China, one of the fastest growing upper-middle income countries in the world, is taking the brunt of the global tobacco epidemic which is gradually shifting to the low- and middle-income countries. China’s large population and high smoking prevalence are part of this scenario. The new millennium has seen rising per capita cigarette consumption in China in contrast to a declining trend worldwide. Evidence suggests that growing affordability of cigarettes has contributed to the increase in cigarette consumption to the utter detriment of public health and the national economy in China.

A recent study led by Nigar Nargis from the American Cancer Society reveals an even more alarming trend—affordability of cigarettes (measured by Relative Income Price or the percentage of per capita household income required to purchase 100 packs of cigarettes of the brands individuals bought in their last purchase) is growing faster among youth,  those with lower income and/or lower education and the non-employed (including unemployed, retired, students, homemakers) (Figure below). This finding informs the Healthy China Plan 2030 to take stronger tobacco tax and price measures targeting youth and people in lower socioeconomic groups. These measures include the introduction of a uniform specific cigarette excise tax structure and minimum price regulations that increase price more for cheaper brands largely consumed by people with lower purchasing ability. The specific tax requires regular adjustment to inflation and income growth to keep affordability from declining. The new study further suggests that the specific tax should be indexed to income growth experienced by those in lower socioeconomic groups and by younger people who are likely situated in the trajectory of faster income growth compared to the broader national level.

Change in Cigarette Affordability Over Time

By Nigar Nargis