Smoking behaviour after enforcement of a 100% tax on tobacco products in Saudi Arabia: a cross-sectional study

Abstract

Background: Raising the prices of cigarettes is a common intervention to control tobacco use. In June 2017, Saudi Arabia imposed a 100% excise tax on tobacco products and energy drinks. Aims: This study aimed to evaluate the impact of the increase in prices on tobacco products and the resulting cigarette smoking behaviour in Jeddah, Saudi Arabia before and after the increase in tobacco product prices. Methods: This cross-sectional study was conducted between December 2017 and March 2018 in Saudi Arabian smokers aged 18 years and more. A validated questionnaire was distributed to a convenience sample in public places and through Twitter. The McNemar matched pairs chi-squared test was used to evaluate the self-reported difference in cigarette smoking before and after the tax came into effect. Binary logistic regression analysis was done to identify the socioeconomic and health factors associated with stopping smoking. Results: In all, 376 participants (80.0% men) completed the questionnaire. A large proportion of the participants (39.6%) reported no change in their smoking behaviour after the tax was imposed, whereas 29.8% switched to cheaper brands. Before the tax, 154 participants smoked 15 cigarettes or more a day; this figure decreased to 134 after the tax (McNemar test, P < 0.001). Respondents who were married, unemployed, had a higher income or who rated their health as fair were significantly more likely to have stopped smoking after the tax. Conclusion: The sharp increase in cigarette prices in Saudi Arabia has led to a statistically significant reduction in smoking. Future research should assess the long-term effects of this intervention on smoking onset, prevalence and relapse.

Socioeconomic Determinants of Smoking in the Kingdom of Saudi Arabia

“…In 2017, the Saudi government levied excise taxes on tobacco products, which was reviewed in 2019 [ 12 ]. In addition, smoking in public places and the sale of cigarettes to minors are prohibited to control smoking [ 2 , 6 ].…”

“…As such, currently, smoking in public places and sales to minors are prohibited [ 2 ]. Additionally, for the first time, the country implemented the WHO FCTC Article 6 by introducing an excise tax on tobacco products in 2017, which was revised in 2019 [ 12 ]. The KSA is also the pioneer of the “sin tax” in the Gulf region [ 13 ].…”

Factors associated with poor outcomes among hospitalized patients with COVID-19: Experience from a MERS-CoV referral hospital

“…Smoking prevalence in Saudi Arabia has a median of 16.5% among students, 22.6% among adults, and 25% among the those above 65 years of age [ 42 ]. However, our cohort showed a much lower rate of only 4.4%, these differences may be due to the cited study being conducted more than a decade ago, since then, in 2017, a 100% excise tax on tobacco products was enforced which led to a significant reduction in smoking in the country [ 43 ]. A meta-analysis of 19 studies showed a progression of COVID-19 in patients with a history of smoking (OR 1.91) [ 44 ].…”

Implementation of Cigarette Plain Packaging: Triadic Reactions of Consumers, State Officials, and Tobacco Companies—The Case of Saudi Arabia

“…The SFDA alone, being the main player in this case from the government side, has one million followers on its Arabic twitter account. It is worth mentioning that in 2019, 56% of internet users in Saudi Arabia were Twitter users, of which 71% were males averaging 26 years of age [24,28,71].…”

“…In June 2017, a 100% taxation was imposed on tobacco products in Saudi Arabia with an increase in standard product price [27]. No population-level studies have measured the effect of taxation on smoking in Saudi Arabia; however, the only study done in the city of Jeddah shows that almost 40% of respondents were resistant to smoking cessation despite the taxation, and 29% changed to a cheaper brand [28].…”