Economic and Health Policy Research, American Cancer Society, Atlanta, Georgia, USA.
School of Medicine, University of Zambia, Lusaka, Zambia.
Tob Control. 2019 May;28(Suppl 1):s45-s52. doi: 10.1136/tobaccocontrol-2017-054037. Epub 2018 Mar 24.
In Zambia, the number of cigarette users is growing, and the lack of strong tax policies is likely an important cause. When adjusted for inflation, levels of tobacco tax have not changed since 2007. Moreover, roll-your-own (RYO) tobacco, a less-costly alternative to factory-made (FM) cigarettes, is highly prevalent.
We modelled the probability of FM and RYO cigarette smoking using individual-level data obtained from the 2012 and 2014 waves of the International Tobacco Control (ITC) Zambia Survey. We used two estimation methods: the standard estimation method involving separate random effects probit models and a method involving a system of equations (incorporating bivariate seemingly unrelated random effects probit) to estimate price elasticities of FM and RYO cigarettes and their cross-price elasticities.
The estimated price elasticities of smoking prevalence are -0.20 and -0.03 for FM and RYO cigarettes, respectively. FM and RYO are substitutes; that is, when the price of one of the products goes up, some smokers switch to the other product. The effects are stronger for substitution from FM to RYO than vice versa.
This study affirms that increasing cigarette tax with corresponding price increases could significantly reduce cigarette use in Zambia. Furthermore, reducing between-product price differences would reduce substitution from FM to RYO. Since RYO use is associated with lower socioeconomic status, efforts to decrease RYO use, including through tax/price approaches and cessation assistance, would decrease health inequalities in Zambian society and reduce the negative economic consequences of tobacco use experienced by the poor.
在赞比亚，吸烟人数不断增加，而缺乏强有力的税收政策可能是一个重要原因。自 2007 年以来，烟草税水平（经通胀调整后）并未发生变化。此外，与工厂制造（FM）香烟相比，成本较低的自卷（RYO）烟草非常普遍。
我们使用 2012 年和 2014 年国际烟草控制（ITC）赞比亚调查的个人层面数据，使用两种估计方法（分别涉及单独的随机效应概率模型和包含双变量似不相关随机效应概率模型的系统方程方法）来估计 FM 和 RYO 香烟的价格弹性及其交叉价格弹性。
FM 和 RYO 香烟的吸烟流行率的估计价格弹性分别为-0.20 和-0.03。FM 和 RYO 互为替代品；也就是说，当一种产品的价格上涨时，一些吸烟者会转而购买另一种产品。FM 向 RYO 的替代效应比相反方向的替代效应更强。
这项研究证实，提高香烟税并相应提高价格可以显著减少赞比亚的香烟使用。此外，减少产品之间的价格差异将减少从 FM 向 RYO 的替代。由于 RYO 使用与较低的社会经济地位相关，因此减少 RYO 使用的努力，包括通过税收/价格措施和戒烟援助，可以减少赞比亚社会中的健康不平等，并减轻穷人因烟草使用而遭受的负面经济后果。
