BMJ 1994;309:923-927 (8 October)

Papers

Cigarette smoking by socioeconomic group, sex, and age: effects of price, income, and health publicity

J Townsend, P Roderick, J Cooper 

MRC Epidemiology and Medical Care Unit, Wolfson Institute of Preventive Medicine, Medical College of St Bartholomew's Hospital, London EC1M 6BQ Correspondence to: J Townsend.

Abstract

Objective : To assess effects of price, income, and health publicity on cigarette smoking by age, sex, and socioeconomic group.
Design : Econometric multiple regression analysis of data on cigarette smoking from the British general household survey.
Subjects : Random sample of adult population in Britain interviewed for biennial general household surveys 1972-90. Main outcome measures - Changes in cigarette consumption and prevalence of smoking.
Results : Price elasticities of demand for cigarettes (percentage change in cigarette consumption for a 1% change in price) were significant at -0.5 (95% confidence interval -0.8 to -0.1) for men and -0.6 (-0.9 to -0.3) for women, were highest in socioeconomic group V (-1.0 for men and -0.9 for women), and lowest (not significantly different from zero) in socioeconomic groups I and II. The gradient in price elasticities by socioeconomic group was significant for men (F=5.6, P=0.02) and for women (F=6.1, P=0.02). Price was a significant factor in cigarette consumption by age for women in every age group and for men aged 25-34. Cigarette consumption by young men aged 16-34 increased with income. There was a significant decrease in smoking over time by women in socioeconomic groups I and II and by men in all age and social groups except socioeconomic group V attributable to health publicity. Price significantly affected smoking prevalence in socioeconomic group V (-0.6 for men and -0.5 for women) and for all women (-0.2).
Conclusions : Men and women in lower socioeconomic groups are more responsive than are those in higher socioeconomic groups to changes in the price of cigarettes and less to health publicity. Women of all ages, including teenagers, appear to have been less responsive to health publicity than have men but more responsive to price. Response to health publicity decreased linearly with age. Real price increases in cigarettes could narrow differences between socioeconomic groups in smoking and the related inequalities in health, but specific measures would be necessary to ameliorate effects on the most deprived families that may include members who continue to smoke. The use of a policy to steadily increase cigarette tax is likely to help achieve the government's targets for smoking and smoking related diseases.

Public health implications

  • Public health implications

  • Cigarette smoking is the greatest cause of preventable disease in Britain, and the government is committed to using health publicity and pricing policies to reduce it.

  • Reductions in cigarette smoking have been least in lower socioeconomic groups (who suffer the highest rates of related diseases), teenagers, and women

  • In this study we examined changes in smoking patterns over the past 20 years in relation to health publicity and the real cost of cigarettes

  • Health publicity was most effective in reducing smoking in younger people and higher socioeconomic groups; cigarette price changes had most effect on lower socioeconomic groups and women

  • These results suggest that increases in the real cost of cigarettes will help reduce differences between socioeconomic groups in the prevalence of smoking and smoking related diseases, although special support may be needed by highly deprived families


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