Smoking initiation and cessation in India – a duration analysis

Rising bidi and cigarette prices have been shown to reduce smoking in India, however existing literature does not estimate the price effect on smoking initiation and cessation. This study provides the first assessment of the impact of tobacco prices on smoking initiation and cessation in India. By utilizing retrospective information on the timing of smoking initiation and cessation from the 2009 Global Adult Tobacco Survey of India and historical tobacco prices from 1998-2009, we estimate the price elasticities of smoking initiation and cessation for bidis and cigarettes in a longitudinal setting. For bidis, we find a 10% increase in price would increase cessation by 3-6% and reduce initiation by 2-3%; for cigarettes, a 10% increase in price would increase cessation by 2% and reduce initiation by 3%. The estimates are consistent with the price elasticities of smoking participation estimated for India in previous studies and suggest a larger impact of bidi prices than cigarette prices on smoking outcomes as well.  Interestingly the estimates by rural-urban strata indicate that the price impact on smoking cessation is significant for rural residents but not for urban residents. In addition, increasing bidi prices are only associated with a lower initiation rate among rural residents while increasing cigarette prices are only associated with a lower initiation rate among urban residents.