Do dual purchasers behave differently? An analysis of purchasing data for households that buy both alcohol and tobacco in the United Kingdom.
Alcohol
consumption patterns
dual purchasers
joint household expenditure
socio-economic inequalities
tobacco
Journal
Addiction (Abingdon, England)
ISSN: 1360-0443
Titre abrégé: Addiction
Pays: England
ID NLM: 9304118
Informations de publication
Date de publication:
09 2021
09 2021
Historique:
revised:
29
10
2020
received:
24
07
2020
accepted:
20
01
2021
pubmed:
11
2
2021
medline:
1
10
2021
entrez:
10
2
2021
Statut:
ppublish
Résumé
Dual purchasers of alcohol and tobacco are at increased health risk from the interacting health impacts of alcohol and tobacco use. They are also at financial risk from exposure to the dual financial cost of policies that increase alcohol and tobacco prices. Understanding whose alcohol and tobacco use exposes them to these health and financial risks is important for understanding the inequality impacts of control policies. This study explores the extent to which household spending on alcohol and tobacco combined varies between socio-economic groups and compares this with results for households which purchase only one of the commodities. Cross-sectional analysis of household-level alcohol and tobacco purchasing data. United Kingdom, 2012-17. A total of 26 021 households. We analysed transaction-level data from individual 14-day spending diaries in the Living Cost and Food Survey (LCFS). We used this to calculate expenditure, volumes of alcohol and tobacco purchased, and the price paid per unit of alcohol (1 unit = 8 g) and per stick of tobacco. This was compared with equivalized total expenditure and quintiles of equivalized household income. Prices were calibrated and pack sizes were imputed using empirical sales data from Nielsen/CGA to correct for reporting bias. Dual purchasing households spent [95% confidence interval] more on alcohol and more on tobacco than their single-purchasing counterparts. In general, lower-income households spent less on both alcohol and tobacco than higher-income households. Furthermore, dual purchasing households in the lowest income group were most exposed to potential increases in price than were other income groups, with (CI = 12.41-13.15%) of their total household budget spent on alcohol and tobacco. Dual purchasers of alcohol and tobacco in the United Kingdom appear to be concentrated evenly among income groups. However, dual purchasers may experience particularly large effects from pricing policies, as they spend a substantially higher proportion of their overall household expenditure on alcohol and tobacco than do households that purchase only one of the commodities.
Sections du résumé
BACKGROUND AND AIMS
Dual purchasers of alcohol and tobacco are at increased health risk from the interacting health impacts of alcohol and tobacco use. They are also at financial risk from exposure to the dual financial cost of policies that increase alcohol and tobacco prices. Understanding whose alcohol and tobacco use exposes them to these health and financial risks is important for understanding the inequality impacts of control policies. This study explores the extent to which household spending on alcohol and tobacco combined varies between socio-economic groups and compares this with results for households which purchase only one of the commodities.
DESIGN
Cross-sectional analysis of household-level alcohol and tobacco purchasing data.
SETTING
United Kingdom, 2012-17.
PARTICIPANTS/CASES
A total of 26 021 households.
MEASUREMENTS
We analysed transaction-level data from individual 14-day spending diaries in the Living Cost and Food Survey (LCFS). We used this to calculate expenditure, volumes of alcohol and tobacco purchased, and the price paid per unit of alcohol (1 unit = 8 g) and per stick of tobacco. This was compared with equivalized total expenditure and quintiles of equivalized household income. Prices were calibrated and pack sizes were imputed using empirical sales data from Nielsen/CGA to correct for reporting bias.
FINDINGS
Dual purchasing households spent [95% confidence interval] more on alcohol and more on tobacco than their single-purchasing counterparts. In general, lower-income households spent less on both alcohol and tobacco than higher-income households. Furthermore, dual purchasing households in the lowest income group were most exposed to potential increases in price than were other income groups, with (CI = 12.41-13.15%) of their total household budget spent on alcohol and tobacco.
CONCLUSIONS
Dual purchasers of alcohol and tobacco in the United Kingdom appear to be concentrated evenly among income groups. However, dual purchasers may experience particularly large effects from pricing policies, as they spend a substantially higher proportion of their overall household expenditure on alcohol and tobacco than do households that purchase only one of the commodities.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
2538-2547Subventions
Organisme : Department of Health
ID : 16/105/26
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/K023195/1
Pays : United Kingdom
Organisme : Cancer Research UK
ID : C1417/A22962
Pays : United Kingdom
Informations de copyright
© 2021 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.
Références
Griswold M. G., Fullman N., Hawley C., Arian N., Zimsen S. R. M., Tymeson H. D., et al. Alcohol use and burden for 195 countries and territories, 1990-2016: a systematic analysis for the global burden of disease study 2016. Lancet 2018; 392: 1015-1035.
Burton R., Sheron N. No level of alcohol consumption improves health. Lancet 2018; 392: 987-988.
Angus C., Henney M., Street R. Modelling the impact of alcohol duty policies since 2012 in England & Scotland. Sheffield, UK: University of Sheffield; 2019.
NHS Digital. Statistics on Smoking, England -2018 [PAS]-NHS Digital. Statistics on Smoking, England-2017. 2017. Available at: https://digital.nhs.uk/data-and-information/publications/statistical/statistics-on-smoking/statistics-on-smoking-england-2020 (accessed 4 February 2021).
World Health Organization (WHO). WHO. From burden to ‘best buys’: reducing the economic impact of NCDs in low- and middle-income countries. WHO [internet] 2015. Available at: https://www.who.int/nmh/publications/best_buys_summary/en/ (accessed 4 February 2021).
Wagenaar A. C., Salois M. J., Komro K. A. Effects of beverage alcohol price and tax levels on drinking: a meta-analysis of 1003 estimates from 112 studies. Addiction 2009; 104: 179-190.
Wagenaar A. C., Tobler A. L., Komro K. A. Effects of alcohol tax and price policies on morbidity and mortality: a systematic review. Am J Public Health 2010; 100: 2270-2278.
Ludbrook A., Petrie D., McKenzie L., Farrar S. Tackling alcohol misuse. Appl Health Econ Health Policy 2012; 10: 51-63.
Sharma A., Sinha K., Vandenberg B. Pricing as a means of controlling alcohol consumption. Br Med Bull 2017; 123: 149-158.
Cook P. J., Moore M. J. The economics of alcohol abuse and alcohol-control policies. Health Aff 2002; 21: 120-133.
Carpenter C., Cook P. J. Cigarette taxes and youth smoking: new evidence from national, state, and local youth risk behavior surveys. J Health Econ 2008; 27: 287-299.
Garnett C., Tombor I., Beard E., Jackson S. E., West R., Brown J. Changes in smoker characteristics in England between 2008 and 2017. Addiction 2019; 115: 748-756.
Holmes J., Meng Y., Meier P. S., Brennan A., Angus C., Campbell-Burton A., et al. Effects of minimum unit pricing for alcohol on different income and socioeconomic groups: a modelling study. Lancet 2014; 383: 1655-1664.
Sassi F., Belloni A., Mirelman A. J., Suhrcke M., Thomas A., Salti N., et al. Equity impacts of price policies to promote healthy behaviours. Lancet 2018; 391: 2059-2070.
Ally A. K., Meng Y., Chakraborty R., Dobson P. W., Seaton J. S., Holmes J., et al. Alcohol tax pass-through across the product and price range: do retailers treat cheap alcohol differently? Addiction 2014; 109: 1994-2002.
Wilson L. B., Pryce R., Hiscock R., Angus C., Brennan A., Gillespie D. Quantile regression of tobacco tax pass-through in the UK 2013-2019. How have manufacturers passed through tax changes for different tobacco products? Tob Control 2020. https://doi.org/10.1136/tobaccocontrol-2020-055931
Meier P. S., Purshouse R., Brennan A. Policy options for alcohol price regulation: the importance of modelling population heterogeneity. Addiction 2010; 105: 383-393.
Meier P. S., Holmes J., Angus C., Ally A. K., Meng Y., Brennan A. Estimated effects of different alcohol taxation and price policies on health inequalities: a mathematical modelling study. PLOS Med 2016; 13: e1001963.
Nyakutsikwa B., Britton J., Langley T. The effect of tobacco and alcohol consumption on poverty in the UK. Addiction 2021; 116: 150-158.
Bulman J, Davies R, Carrel O. Living Costs and Food Survey: Technical Report for survey year April 2015 to March 2016. Newport, UK: Office for National Statistics; 2017.
Purshouse R, Brennan A, Latimer N, Meng Y, Rafia R, Jackson R et al. Modelling to assess the effectiveness and cost-effectiveness of public health related strategies and interventions to reduce alcohol attributable harm in England using the Sheffield Alcohol Policy Model version 2.0. Report to the NICE Public Health ProgrammeDevelopment Group, 9 November 2009. University of Sheffield, Sheffield; 2009. Available at: http://guidance.nice.org.uk/PHG/21/EconomicModellingReport/pdf/English (accessed 5 November 2020).
Hiscock R., Branston J. R., McNeill A., Hitchman S. C., Partos T. R., Gilmore A. B. Tobacco industry strategies undermine government tax policy: evidence from commercial data. Tob Control 2018; 27: 488-497.
Hiscock R., Branston J. R., Partos T. R., McNeill A., Hitchman S. C., Gilmore A. B. UK tobacco price increases: driven by industry or public health? Tob Control 2019; 28: e148-e150.
Gallus S., Lugo A., Ghislandi S., La Vecchia C., Gilmore A. B. Roll-your-own cigarettes in Europe: use, weight and implications for fiscal policies. Eur J Cancer Prev 2014; 23: 186-192.
Anyaegbu G. Using the OECD equivalence scale in taxes and benefits analysis. Econ Labour Mark Rev 2010; 4: 49-54.
Wagenaar A. C., Maldonado-Molina M. M., Wagenaar B. H. Effects of alcohol tax increases on alcohol-related disease mortality in Alaska: time-series analyses from 1976 to 2004. Am J Public Health 2009; 99: 1464-1470.
Brown J., Beard E., Kotz D., Michie S., West R. Real-world effectiveness of e-cigarettes when used to aid smoking cessation: a cross-sectional population study. Addiction 2014; 109: 1531-1540.
Cotti C., Nesson E., Tefft N. The relationship between cigarettes and electronic cigarettes: evidence from household panel data. J Health Econ 2018; 61: 205-219.
Chan G., Morphett K., Gartner C., Leung J., Yong H.-H., Hall W., et al. Predicting vaping uptake, vaping frequency and ongoing vaping among daily smokers using longitudinal data from the International Tobacco Control (ITC) Four Country Surveys. Addiction 2019; 114: 61-70.
Beard E., Brown J., West R., Acton C., Brennan A., Drummond C., et al. Protocol for a national monthly survey of alcohol use in England with 6-month follow-up: ‘the alcohol toolkit study’. BMC Public Health 2015; 15: 230.
Fidler J. A., Shahab L., West O., Jarvis M. J., McEwen A., Stapleton J. A., et al. The smoking toolkit study: a national study of smoking and smoking cessation in England. BMC Public Health 2011; 11: 479.
Beard E., West R., Michie S., Brown J. Association of prevalence of electronic cigarette use with smoking cessation and cigarette consumption in England: a time-series analysis between 2006 and 2017. Addiction 2020; 115: 961-974.
Whitaker D. Sin Taxes: Tobacco. Estimation of price elasticities of demand for cigarettes and rolling tobacco in the United Kingdom. London, UK: Deloitte; 2019.