Cross-border Purchasing of Cigarettes among Smokers in Six European Countries: Findings from the EUREST-PLUS ITC Europe Surveys
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Department of Psychology, University of Waterloo (UW), Waterloo, Canada
Publication date: 2019-03-26
Tob. Prev. Cessation 2019;5(Supplement):A12
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The availability of lower-cost cigarettes provides price-sensitive smokers with incentives to purchase cheaper cigarettes in order to minimize their financial costs of continuing to smoke. This study estimates the prevalence of and factors associated with cross-border purchasing of cheaper cigarettes among nationally representative samples of smokers from Germany, Greece, Hungary, Poland, Romania, and Spain (n = 6,011).

Material and Methods:
The primary outcome was purchasing cheaper out-of-country cigarettes in the last six months. The prevalence of cross-border purchasing was estimated by country and residential location, defined as (a) living in regions bordering a country where the cost of the most popular price category brand of cigarettes was at least €1/pack lower than in smokers' home countries, (b) living in regions bordering a country with similar cigarette prices, and (c) living in regions not bordering other countries. Weighted multivariable logistic regression tested differences in purchasing cheaper out-of-country cigarettes by country and residential location.

Residential location was associated with purchasing cheaper out-of-country cigarettes in Germany and Poland (p < 0.05): 31% of German and 11% of Polish smokers living in regions bordering lower-price countries made such purchases in the last six months. Across all countries, smokers living in areas bordering lower-price countries had 4.21 times greater odds of purchasing cheaper out-of-country cigarettes compared to smokers living in non-border areas (95% CI: 2.39-7.42).

Tax harmonization policies that minimize cross-border price differentials can eliminate lower-priced alternatives for price-sensitive smokers.

This project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 681109 (C. I. V.) and the University of Waterloo (G. T. Fong). Additional support was provided to the University of Waterloo by the Canadian Institutes of Health Research (FDN-148477). G. T. Fong was supported by a Senior Investigator Grant from the Ontario Institute for Cancer Research. E. Fernández is partly supported by Ministry of Universities and Research, Government of Catalonia (2017SGR319) and by the Instituto Carlos III and co-funded by the European Regional Development Fund (FEDER) (INT16/00211 and INT17/00103), Government of Spain.
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