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      Comparison of Trends in Self-reported Cigarette Consumption and Sales in England, 2011 to 2018

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          Key Points

          Question

          How has population cigarette consumption in England changed since 2011, and to what extent do survey measures of consumption and recorded cigarette sales produce similar estimates?

          Findings

          This study of survey and sales data found close alignment between estimates of long- and short-term changes in population cigarette consumption in England derived from the Smoking Toolkit Study, a monthly national survey, and recorded sales. According to both methods, monthly cigarette consumption decreased by almost one-quarter between 2011 and 2018, equating to a decline of more than 117 million cigarettes per month or 1.4 billion cigarettes per year.

          Meaning

          Cigarette consumption in England has decreased since 2011, with survey and sales data providing similar estimates.

          Abstract

          This study compares estimates of changes in cigarette consumption in England between 2011 and 2018 using survey data from a nationally representative sample vs retail sales data.

          Abstract

          Importance

          Population cigarette consumption is declining in many countries. Accurate estimates of long- and short-term changes are vital for policy evaluation and planning. Survey data and sales data that are used to make these estimates each have important potential biases, so triangulation using different methods is required for robust estimation.

          Objectives

          To compare monthly estimates of cigarette consumption in England from a nationally representative survey and recorded cigarette sales and to triangulate an accurate estimate of changes in cigarette consumption since 2011.

          Design, Setting, and Participants

          This study used time series analyses based on survey data and recorded cigarette sales to estimate and compare trends in population cigarette consumption in England from 2011 to 2018. Survey participants were representative samples of 1700 people aged 16 years or older each month in England.

          Main Outcomes and Measures

          Monthly cigarette retail sales data from August 2011 through February 2018 were obtained from a data agency. Monthly self-reports of cigarette consumption were collected over the same period using the Smoking Toolkit Study.

          Results

          A total of 136 677 individuals (51.1% female; mean [SD] age, 46.7 [18.8] years) were surveyed. Over the study period, mean monthly cigarette consumption in England was 2.85 billion (95% CI, 2.78 billion to 2.93 billion) cigarettes based on survey data compared with 3.08 billion (95% CI, 3.03 billion to 3.13 billion) estimated from sales data. Over the whole period, cigarette consumption declined by 24.4% based on survey data and 24.1% based on sales data. This equated to 118.4 million and 117.4 million fewer cigarettes consumed per month (or approximately 1.4 billion per year) based on survey data and sales data, respectively. After adjusting for underlying trends, month-by-month changes in cigarette consumption were closely aligned: a 1% change in survey-estimated cigarette consumption was associated with a 0.98% (95% CI, 0.53%-1.44%) change in sales estimates.

          Conclusions and Relevance

          Survey data and sales data were closely aligned in showing that overall cigarette sales in England have declined by almost a quarter since 2011, amounting to more than 1 billion fewer cigarettes smoked each year. The alignment between the 2 methods provides increased confidence in the accuracy of parameters provided by the Smoking Toolkit Study and sales data. It indicates that estimated changes in cigarette consumption are robust and provide a meaningful basis for policy evaluation and planning.

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          Most cited references38

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          A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010

          The Lancet, 380(9859), 2224-2260
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            Tobacco taxes as a tobacco control strategy.

            Increases in tobacco taxes are widely regarded as a highly effective strategy for reducing tobacco use and its consequences. The voluminous literature on tobacco taxes is assessed, drawing heavily from seminal and recent publications reviewing the evidence on the impact of tobacco taxes on tobacco use and related outcomes, as well as that on tobacco tax administration. Well over 100 studies, including a growing number from low-income and middle-income countries, clearly demonstrate that tobacco excise taxes are a powerful tool for reducing tobacco use while at the same time providing a reliable source of government revenues. Significant increases in tobacco taxes that increase tobacco product prices encourage current tobacco users to stop using, prevent potential users from taking up tobacco use, and reduce consumption among those that continue to use, with the greatest impact on the young and the poor. Global experiences with tobacco taxation and tax administration have been used by WHO to develop a set of 'best practices' for maximising the effectiveness of tobacco taxation. Significant increases in tobacco taxes are a highly effective tobacco control strategy and lead to significant improvements in public health. The positive health impact is even greater when some of the revenues generated by tobacco tax increases are used to support tobacco control, health promotion and/or other health-related activities and programmes. In general, oppositional arguments that higher taxes will have harmful economic effects are false or overstated.
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              • Record: found
              • Abstract: found
              • Article: not found

              Trends in smoking behaviour between 1985 and 2000 in nine European countries by education.

              To examine whether trends in smoking behaviour in Western Europe between 1985 and 2000 differed by education group. Data of smoking behaviour and education level were obtained from national cross sectional surveys conducted between 1985 and 2000 (a period characterised by intense tobacco control policies) and analysed for countries combined and each country separately. Annual trends in smoking prevalence and the quantity of cigarettes consumed by smokers were summarised for each education level. Education inequalities in smoking were examined at four time points. Data were obtained from nine European countries: Norway, Sweden, Denmark, Finland, the United Kingdom, the Netherlands, Germany, Italy, and Spain. 451 386 non-institutionalised men and women 25-79 years old. Smoking status, daily quantity of cigarettes consumed by smokers. Combined country analyses showed greater declines in smoking and tobacco consumption among tertiary educated men and women compared with their less educated counterparts. In country specific analyses, elementary educated British men and women, and elementary educated Italian men showed greater declines in smoking than their more educated counterparts. Among Swedish, Finnish, Danish, German, Italian, and Spanish women, greater declines were seen among more educated groups. Widening education inequalities in smoking related diseases may be seen in several European countries in the future. More insight into effective strategies specifically targeting the smoking behaviour of low educated groups may be gained from examining the tobacco control policies of the UK and Italy over this period.
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                Author and article information

                Journal
                JAMA Netw Open
                JAMA Netw Open
                JAMA Netw Open
                JAMA Network Open
                American Medical Association
                2574-3805
                28 August 2019
                August 2019
                28 August 2019
                : 2
                : 8
                : e1910161
                Affiliations
                [1 ]Department of Behavioural Science and Health, University College London, London, United Kingdom
                [2 ]Sandtable, London, United Kingdom
                [3 ]Public Health England, London, United Kingdom
                [4 ]Department of Clinical, Educational and Health Psychology, University College London, United Kingdom
                Author notes
                Article Information
                Accepted for Publication: July 2, 2019
                Published: August 28, 2019. doi:10.1001/jamanetworkopen.2019.10161
                Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2019 Jackson SE et al. JAMA Network Open.
                Corresponding Author: Sarah E. Jackson, PhD, Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London WC1E 6BT, United Kingdom ( s.e.jackson@ 123456ucl.ac.uk ).
                Author Contributions: Dr Jackson had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
                Concept and design: Jackson, Michie, Shahab, West, Brown.
                Acquisition, analysis, or interpretation of data: Jackson, Beard, Kujawski, Sunyer, Shahab, West, Brown.
                Drafting of the manuscript: Jackson, Beard, Shahab, West.
                Critical revision of the manuscript for important intellectual content: All authors.
                Statistical analysis: Beard, Kujawski.
                Obtained funding: Shahab, West, Brown.
                Administrative, technical, or material support: Michie.
                Supervision: Sunyer, Shahab, West, Brown.
                Conflict of Interest Disclosures: Dr Beard reported grants from Pfizer outside the submitted work. Dr Shahab reported grants from Pfizer outside the submitted work. Dr West reported grants and personal fees from and consultancy for Pfizer, personal fees from and consultancy for GlaxoSmithKline, and personal fees from and consultancy for Johnson and Johnson outside the submitted work. Dr Brown reported grants from Pfizer outside the submitted work. No other disclosures were reported.
                Funding/Support: Cancer Research UK funded the Smoking Toolkit Study data collection (grants C1417/A22962 and C44576/A19501) and the salaries of Drs Jackson, Beard, and Brown (grant C1417/A22962). Dr Jackson’s salary was also supported by the Economic and Social Research Council (grant ES/R005990/1). Dr Beards’ salary is partly funded by the National Institute for Health Research School for Public Health Research.
                Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
                Disclaimer: The views are those of the authors and not necessarily those of the National Health Service, the National Institute for Health Research, or the Department of Health.
                Additional Information: Data are available from the authors on reasonable request. The study analysis plan is registered on the Open Science Framework at https://osf.io/t9zsv/. The School for Public Health Research is a partnership between the University of Sheffield, University of Bristol, Cambridge University, Imperial College London, University College London, The London School for Hygiene and Tropical Medicine, the LiLaC collaboration between the Universities of Liverpool and Lancaster and Fuse, and The Centre for Translational Research in Public Health, a collaboration between Newcastle University, Durham University, Northumbria University, the University of Sunderland, and Teesside University.
                Article
                zoi190397
                10.1001/jamanetworkopen.2019.10161
                6716287
                31461148
                a0d84103-cfc4-4124-a206-25f867c4d7e7
                Copyright 2019 Jackson SE et al. JAMA Network Open.

                This is an open access article distributed under the terms of the CC-BY License.

                History
                : 29 April 2019
                : 2 July 2019
                Categories
                Research
                Original Investigation
                Online Only
                Public Health

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