Boston, MA—While trends in cigarette smoking and sales have declined in the U.S. for the past decade, sales of non-cigarette tobacco products have been on the rise. Researchers from the Harvard School of Public Health, led by Professor Greg Connolly, director of the Tobacco Control Research Program at HSPH, and Hillel Alpert, research associate in the program, sought to compare trends in sales of all tobacco products in the U.S. and found that 30% of the recent decline in cigarette sales may be offset by the robust sale of small cigars, snuff and roll-your-own products. Thus, the apparent magnitude of overall decline in tobacco use in the U.S. may be illusory. The comparative research of tobacco sales of all kinds across the past decade is published in the June 11, 2008 issue of the Journal of the American Medical Association (JAMA). It is the first study to examine concurrent sales of cigarettes and other tobacco products.
The major factor in the apparent switch to non-cigarette products by smokers appears to be price -- with the federal tax on other forms of tobacco 1/10th that of cigarettes -- and the heavy attention given to campaigning against cigarette use but not against other forms of tobacco products in recent years. Price increases have proven to be the single most effective form of curbing tobacco use in the U.S. population. According to the National Cancer Institute, in the U.S. smoking-related illnesses account for an estimated 438,000 deaths each year. An estimated 25.9 million men (23.9 percent) and 20.7 million women (18.1 percent) in the U.S. are smokers, according to the American Heart Association.
"Tobacco kills, no matter if it's in a cigarette, a cigar, a snuff can or a roll-your-own," said Connolly. "Lower federal and state taxes on these non-cigarette products is keeping tobacco addiction "affordable" and encouraging preventable disease and death. All forms of tobacco should be taxed equally, and state campaigns to curb tobacco use should address this loophole for death."
Since 1998, tobacco sales in the U.S. have declined by 2% a year, which has been hailed as an indicator that smoking itself is on the decline. Overall, cigarette sales declined 18% from 21.1 billion packs in 2000 to 17.4 billion packs in 2007. During the same interval sales of other tobacco products increased by 1.10 billion cigarette pack equivalents (CPE's) an estimate based on the products' tobacco and nicotine content (714 million moist snuff, 256 million roll-your-own tobacco, 130 million small cigars). Figures were obtained from The Alcohol and Tobacco Tax and Trade Bureau, the U.S. Department of Agriculture and from The Tax Burden on Tobacco report. Nicotine ratings were obtained from the Massachusetts Department of Public Health filed by tobacco manufacturers under Massachusetts law.
"Cigarette companies are responding to the changing pattern of consumption," write the researchers, "by entering other tobacco markets, including acquisition of major U.S. moist snuff manufacturer Conwood by R.J. Reynolds, and by marketing new snuff and snus products to attract new smokers and new tobacco users." Snus is a moist tobacco powder placed under the upper lip.
"Cigars, roll-your-own and smokeless tobacco products are generally priced lower than cigarettes," they write. "The weekly cost for a typical user of a premium moist-snuff brand is 55% less than for a typical cigarette smoker. State and federal cigarette taxation policies appear to have been effective in reducing smoking, but small cigars and roll-your-own tobacco are taxed at 5% to 10% the rate of cigarettes, resulting in prices much less than an equivalent pack of cigarettes. These findings should be considered in future policy decisions meant to curb smoking."
The research letter "Trends in the Use of Tobacco Products 2000 – 2007" appears in JAMA June 11, 2008, Vol 299, No. 22.
Harvard School of Public Health (www.hsph.harvard.edu) is dedicated to advancing the public's health through learning, discovery, and communication. More than 400 faculty members are engaged in teaching and training the 1,000-plus student body in a broad spectrum of disciplines crucial to the health and well being of individuals and populations around the world. Programs and projects range from the molecular biology of AIDS vaccines to the epidemiology of cancer; from risk analysis to violence prevention; from maternal and children's health to quality of care measurement; from health care management to international health and human rights. For more information on the school visit: www.hsph.harvard.edu
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