Matsubayashi Keisuke, Tabuchi Takahiro, Iso Hiroyasu
Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.
Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan.
Nicotine Tob Res. 2021 Mar 19;23(4):716-723. doi: 10.1093/ntr/ntaa178.
Assessing long-term smoking cessation after tobacco price increases is more valuable than short-term cessation as smokers often relapse after temporary cessation. We investigated whether tobacco price increases were associated with long-term smoking cessation and whether the association differed according to demographic, socioeconomic, and behavioral factors, using a national longitudinal survey of middle-aged individual-level data from 10 waves, every November from 2005 to 2014.
Temporary and long-term at least 1 year (1y+) or 2 years (2y+) quitters were defined by smoking in any one wave and quitting in the subsequent two or three waves in a discrete-time design. November 2006 (after July 11% increase) and November 2010 (after October 37% increase) were used as proxy variables for price increases. Generalized estimating equation models adjusted for demographic, socioeconomic, and behavioral covariates, and analyses stratified by these covariates were performed to estimate the association between price increases and smoking cessation.
Of 43 630 smokers aged 50-65, 7.7%, 5.6%, and 5.2% of smokers quit temporarily, for at least 1 year and at least 2 years, respectively. 2y+ quitters significantly increased in November 2005-November 2008 (adjusted odds ratio = 1.23, 95% confidence interval: 1.06-1.43) and November 2009-November 2012 (adjusted odds ratio = 1.85, 95% confidence interval = 1.57-2.16). In stratified analyses, higher prices were associated with 2y+ quitters in all subgroups with some exceptions, including participants who smoked 21-30 cigarettes per day and those aged 60-65.
Increasing tobacco prices may be effective in promoting long-term smoking cessation in various subgroups among middle-aged Japanese adults.
Few longitudinal studies have examined the effect of a tobacco price increase on long-term smoking cessation. In a national longitudinal survey of middle-aged Japanese from 10 waves, the 37% tobacco price increase was found to be a trigger for successful smoking cessation for two or more years. Price increases were significantly associated with 2y+ smoking cessation in most demographic, behavioral, and socioeconomic subgroups. Results indicate that higher tobacco prices may be effective for long-term smoking cessation in almost all subgroups. Raising tobacco taxes and prices may be one of the most effective strategies for promoting long-term smoking cessation.
评估烟草价格上涨后的长期戒烟情况比短期戒烟更有价值,因为吸烟者在短期戒烟后往往会复发。我们利用2005年11月至2014年11月期间对中年个体层面数据进行的全国纵向调查的10个波次数据,研究了烟草价格上涨是否与长期戒烟相关,以及这种关联是否因人口统计学、社会经济和行为因素而有所不同。
在离散时间设计中,通过在任何一个波次吸烟并在随后的两到三个波次戒烟来定义短期和长期(至少1年或2年)戒烟者。2006年11月(7月价格上涨11%之后)和2010年11月(10月价格上涨37%之后)被用作价格上涨的代理变量。采用广义估计方程模型对人口统计学、社会经济和行为协变量进行调整,并对这些协变量进行分层分析,以估计价格上涨与戒烟之间的关联。
在43630名50 - 65岁的吸烟者中,分别有7.7%、5.6%和5.2%的吸烟者短期戒烟、至少戒烟1年和至少戒烟2年。在2005年11月至2008年11月(调整后的优势比 = 1.23,95%置信区间:1.06 - 1.43)以及2009年11月至2012年11月(调整后的优势比 = 1.85,95%置信区间 = 1.57 - 2.16)期间,戒烟至少2年的人数显著增加。在分层分析中,除了一些例外情况,包括每天吸21 - 30支烟的参与者和60 - 65岁的参与者外,较高的价格与所有亚组中戒烟至少2年的人相关。
提高烟草价格可能有助于促进日本中年成年人各亚组的长期戒烟。
很少有纵向研究考察烟草价格上涨对长期戒烟的影响。在一项对日本中年人的全国纵向调查的10个波次中,发现烟草价格上涨37%是成功戒烟两年或更长时间的一个触发因素。在大多数人口统计学、行为和社会经济亚组中,价格上涨与戒烟至少2年显著相关。结果表明,较高的烟草价格可能对几乎所有亚组的长期戒烟都有效。提高烟草税和价格可能是促进长期戒烟的最有效策略之一。