CONFERENCE PROCEEDING
Smokers’ strategies to reduce tobacco spending after a major tobacco tax increase: Findings from the 2020 International Tobacco Control (ITC) Netherlands Survey
 
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1
Care and Public Health Research Institute, Department of Health Promotion, Maastricht University, Maastricht, The Netherlands
 
2
Trimbos Institute, The Netherlands Expertise Centre for Tobacco Control, Utrecht, The Netherlands
 
3
Care and Public Health Research Institute, Department of Methodology and Statistics Maastricht University, Maastricht, The Netherlands
 
4
IVO Research Institute, The Hague, The Netherlands
 
5
Department of Communication, Amsterdam School of Communication Research, University of Amsterdam, Amsterdam, The Netherlands
 
6
Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
 
7
School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
 
8
Ontario Institute for Cancer Research, Toronto, Ontario, Canada
 
 
Publication date: 2023-04-25
 
 
Corresponding author
Cloé Geboers   

Care and Public Health Research Institute, Department of Health Promotion, Maastricht University, Maastricht, The Netherlands
 
 
Tob. Prev. Cessation 2023;9(Supplement):A2
 
KEYWORDS
ABSTRACT
Introduction:
Tobacco taxation is an effective tobacco control measure because of its impact on increasing quitting and reducing consumption. Some smokers, however, may instead use price-minimising strategies, such as purchasing less-expensive brands. This study examined whether smokers’ responses to a major tobacco tax increase differed by age, income, and education. We also examined whether price played a role in quitters’ decision to quit.

Material and Methods:
Cross-sectional data was analysed from the 2020 International Tobacco Control (ITC) Netherlands Survey, conducted 6 months after a tax increase that increased prices by circa 13%. Responses to the tax increase by smokers (N=1790) were categorised as intended (reducing consumption to reduce spending) or unintended (using only price-minimising behaviours to reduce spending). We also examined whether price was reported by quitters as a reason for quitting (N=125). We used multinomial and logistic regression to examine whether responses varied by equity variables (e.g., income) and nicotine dependence.

Results:
In response to the tax increases, 35.6% of smokers reduced consumption and 19.3% engaged only in price-minimising behaviours. 82.1% of quitters stated that price influenced their decision to quit. Low-income individuals were more likely to reduce consumption or quit due to price, but also to purchase less expensive brands. Highly dependent smokers were less likely to reduce consumption and more likely to use price-minimising behaviours.

Conclusions:
Increasing taxation has a positive public health benefit: four out of five quitters said price influenced their decision to quit, and more than one-third of smokers reduced their consumption, with low-income smokers being more likely to reduce consumption or quit smoking, providing further evidence that increasing tobacco taxes can reduce health inequalities caused by smoking. Price-minimising strategies were most common among highly dependent smokers.

CONFLICTS OF INTEREST
Geoffrey T. Fong has served as an expert witness or a consultant for governments defending their country’s policies or regulations in litigation. All other authors have no conflicts of interest to declare.
FUNDING
The ITC Netherland Survey was supported by grants from Longfonds (Lung Foundation Netherlands), Hartstichting (Netherlands Heart Foundation), KWF Kankerbestrijding (Dutch Cancer Society), Trombosestichting Nederland (Thrombosis Foundation), Diabetesfonds (Diabetes Funds) (#2.1.19.004), and the Canadian Institutes for Health Research (FDN-148477). Additional support to GTF was provided by a Senior Investigator Grant from the Ontario Institute for Cancer Research and the Canadian Cancer Society O. Harold Warwick Prize. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.
eISSN:2459-3087
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