Tobacco control policies and smoking cessation: a cross-country analysis

Tobacco control policies range from high excise taxes, to direct restrictions on smoking in public places, to the regulation of pharmaceutical products that aid smoking cessation. In this paper we depart from the standard cross-sectional approach and instead adopt a life course perspective to study the impact of tobacco control policies across countries--Great Britain, Germany, Russia, and the United States. Of the four countries we study, Great Britain taxes cigarettes most heavily-the price of cigarettes in Great Britain are more than twice the average price in Germany, and are more than six times the average price in the Russian Federation. The U.S. has the most restrictions on smoking in public places and the least restrictions on the sale of smoking cessation products. For example, in the U.S. nicotine patches are allowed to be sold widely over-the-counter, while in Great Britain, Germany and the Russian Federation these products are available only in pharmacies or by prescription.

Given the different mixes of tobacco control policies, it is intriguing to note that the prevalence of smoking in Great Britain and the U.S. is fairly similar, while in Germany smoking rate are somewhat higher and in Russia smoking rates are very high for men but much lower for women. According to Corrao et al. (2000), the 1996 British smoking prevalence rate was 29 percent for males and 28 percent for females; the 1997 U.S. smoking prevalence was 28 percent for males and 22 percent for females; the 1997 German smoking prevalence was 43 percent for males and 30 percent for females; and the 1996 Russian smoking prevalence was 63 percent for males and 13 percent for females. While some part of these differences are likely due to differences in cultural norms about smoking, it is likely that the mix of tobacco control policies in each country also plays an important role.

In this paper we lay the groundwork for researchers to take advantage of large differences across countries in tobacco control policies. To do so, we first summarize available information on tobacco control policies in force in each country. We then document in several ways the rates of smoking in Germany, Great Britain, Russia, and the U.S. In particular we describe the life course patterns of smoking by men and women in each country over time. Finally, we present preliminary econometric results from a discrete time hazard model of a sample of U.S. women smokers’ decisions.

• http://www.diw.de/documents/dokumentenarchiv/17/diw_01.c.39218.de/kenkel_lillard_mathios.pdf