Socioeconomic differences in the impact of smoking tobacco and alcohol prices on smoking in India

by Frank J Chaloupka, Emmanuel Guindon, Prabhat Jha and Arindam Nandi

Vox
December 23, 2011

In India, 1 in 5 of all adult male deaths and 1 in 20 of all adult female deaths at ages 30-69 are due to smoking. This column estimates that raising the price of cigarettes by 1% would decrease smoking by about 1.1% and even more so for poorer households.

“Sugar, rum, and tobacco, are commodities which are no where necessaries of life, which are become objects of almost universal consumption, and which are therefore extremely proper subjects of taxation”

—Adam Smith, The Wealth of Nations, 1776

Tobacco smoking and chewing are both common in India (Government of India 2010, Rani et al 2003), but the individual risks from smoking are markedly greater (Gajalakshmi et al 2003, Jha et al 2008). A large, nationally-representative study of mortality in over 1.1 million homes indicates that already 1 in 5 of all adult male deaths and 1 in 20 of all adult female deaths at ages 30-69 are due to smoking and India will soon have a million smoking deaths a year (Jha et al 2008). The study also suggests that the relative risk of death from any medical cause does not depend on educational level, but does depend on whether bidis or cigarettes were smoked, and the amount smoked (Figure 1). The risk ratio for a given number of bidis or cigarettes smoked was greater for cigarettes than for bidis. For example, compared to non-smokers, the risk of dying as a result of smoking 1-7 bidis per day was 30% higher compared to an increase in risk of 80% from smoking the same number of cigarettes per day.

Figure 1. Relative risk of death by amount and type of smoking, men aged 30-69

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