April 5, 2018
Mohammed Jawad , several other colleagues, and I recently published “Price elasticity of demand of non-cigarette tobacco products: a systematic review and meta-analysis” in Tobacco Control. Most studies of the effects of price on tobacco consumption deal with cigarettes. This paper identified studies of the effect of price on consumption on non-cigarette tobacco products and found, like with cigarettes (and most things) raising price is associated with lower consumption. The level of price sensitivity (elasticity) is around the same level as cigarettes. If anything, users of non-cigarette tobacco products are more price sensitive (higher elasticity) than cigarette smokers.
The policy implication of this work is that tax increases (to increase price and reduce consumption) is good public health policy for nonsmoked tobacco products, too.
Objective To systematically review the price elasticity of demand of non-cigarette tobacco products. Data sources Medline, Embase, EconLit and the Web of Science without language or time restrictions.
March 29, 2018
Nicotine and Tobacco Research just published Lauren Lempert and my paper “Tobacco Industry Promotional Strategies Targeting American Indians/Alaska Natives and Exploiting Tribal Sovereignty” as an “editor’s choice,” which means it is freely available to everyone. In this paper we detail how the tobacco companies exploited the fact that (a different form of) tobacco is used in some AI/AN ceremonies as well as the fact that tribal sovereignty created places that were not covered by state laws, particularly cigarette taxes and smokefree laws.
Here is the abstract:
Introduction: American Indians/Alaska Natives have the highest commercial tobacco use in the United States, resulting in higher tobacco-caused deaths and diseases than the general population. Some American Indians/Alaska Natives use commercial tobacco for ceremonial as well as recreational uses. Because federally-recognized Tribal lands are sovereign, they are not subject to state cigarette taxes and smokefree laws. This study analyzes tobacco industry promotional efforts specifically targeting American Indians/Alaska Natives and exploiting Tribal lands to understand appropriate policy responses in light of American Indians’/Alaska Natives’ unique sovereign status and culture.
March 28, 2018
Nancy Rigotti and colleagues just published a well-done study of the effects of e-cigarette use on smoking cessation among a cohort of smokers who planned to stop smoking after being hospitalized. They randomized smokers into two groups, one that was given an active intervention to help them quit smoking and a control group who just received advice to quit. Smokers were followed prospectively for 6 months to examine successful quitting as a function of whether or not the patients used e-cigarettes as well as the assigned therapy.
Only 10.1% of the smokers who used e-cigarettes had quit smoking after 6 months compared to 26.6% of smokers who did not use e-cigarettes. In other words, smokers who used e-cigarettes while trying to quit had their chances of successfully quitting cut by two thirds.
This is a very strong study because it is done prospectively by a well-respected group. In addition, Rigotti and her colleagues carefully controlled for differences between the e-cigarette users and non-e-cigarette users and made a strong case that their results were very unlikely to be due to some unobserved confounder.
March 27, 2018
Tired of waiting for the FDA to deal with menthol and other flavored tobacco products, last fall the San Francisco Board of Supervisors passed a law ending the sale of all flavored tobacco products, including menthol. While other cities have passed restrictions on flavored tobacco products, the San Francisco law is the most comprehensive. Big tobacco in the person of RJ Reynolds dropped into town and is spending millions to convince voters to reject the law in a referendum election in June.
Why is the industry so hysterical about menthol/flavor bans? There is lots of survey research showing that many menthol smokers say that, without menthol cigarettes, they would just quit altogether.
March 27, 2018
Samir Soneji and his colleagues have just published the best-done model for assessing the effects of e-cigarettes on population health so far (including the one Sara Kalkhoran and I published). Their model accounts for the effects of e-cigarette use on youth and young adult initiation as well as cessation in adult smokers. The model is based on extensive population data on smoking behavior and how it evolves over time as well as the health effects of smoking. Most impressively, they use their baseline data to predict future behavior that was subsequently observed and show that the model is accurate. This is the first time anyone has done such a validation, which is a particular strength of the study.
What they find is that even making very optimistic assumptions about the effects of e-cigarettes on smoking cessation and assuming a 95% reduction in risk associated with e-cigarette use, the availability of e-cigarettes is associated with net population harm (1.5 million years of life lose based on e-cigarette use patterns in 2014).
They found about 80 new smokers for ever one that quit even making the optimistic assumption that smoking cessation increased among e-cigarette users.