BACKGROUND: South Africa is an interesting case to explore given its high smoking rates and quit intentions, its experience with periods of tax- and industry-initiated cigarette price increases, and the mixed evidence of the effect of prices on smoking cessation (particularly in low- and middle-income countries).
METHODS: We used data from five waves of the National Income Dynamics Study, a nationally-representative survey conducted between 2008 and 2017, and duration analysis techniques to examine whether cigarette prices were associated with South African smokers’ decision to quit smoking. Smoking histories were constructed from self-reported age of onset and cessation and matched to monthly price data from 1970 to 2017.
RESULTS: We found that price was associated with smoking cessation: a 10% increase in the price of cigarettes was associated with an increase in smoking cessation of 5.8 to 7.9%, depending on model specification. We found that despite a large sex disparity in smoking cessation (in our sample, females quit at a rate that was about 1.8 times higher than that of males), both males and females in South Africa responded similarly to price changes. We also found a positive gradient between education and smoking cessation.
CONCLUSIONS: Our results indicate that increasing the excise tax on cigarettes above inflation would likely encourage smoking cessation in South Africa, provided measures to reduce illicit cigarette trade are concurrently implemented.