The association between the retail price of manufactured cigarettes and bidis on current smoking status in India

Introduction: In India, the retail prices of bidis and cigarettes varied between the two Global Adult Tobacco Surveys (GATS) conducted in 2009/10 and 2016/17. The relationship between the retail price of smoked tobacco products and their use is unclear for India. Our study thus aimed to use available datasets to investigate the association between the retail price and current smoking status of bidis and cigarettes in India. Methods: Current smoking status data for bidis and cigarettes were obtained from the two GATS rounds. The average state-level retail prices of bidis and cigarettes were obtained from India’s Consumer Price Index- Industrial Workers database. Descriptive statistics were used to describe current smoking status patterns. Generalized Linear Mixed Models (GLMM) were used to investigate the association between the retail prices and current smoking status of bidis and cigarettes. Results: For cigarettes, an increase in the average retail price by one Indian Rupee was associated with a reduction in the odds of being a current smoker of 7% (OR 0.925 [95% CI = 0.918 – 0.932], p<0.001). For bidis, the association between the retail price and current smoking status was not statistically significant (OR 1.01 [95% CI = 1.00 - 1.02], p = 0.082). Conclusions: Current increases in the retail prices of tobacco products in India seem to have an impact on the use of cigarettes but not bidis. This highlights the need for tobacco product tax increases that result in sufficient retail prices increases to make all tobacco products less affordable and reduce their use.