Is the affordability of cigarettes associated with the prevalence of smoking and quitting at the regional level in Russia?

Introduction

Tobacco prices and income determine the affordability of cigarettes. Affordability in turn affects smoking prevalence. Both prices and incomes can vary widely across a large country. The aim of this paper is to find out whether there is an association between affordability of cigarettes and smoking/cessation prevalence across Russian regions. We assess the proportions of people who smoke and those who smoked and quit.

Methods

We use microdata from a repeated survey on the living conditions of the Russian population that is representative at the regional level (2014, 2016, 2018, 2020, 2022, 77 regions). We aggregate the microdata by region and combine them with official macro data. Using descriptive and multivariable analyses, we identify factors that correlate with the prevalence of smoking and quitting in the regions.

Results

A one per cent increase in real prices was associated with a 0.1% decrease in the smoking prevalence rate and with a 0.2% increase in quitting prevalence rate. A 1% decrease in real income is associated with a 0.5% increase in the proportion of those who quit. The more cigarettes that can be purchased for a daily per capita income, the higher the smoking prevalence rate and the lower the proportion of quitting, with affordability elasticities of 0.1 and -0.27 respectively.

Conclusions

Rising real prices, as well as reduced affordability of cigarettes not only reduce the proportion of people who smoke, but also increase the proportion of those who quit. In a country with a large geographical spread and high regional income inequality, tobacco taxes should be set at the regional level to eliminate significant differences in the affordability of cigarettes.