Socio-Economic Status (SES) differences in changing affordability of tobacco products from 2011-12 to 2018-19 in India

INTRODUCTION We studied the change in affordability of tobacco products, an important determinant of tobacco use, across the different socio-economic status (SES) in India. METHODS We calculated affordability in the form of relative income price (RIP-cost of tobacco products relative to income) for years 2011-12 and 2018-19 using three different denominators, i.e., per capita Gross Domestic Product (GDP) and Net State Domestic Product (NSDP) at national and state levels, respectively; monthly per capita consumer expenditure (MPCE); and individual wages. We investigated RIP for cigarettes, bidis and smokeless tobacco (SLT) across different SES groups (caste groups, type of employment and education). RESULTS RIP increased marginally for cigarettes, bidis and remained almost constant for SLT across casual workers. However, when RIP was adjusted with SES variables, there was no significant change (p>0.05) in affordability of products for casual workers in year 2018-19 as compared to 2011-12. For regular workers, cigarettes and bidis became marginally less affordable (βvariables SLT reported no change in affordability. There was a marginal increase in affordability for all products when RIP was calculated with GDP. CONCLUSION Although implementation of GST has increased the price of tobacco products, it is still not sufficient to reduce the affordability of tobacco products, particularly SLT and especially for the lower SES group.