Cigarette prices and smoking among adults in eight sub-Saharan African countries: evidence from the Global Adult Tobacco Survey.

backgroundDespite growing concern over tobacco use in sub-Saharan Africa, evidence on the association between cigarette prices and adult smoking behaviour in the region is limited.

objectivesTo provide new evidence on the association between cigarette prices and adult smoking in eight sub-Saharan African countries.

methodsThe analysis uses data from 51 270 individuals taken from the Global Adult Tobacco Survey, which was conducted in eight African countries during 2012-2018. The relationship between prices and smoking is estimated using probit models for smoking participation and generalised linear models for conditional cigarette demand.

resultsHigher prices are significantly associated with lower cigarette demand across African countries. The estimated price elasticity of participation is -0.362 (95% CI -0.547 to -0.177). The price elasticity of conditional cigarette demand is -0.133 (95% CI -0.194 to -0.072) for people who have just started smoking. The estimated total price elasticity of cigarette demand by new adult smokers is -0.495. The absolute value of the conditional demand elasticity becomes smaller by 0.004 units for each additional year that a person smokes. For the average smoker in the sample, with a smoking duration of 18.07 years, the total elasticity estimate is -0.422.

conclusionsHigher cigarette prices significantly decrease the likelihood of smoking and decrease the intensity of cigarette consumption among African adults. Increases in the excise tax that increase the retail price of cigarettes will play an important role in reducing adult tobacco use on the continent. Governments are encouraged to increase excise taxes to improve public health.