BACKGROUND: Loose or individual cigarettes, sold individually, pose a substantial challenge to tobacco regulation, particularly among adolescents, by reducing economic and psychological barriers to initiating smoking. This study examines the impact of loose cigarette bans on youth smoking behaviors across 13 countries using data from the Global Youth Tobacco Survey (GYTS) and timelines of tobacco control legislation.
METHODS: Smoking prevalence data from the GYTS were analyzed across 13 countries from Wave1 (2002–2004) to Wave5 (2019–2021). These countries were chosen for their implementation of loose cigarette bans and availability of pre- and post-ban GYTS data, enabling a comprehensive evaluation of the bans' impact. Youth smoking prevalence, including gender-specific trends, was assessed before and after the bans. Legislative timelines were mapped to identify the introduction of bans alongside measures like tax increases, smoke-free policies, and sales restrictions. A triangulated analysis evaluated the collective impact of these interventions.
RESULTS: Countries implementing loose cigarette bans demonstrated significant reductions in youth smoking prevalence. In Panama, prevalence dropped from 13.2% in Wave1 (2002) to 3.9% in Wave4 (2017) after the 2008 nationwide ban. Bhutan stabilized smoking rates between Wave2 (2006) and Wave4 (2013) following the Tobacco Control Act, which included bans and import taxes. Gender-specific trends revealed consistently higher male smoking rates, while female prevalence declined sharply, such as in Georgia, where rates fell from 12.9% in Wave1 (2003) to 4.4% in Wave4 (2017). Conversely, El Salvador experienced an increase in youth smoking prevalence in Wave4 (2021), likely due to weak enforcement or socio-environmental factors.
CONCLUSIONS: Loose cigarette bans, as part of comprehensive tobacco control strategies, significantly reduce youth smoking rates. Success depends on strict enforcement, gender-specific interventions, and complementary measures such as taxation and public awareness campaigns. GYTS data remains invaluable for tracking and enhancing global tobacco control efforts.