Reducing tobacco use has been an important issue for policymakers ever since the US Surgeon General’s 1964 report on the adverse health effects of tobacco. Tobacco is now established as a leading cause of preventable death worldwide and is expected to claim nearly a billion lives in the 21st century (WHO 2008).
Youth smoking in developing nations
The majority of the tobacco public health burden will be carried by developing countries, due to the unfortunate combination of increasing consumption and health system inadequacy. Of particular concern in developing countries is youth smoking, which can start at very young age and is the primary way of establishing adult smoking habits.
Although tobacco use is a major public health problem in lower-income countries, most of the evidence on what determines smoking comes from a few industrialised countries, primarily the US. There is a wealth of research on the impact of US cigarette prices or taxes, most of which agrees that taxes/prices can be used effectively to influence smoking decisions.
However, many studies have difficulty in claiming a causal price effect due to inability to control for variation in state characteristics. The most recent research on US youth smoking employs better identification techniques (DeCicca et al. 2008, Carpenter and Cook 2008, and Tauras et al. 2005), but the results have been mixed with regards to the impact of price. This hinders extrapolation of US-based results to other countries.
Even if uniform evidence on US price effects were available, US results may not be easily generalised to other countries due to differences in income, cultural environment, and individual behaviour.
New evidence from 20 developing nations
In recent work, co-authors and I claim that policymakers in lower-income countries would be able to reduce youth cigarette consumption through tax policies that increase the price of cigarettes (Kostova et al. 2010). Using individual-level data from 20 developing countries, we estimate that the price elasticity of cigarette demand among youth is -1.83.
We focus on youth (the average age in our sample is 14 years) since smoking habits are established primarily in adolescence, making this the optimal age for intervention. Our data come from the Global Youth Tobacco Survey (GYTS), combined with cigarette price data from the Economist Intelligence Unit Cost of Living Survey.
Our total price elasticity estimate can be decomposed into two parts:
- the price elasticity of smoking participation (-0.63), and
- the price elasticity of consumption intensity (-1.2).
The first represents the effect of price on smoking prevalence while the second represents the effect of price on the number of cigarettes consumed by smokers. We estimate that a 10% increase in price would reduce youth smoking rates by 6.3%. We also estimate that a 10% increase in price would reduce the average number of cigarettes consumed by young smokers by 12%. Overall, a 10% increase in cigarette price would reduce youth cigarette demand by 18.3%.
The causal effect of cigarette prices on smoking in our analysis is identified by:
- using country fixed effects, and
- including a measure of local anti-smoking sentiment.
These measures control for unobserved country characteristics which could affect both price and demand, and could potentially bias the price estimate. We further reduce unobserved country heterogeneity by controlling for confounding environmental factors such as the prevalence of cigarette advertising, anti-tobacco media outreach, and compliance with youth access restrictions.
Conclusion: Higher prices reduce youth smoking in developing nations
Our results suggest that price is a significant determinant of cigarette demand among youth in lower-income countries, and the price may be used as a policy tool to curb smoking in the developing world.
DeCicca, Philip, Don Kenkel, and Alan Mathios (2008), "Cigarette Taxes and the Transition from Youth to Adult Smoking: Smoking Initiation, Cessation, and Participation", Journal of Health Economics, 27(4):904-917.
Carpenter, Christopher and Philip J Cook (2008), “Cigarette Taxes and Youth Smoking: New Evidence from National, State, and Local Youth Risk Behaviour Surveys”, Journal of Health Economics, 27:287-299.
Kostova, Deliana, Hana Ross, Evan Blecher, and Sara Markowitz (2010), “Prices and Cigarette Demand: Evidence from Youth Tobacco Use in Developing Countries”, NBER Working Papers 15781.
Tauras, John, Sara Markowitz, and John Cawley (2005), “Tobacco Control Policies and Youth Smoking: Evidence from a New Era”, in Advances in Health Economics and Health Services Research, Vol. 16-Substance Use: Individual Behaviour, Social Interactions, Markets and Politics, edited by Bjorn Lindgren and Michael Grossman, Elsevier, Oxford, England.