Who purchases cheaper cigarettes in China? Findings from the International Tobacco Control (ITC) China Survey

Low-priced cigarettes constitute a major challenge to public health throughout the world. The goals of this study were (1) to identify factors associated with purchasing cheaper cigarettes (according to self-report) among smokers (age ≥18) in China, and (2) to compare cigarette price elasticities among smokers who purchase cheaper cigarettes with elasticities among smokers who do not. Data were analyzed from Wave 3 of the ITC China Survey, conducted in 2009 among smokers in China (N=5,883). One survey question asked, “Have you purchased cheaper cigarettes in the past six months?” Socio-demographics included age, gender, marital status, education, income, and employment status. Socioeconomic status (SES) was measured by a combination of education and income. Factors associated with purchasing cheaper cigarettes were analyzed using logistic regression model. Price elasticities were estimated by semi-log models for cigarette consumption with cigarette prices and income as independent variables. 10.6% of smokers reported purchasing cheaper cigarettes. After controlling for other covariates, low SES smokers were more likely to purchase cheaper cigarettes than high SES smokers (19.4% vs.8.2%; OR=2.36, 95%CI=1.66-3.35).The cigarette consumption models showed that smokers who purchase cheaper cigarettes have higher price elasticity than those who do not (-0.35 vs.-0.14).Our findings indicate that tobacco control policies that ultimately increase prices could have greater effect on reducing cigarette consumption among low SES smokers in China. Moreover, these findings point to the failure of 2009 tobacco tax increase in China as a public health policy because it has not yet resulted in any price increase.