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      Effects of Prices on Youth Cigarette Smoking and Tobacco Use Initiation in Ghana and Nigeria

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          Background: Population growth in the African region is set to outpace the rate of decline in smoking prevalence, leading to a projected increase in the total number of smokers. As most tobacco users initiate during their adolescent years, tobacco prevention strategies targeting youth will be particularly important. Methods: This study estimated the impact of cigarette prices on youth cigarette smoking and tobacco use initiation in Ghana and Nigeria using the Global Youth Tobacco Survey data. First, we used cross-section data and logit models to estimate the effects of prices on youth cigarette smoking. Second, we created pseudo longitudinal data and used continuous-time hazard models to evaluate the impact of cigarette prices on tobacco use initiation. Results: We found that higher cigarette prices decreased both 30-day cigarette smoking and tobacco use onset significantly in both Ghana and Nigeria. Additionally, the price elasticity of cigarette smoking and tobacco use initiation ranged from −0.44 to −1.13, and −1.04 to −3.66, respectively. Conclusions: As one of the first studies on youth tobacco consumption in Sub-Saharan Africa, this study strongly suggests that policies that increase real cigarette prices can lower both cigarette smoking and tobacco use initiation among youth in Ghana and Nigeria.

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          Most cited references 29

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          Is youth smoking responsive to cigarette prices? Evidence from low- and middle-income countries.

          To estimate the price elasticity of cigarette demand among youth in low- and middle-income countries (LMIC). The Global Youth Tobacco Survey was used to obtain data on the smoking behaviour of 315,353 adolescents from 17 LMIC. Two-part model of cigarette demand with country fixed effects. The first part estimates the impact of prices on smoking participation while the second part estimates the impact of prices on the number of cigarettes smoked among current smokers. Besides controlling for individual characteristics such as Age, Gender, Parental Smoking and availability of Pocket Money, the authors control for confounding environmental factors such as anti-smoking sentiment, the prevalence of cigarette advertising and anti-tobacco media messAges, and ease of purchasing cigarettes. All countries in this study are represented with at least two observations over time, which allows us to control for unobserved country characteristics and/or policies that may influence smoking patterns within countries. Cigarette price is an important determinant of smoking. The estimated price elasticity of smoking participation is -0.74, and the estimated price elasticity of conditional cigarette demand is approximately -1.37. The total price elasticity of cigarette demand is -2.11, implying that an increase in price of 10% would reduce youth cigarette consumption by 21.1% at the mean.
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            Global and Regional Patterns of Tobacco Smoking and Tobacco Control Policies.

            Tobacco smoking is a major worldwide cause of morbidity and mortality from various diseases, including urologic diseases.
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              The impact of tobacco prices on smoking onset: a methodological review.

              The benefits of preventing smoking onset are well known. Existing reviews clearly demonstrate that increasing the prices of tobacco products reduces smoking prevalence and cigarette consumption. However, only a small number of studies included in existing reviews have examined smoking onset (the transition between never smoking and smoking). Moreover, existing reviews provide limited quality assessment of the data and methods utilised. This paper systematically searches for and critically reviews studies that examine the impact of tobacco prices or taxes on smoking onset. Most studies reviewed have important methodological limitations, including recall bias; a general failure to apply diagnostic tests, to discuss the choice of estimators and distributional assumptions and to conduct sensitivity analysis; and a reliance on empirical approaches that are methodologically weak. On the whole, existing studies do not provide strong evidence that tobacco prices or taxes affect smoking onset.

                Author and article information

                Int J Environ Res Public Health
                Int J Environ Res Public Health
                International Journal of Environmental Research and Public Health
                27 August 2019
                September 2019
                : 16
                : 17
                [1 ]Department of Economics, Andrew Young School of Policy Studies, Georgia State University, Atlanta, GA 30303, USA
                [2 ]Economic and Health Policy Research, American Cancer Society, Atlanta, GA 30303, USA
                [3 ]Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
                Author notes
                [* ]Correspondence: sasare1@ ; Tel.: +1-404-413-2000
                © 2019 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (



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