Determinants of regular smoking onset in South Africa using duration analysis

Abstract

ObjectivesSouth Africa has achieved significant success with its tobacco control policy. Between 1994 and 2012, the real price of cigarettes increased by 229%, while regular smoking prevalence decreased from about 31% to 18.2%.MethodsCigarette prices and socioeconomic variables are used to examine the determinants of regular smoking onset. We apply duration analysis techniques to the National Income Dynamics Study, a nationally representative survey of South Africa.ResultsWe find that an increase in cigarette prices significantly reduces regular smoking initiation among males, but not among females. Regular smoking among parents is positively correlated with smoking initiation among children. Children with more educated parents are less likely to initiate regular smoking than those with less educated parents. Africans initiate later and at lower rates than other race groups.ConclusionsAs the tobacco epidemic is shifting towards low-income and middle-income countries, there is an increasing urgency to perform studies in these countries to influence policy. Higher cigarette excise taxes, which lead to higher retail prices, reduce smoking prevalence by encouraging smokers to quit and by discouraging young people from starting smoking.

Prices, Inflation, and Smoking Onset: The Case of Argentina

“…This study adds to the small but growing body of evidence from LMIC that finds that higher tobacco prices decrease the hazard of smoking onset (Guindon 2014a;Vellios and van Walbeek 2016;Laxminarayan and Deolalikar 2004). Of particular interest is the finding that prices have no effect on the hazard of smoking onset in periods of hyper-and very high inflation.…”

Prevalence and factors associated with tobacco use among adults attending selected healthcare facilities in Buffalo City Metropolitan Municipality, South Africa

“…15 Over the past 20 years, a modest reduction in the prevalence of tobacco use has been documented in South Africa following the implementation of comprehensive tobacco control legislation; the number of smokers, however, remains the same as a result of increase in population. 16,17 Tobacco control legislation includes an increase in cigarette tax, anti-smoking legislation, as well as improved awareness of the dangers of cigarette smoking. [16][17][18] Recently, a smoke-free law was also enacted in South Africa, which allows smoking only in designated smoking areas in workplaces and public places.…”

“…16,17 Tobacco control legislation includes an increase in cigarette tax, anti-smoking legislation, as well as improved awareness of the dangers of cigarette smoking. [16][17][18] Recently, a smoke-free law was also enacted in South Africa, which allows smoking only in designated smoking areas in workplaces and public places. 3,19,20 Over the past 20 years, data on tobacco use have informed the effectiveness of South Africa's tobacco control strategies.…”

Quasi-experimental evidence on tobacco tax regressivity

“…Following successive tax increases, expenditure on cigarettes in Mexico has risen, which suggests an increase in the tobacco burden; however, they did not directly consider regressivity. In South Africa, Vellios and van Walbeek (2016) find that higher prices reduce smoking 'onset' for men, but not for women. Given that women are generally poorer than men, their analysis suggests that tobacco taxes may have worsened regressivity.…”

“…In addition, the data allows for the examination of expenditure patterns in South African households, especially when it is combined with other information regarding individuals in the household. Previous South African tobacco studies have made extensive use of the 2000 Income and Expenditure Survey data, (van Walbeek, 2002a;Ground and Koch, 2008;Tshiswaka-Kashalala and Koch, 2008), the All Products Market Survey (AMPS) data (van Walbeek, 2002b), the 1993 Living Standards Measurement Survey (Berg and Kaempfer, 2001), wholesale cigarette shipments from one of the large manufacturers in South Africa (Boshoff, 2008) and the National Income Dynamics Study (Vellios and van Walbeek, 2016).…”