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Open AccessArticle

Cigarette Affordability in China, 2006–2015: Findings from International Tobacco Control China Surveys

American Cancer Society, 555 11th Street NW, Suite 300, Washington, DC 20004, USA
School of International Trade and Economics, University of International Business and Economics, Beijing 100029, China
Department of Psychology, University of Waterloo, Waterloo, ON N2L 3G1, Canada
Ontario Institute for Cancer Research, Toronto, ON M5G 0A3, Canada
Chinese Center for Disease Control and Prevention (China CDC), Beijing 102206, China
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2019, 16(7), 1205;
Received: 14 March 2019 / Revised: 27 March 2019 / Accepted: 29 March 2019 / Published: 3 April 2019
(This article belongs to the Special Issue Tobacco Control: Policy Perspectives)
China is world’s largest market of machine-made cigarettes. In 2015, more than 315 million or around 26.9% of the adult population in China were smokers—50.6% among men and 2.2% among women. Growing affordability of cigarettes led to increased cigarette consumption in China to the detriment of public health. This study investigated whether the level and growth in cigarette affordability in China was equally shared by smokers from all demographic and socio-economic statuses (SES) and across all price tiers of cigarette brands. The data came from the urban smoker sample (≥18 years) of the International Tobacco Control China Surveys conducted in five waves over 2006–2015. Cigarette affordability was measured by Relative Income Price—percentage of per capita household income needed to purchase 100 cigarette packs of the last purchased brand. Overall and group-specific trends in affordability by age, gender, SES (e.g., income, education, and employment status), and price tiers were analyzed using generalized estimating equations method. Cigarette affordability was higher among older, female, and higher-SES smokers, and for cheaper brands. It increased overall and across all groups over time. The increase was significantly larger among younger and lower-SES smokers, a trend that poses an added challenge to tobacco control and health equity. To reduce cigarette affordability and consumption among these vulnerable groups, a uniform specific excise system should be introduced in place of the existing tiered ad valorem excise. The specific excise should be periodically adjusted to inflation and per capita income growth observed among younger and lower-SES people, who can potentially experience faster income growth than the national average. The excise tax policy can also be complimented with minimum price regulations and restrictions on price promotions. View Full-Text
Keywords: cigarette consumption and affordability; socio-economic pattern; public health cigarette consumption and affordability; socio-economic pattern; public health
MDPI and ACS Style

Nargis, N.; Zheng, R.; Xu, S.S.; Fong, G.T.; Feng, G.; Jiang, Y.; Wang, Y.; Hu, X. Cigarette Affordability in China, 2006–2015: Findings from International Tobacco Control China Surveys. Int. J. Environ. Res. Public Health 2019, 16, 1205.

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