SBCA Program

Smoking remains a leading and preventable cause of death and disability. Türkiye is a country with a high prevalence rate of cigarette smoking. The market for tobacco-related products in Türkiye has been evolving rapidly with the introduction of noncombustible cigarette-like products such as electronic cigarettes (e-cigarettes). Although conventional combustible cigarettes (packaged cigarettes and roll-your-own (RYO) cigarettes) remain the primary choice of consumers, e-cigarettes are quickly gaining popularity. Turkish regulation requires that flavored cigarettes cannot be present in the market after 2020. Moreover, the import of e-cigarettes was banned in 2020, although an exception was provided for imports for personal use. The import ban is reinforced by a production ban, effectively prohibiting sales in the country. Existing smoking restrictions (such as on indoor smoking) also apply to e-cigarettes. Moreover, restrictions apply to virtually all forms of advertising and promotion. The legal sale of roll-your-own cigarettes and e-cigarettes is prohibited, although they are accessible under-the-counter, and their use is not insignificant. Our research focuses on packaged cigarettes, RYO cigarettes, and e-cigarettes. In Türkiye, packaged cigarettes are regulated and heavily taxed, whereas roll-your-own cigarettes and e-cigarettes are not, making them potentially less costly choices for consumers. The proposed research will assess the role that attributes of these products (in particular, prices, legal status, and flavor availability) play in consumers’ choices. It aims to investigate the tradeoffs that adult consumers in Türkiye face when making the choice among the four options of using one of the three products and using none, by using a discrete choice experiment (DCE) embedded in an online survey. DCEs are known to have strong internal validity to determine causal effects. Survey data has been collected via an online panel among adults (ages-18-65) in Türkiye. Using state-of-the-art econometric methods, such as panel mixed logit regression model, estimates will be obtained for the effects of product attributes and consumer characteristics on the choices made. This research aims to answer policy-relevant questions in the Turkish context. Regression analyses will be used to estimate the disutility of the ban and predict how consumers would behave in a different regulatory environment.

The Further Consolidated Appropriations Act, signed into law in December 2019, established a new Federal minimum age of sale for tobacco products. This law increased the minimum age of sale for cigarettes, smokeless tobacco, and covered tobacco products from 18 to 21 years of age; increased the minimum age for age verification by means of photographic identification for cigarettes, smokeless tobacco, and covered tobacco products from under the age of 27 to under the age of 30; and increased the minimum age of individuals who may be present or permitted to enter facilities that maintain tobacco vending machines and self-service displays from 18 to 21 years of age. This presentation discusses an approach to accounting for state and local “Tobacco 21” policies that predate federal action into the analytic baseline used to assess the impacts of the 2019 law. The analysis discusses the implications of the choice of baseline when identifying changes in long-run smoking prevalence, mortality, and time spent on age verification attributable to the 2019 law.

Evaluating the benefits and costs of policies aiming to reduce smoking or vaping requires knowledge of how demand for these products is interrelated and whether use of e-cigarettes helps people quit smoking. This study examines the impact of e-cigarette use on smoking-related disparities among historically disadvantaged groups in the U.S. Smoking and related harms are concentrated in historically disadvantaged groups in the U.S. Similarly, e-cigarette use is not uniformly distributed across the population. Little is known about how e-cigarettes influence existing smoking-related disparities. If e-cigarette use is concentrated among disadvantaged groups, assists smokers in quitting, and has similar cessation effects in these groups as in the general population, e-cigarettes could reduce smoking-related disparities. Conversely, if adoption is more common among higher socioeconomic status (SES) groups, e-cigarettes may leave disadvantaged smokers further behind. This study will investigate which scenario predominates among various disadvantaged groups, including low-income individuals and racial and ethnic minorities. We will use survey data from PATH, the CPS-Tobacco Use Supplement, and other sources to model smoking, cessation, and e-cigarette use based on demographics, socioeconomic factors, and economic variables. Regression models will be estimated with or without corrections for unobserved confounding factors by incorporating random or fixed effects or directly modeling the selection process. Various estimators from the treatment effects literature (biprobit, copula-based, and moment-based control function models) will be employed to account for selection effects in e-cigarette use. This investigation will focus on how e-cigarette use affects smoking and cessation differently across groups. Key to the investigation will be the recognition that e-cigarette use may affect smoking and cessation differently for different groups. Thus, the models will allow for such disparate treatment effects. The results will address whether the availability and use of e-cigarettes help or hinder smoking cessation among disadvantaged populations.

Persistent smoking prevalence provides an opportunity to reduce harm. This study investigates consumer perceptions and decision-making processes concerning Tobacco Harm Reduction Products (THRPs) such as e-cigarettes in Indonesia. We conducted an online discrete choice experiment (DCE) in which respondents chose between combustible cigarettes, electric cigarettes, or quit (opt-out) using five attributes: price, flavor, excise tax description, graphic warning messages, and nicotine level. The sample consisted of 627 regular smokers aged 18 years and above from an Internet panel involving smokers. We fitted linear probability models, logistic regression models, and McFadden’s conditional logit choice model using Stata. The findings demonstrate that price is a critical determinant, with higher cigarette prices significantly reducing smoking rates and encouraging a shift toward e-cigarettes. The results also revealed that younger consumers were more inclined to adopt e-cigarettes as a perceived less harmful alternative, whereas older consumers tended to quit smoking altogether in response to price increases. Our model provides further insights, showing that consumer preferences evolve over time, with younger users exhibiting sustained loyalty to e-cigarettes despite fluctuations in traditional cigarette prices. This study highlights the necessity for targeted and multifaceted tobacco control policies that should include price interventions, support for alternative nicotine products, and continuous monitoring to respond to market and regulatory dynamics. This study contributes to the existing literature by offering a detailed analysis of THRPs in a developing-country setting, emphasising the interaction between economic, demographic, and product-related factors. The dynamic analysis provided by the CMC Logit model sheds light on the long-term effects of tobacco control policies, particularly in emerging markets, and underscores the need for interventions that address the diverse needs of different consumer segments to enhance the efficacy of tobacco harm reduction strategies.