarettes	Baseline: 22.2%; Final: 17.9%; Coeff.: −0.016; 𝑃<0.001; Elasticity = −0.193
Franks et al., 2007 [32]	US (BRFSS)	Before/after w/o comparison	1984–2004	Adults, age 18+	Changes in real price* (2004 US$)	Current smoker	1984–1996, lowest income quartile; Elasticity: −0.45 (−0.67–−0.22); 𝑃<0.01; 1984–1996, other income quartiles; Elasticity: −0.22 (−0.35–−0.10), 𝑃<0.01; 1997–2004, lowest income quartile; Elasticity: −0.14 (−0.36–0.08); 1997–2004, other income quartiles; Elasticity: −0.07 (−0.18–0.05)
Sloan and Trogdon, 2004 [33]	US (BRFSS)	Before/after w/o comparison	1990–2002	Adults, age 18+; 35–46% male	Changes in real price* (2002 US$)	Daily or some day smoker	18 to 20 years old; Coeff. (se): −0.025 (0.012); 𝑃<0.05; 21 to 24 years old; Coeff. (se): −0.011 (0.008); 𝑃>0.05; 25 to 44 years old; Coeff. (se): −0.009 (0.005); 𝑃<0.05; 45 to 64 years old; Coeff. (se): −0.008 (0.007); 𝑃>0.05; 65+ years old; Coeff. (se): −0.010 (0.004); 𝑃<0.05
Gallus et al., 2003 [34]	Italy	Before/after w/o comparison	1970–2000	Adults, age 15+	Changes in real price, taxes represented 74.7% of cost in 2000 (NR)	NR	Elasticity (se): −0.30 (0.05); 𝑃<0.001
Scollo et al., 2003 [35]	Australia (NTC)	Before/after w/o comparison	1997–2000	Adults, ages 18–40	Multiple changes to the taxation structure, including the end of the State franchise fees in Aug 97, a change from a weight to a stick-based system of levying excise duty in Nov 99, and the imposition of the Goods and Services Tax in Jul 00^‡ (NR)	NR	Prevalence (May 1997): 29.5%; Prevalence (Nov 1998): 27.9%; Prevalence (Nov 2000): 26.7%; Change percentage from May 1997 to Nov 1998: −5.42%; Change percentage from Nov 1998 to Nov 2000: −4.30%
Arunatilake, 2002 [84]	Sri Lanka	Before/after w/o comparison	1991–2000	Age < 20: 40%; age 20–30: 18%; age 30–40: 13%; age 40–50: 12%; age 50–60: 9%; age 60+: 8%; 100% male	Annual increases in tax, ranging from 27.6% of selling price in 1995 to 76.8% in 2000 (NR)	NR	Elasticity: 0.10, 𝑃<0.1
van Walbeek, 2002 [36]	South Africa (AMPS)	Before/after w/o comparison	1993–2000	Adults, age 16+; ages 16–24: 28%; ages 25–34: 26%; ages 35–49: 26%; ages 50+: 21%; 48% male	Increases in the real price of cigarettes by 93% (1995 Rand)	Smoking prevalence is defined as the number of respondents who declare cigarette usage expressed as a percentage of the population	1993 Prevalence: 32.6%; 2000 Prevalence: 27.1%; Change percentage: −16.9%; Elasticity: −0.30
Farrelly et al., 2001 [37]	US (NHIS)	Before/after w/o comparison	1976–1993	Adults, age 18+; mean age 43.9; 47% male	Changes in the real price* (1982–1984 US$)	Smoked at least 100 cigarettes during lifetime and currently smoke cigarettes every day or some days	Elasticity: −0.13; Males; elasticity: −0.03; Females; elasticity: −0.19

*Data obtained from the tax burden on tobacco.
^‡Data was obtained from the Australian Retail Tobacconist.
Unless otherwise specified, elasticity is price participation elasticity (PPE, percentage change in smoking prevalence for one percentage change in price).
All odds ratios and relative risks can be interpreted as the change in outcome comparing the intervention to control group or after versus before an intervention or a unit increase in the intervention (e.g., 1$ in tax increase).
AMPS: All Media and Products Survey; aOR: adjusted odds ratio; AU$: Australian dollars; BRFSS: Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System; C$: Canadian dollars; CHNS: China Health and Nutrition Survey; CI: confidence interval; Coeff.: coefficient; CTS: California Tobacco Survey; CTUMS: Statistics Canada/Health Canada Canadian Tobacco Use Monitoring Survey; GYTS: Global Youth Tobacco Survey; ENIGH: National Household Income and Expenditure Survey; ITC: International Tobacco Control Policy Evaluation Survey; LMIC: low- and middle-income countries; MS: Master Settlement Agreement; MTF: Monitoring the Future: a Continuing Study of American Youth; NA: not applicable; NELS: 88: National Education Longitudinal Survey of 1988; NHIS: National Health Interview Surveys; NLSY97: National Longitudinal Survey of Youth 1997 Cohort; NR: not reported; NTC: National Tobacco Campaign Evaluation respondent surveys; OR: odds ratio; OSDUS: Ontario Student Drug Use Survey; RLMS: Russian Longitudinal Monitoring Survey; se: standard error; SPST: special production and services tax; US: United States; US$: United States dollars; YRBS: Youth Risk Behavior Survey.