A systematic review of the effects of price on the smoking behaviour of young people

Smoking is a significant contributor to preventable illness and premature death. It has also been shown to be a major contributor to social inequalities in health. The uptake of smoking among young people and the perpetuation of smoking into adult life is a concern for the UK Government. Deterring non-smokers starting to smoke and encouraging young smokers to quit is a serious public health issue that has long term consequences in terms of future health gains and associated costs to the NHS and the wider economy. A range of interventions have been proposed, developed, evaluated and implemented to deter smoking among young people. Conventional economic theory suggests that young people are more sensitive than adults to price in determining their consumption behaviour. The aim of this study was to systematically review the evidence on the effects of price as an economic instrument to target youth smoking. The majority of studies assessing the impact of price on smoking behaviour are best described as econometric analyses of observational survey data. There is huge variation in the surveys used and the empirical methods adopted, coupled with concerns about the overall quality and representativeness of most of the surveys employed. Most of the studies also failed to report adequate detail about the surveys, price (or tax) data and about the empirical methods used. Bearing in mind these shortcomings, the overall findings of the review suggest that price is an effective instrument in modifying the smoking behaviour of young people. The evidence suggests that increases in price reduce smoking participation and prevalence, as well as the level of smoking. Increased price also induces reductions in smoking initiation and increases in quit rates. There is, however, heterogeneity in the size of the effect for each of these outcomes, with a range of estimated effects reported. The results support the notion that price should be viewed as a legitimate instrument to be used alongside other policies aimed at reducing cigarette consumption among young people.