Cigarette type 'switchers': a descriptive analysis.

Tobacco price increases, such as through taxation, are an effective strategy to reduce smoking prevalence, however this strategy is undermined by both discount and contraband tobacco.1 The discount cigarette market has grown substantially since 2003, with discount cigarettes selling for approximately $10-15 less per carton than premium brands.2 The illegal sale of contraband cigarettes has become increasingly common, providing an even cheaper source of cigarettes.3 While the cost of cigarettes has been shown to influence smokers’ decisions to switch cigarette types,1,4,5 little is known about the nature and extent of switching, or factors that influence switching. To examine the incidence of cigarette type switching and the characteristics of those who switch, we compared baseline to 12-month follow-up data from the Ontario Tobacco Survey, a population-based cohort of adult smokers.6,7 Smokers’ usual brand of cigarettes was categorized as premium, discount or contraband, according to a list of discount cigarette brands8 and known contraband cigarettes in Ontario.9 Patterns of switching were examined by cigarette type at baseline. Socio-demographic and smoking-related characteristics of switchers and non-switchers were examined, adjusting for the complex survey design. Overall, 24% of smokers switched the category of cigarette they smoked over the one-year period. One in five premium smokers switched to a lower-cost cigarette type (Table 1). Similarly, about one in five discount smokers switched cigarette types, with slightly more switching to a premium brand (13%) than to contraband cigarettes (9%). Sixteen percent of contraband smokers switched, with almost half of switchers moving to a premium brand. With 70% of switchers moving from a more expensive to a less expensive cigarette type, the overall result was a considerable decrease in the number of premium smokers, and a substantial increase in the number of contraband cigarette smokers. Those who switched to a less expensive category of cigarette were more likely to be under the age of 45 compared to those who switched to a more expensive brand (p<0.01) (Table 2). Those who switched cigarette type at either the 6or 12-month follow-up were more likely to have less education (p<0.01). The type of cigarette smoked at baseline predicted (p=0.07) a change in cigarette type over the one-year period. With approximately 1 in 4 smokers reporting that they switched the type of cigarette they smoked over a one-year period, cigarette type appears to be relatively fluid, considering the tobacco industry is known for its high brand loyalty.10 Of note are the large number of smokers moving to contraband cigarettes, with the number of contraband smokers increasing by 45% over one year. Further, as the percentage of smokers remaining in the contraband category was highest (85%) among the three cigarette types, those who switch to contraband cigarettes are likely to remain in this group. If this pattern of switching persists, we would expect a continuing growth of the contraband cigarette market. Finally, the fact that 11% of lower-cost-cigarette smokers switched to a premium brand was unexpected. This may be attributable to the brand recognition and prestige associated with premium brands, offsetting the cost savings of the less expensive brands for some individuals. Limitations of this study include a lack of data regarding other factors that may influence an individual to change cigarette type, including changes in individual economic and social situations. While we found little difference in the socio-demographic or smoking characteristics between switchers and non-switchers, a larger-than-expected group of smokers appears unstable in the type of cigarette they smoke.