Impact of the Spanish smoke-free laws on cigarette sales by brands, 2000-2021: Evidence from a club convergence approach.

INTRODUCTION: In January 2006, the Spanish government enacted a tobacco control law that banned the advertising, promotion and sponsorship of tobacco. In January 2011, further legislation on this matter was adopted to provide a more restrictive specification of the ban. In this study, we analyze the effect produced on cigarette sales by these two prohibitions. We address this problem using a cluster time-series analysis to test whether the sales of cigarettes by brands have been homogenized with the prohibition of advertising, promotion, and sponsorship. METHODS: The data source used was the official data on legal sales of cigarettes by brands in Spain, from January 2005 to December 2021 (excluding the Canary Islands and the Autonomous Communities of the cities of Ceuta and Melilla). To achieve our objective, we used log(t) test statistics to check if there is global convergence in the three selected periods according to the regulatory changes that have occurred in Spain (2005-2021, 2005-2010 and 2011-2021). Second, once absolute convergence is rejected, we applied a clustering algorithm to test for the existence of subgroup convergence. RESULTS: The cigarette brands that have been marketed during the period 2005-2021 (n=40), can only be grouped into three groups according to the behavior of their sales. When we focus on the period 2005-2010 (n=74), cigarette brands are grouped into five groups according to their sales behavior. Finally, the cigarette brands marketed during the period 2011-2021 (n=67) are grouped into three groups according to the temporal evolution of their sales. These results suggest a greater homogenization of cigarette sales after the application of the law of January 2011. CONCLUSIONS: Act 42/2010 (total ban on tobacco advertising, promotion, and sponsorship actions) was associated with greater homogenization of cigarette sales than the application of Act 28/2005 (partial ban). This finding supports what is established in the previous literature that indicates that Act 42/2010 provided a more restrictive specification of the ban than Act 28/2005.

Mental health, suicide attempt, and family function for adolescents' primary health care during the COVID-19 pandemic.

Background: The study's purpose was to identify associations between mental health risk, suicide attempts, and family function.   Methods: A correlational, descriptive, and cross-sectional study was carried out in a group of adolescents in the last grade of secondary school to establish the association between mental health risk, suicide attempt, and family functionality. The instruments used were the self-report questionnaire, the suicide risk assessment scale, and the family APGAR. Data analysis was performed using the artificial intelligence algorithm (gower clustering).  Results: 246 adolescents responded to the three instruments, which made it possible to select those with correlations of sensitive interest and, based on these, an intervention plan. Psychological distress was found in 28%, psychotic symptoms in 85%, and problematic alcohol use in 9%. Good family functioning was identified in 34% and some type of family dysfunction in 66%. In terms of suicide risk, there was a low suicide risk of 74%, 24% medium risk, and 2% high risk. It could be shown that there is a correlation in a group of 15% of the respondents.  Conclusions: The risk of suffering mental health deterioration and the suicide risk, during this pandemic period, seems to be related to family functionality.

The relationship between the socio-economic gradient and cigarette consumption in Spain. / La relación entre el gradiente socioeconómico y el consumo de cigarrillos en España.

The objective of the study was to analyze the relationship between individual socioeconomic characteristics and cigarette consumption in Spain. The sample consisted of 19,931 individuals aged 15 or older who completed the European Health Interview Survey for Spain (EHSS-2014). Variables: prevalence and intensity of cigarette consumption. Multivariate ordered logistic regression analysis was performed with the following socioeconomic variables: social classes, educational attainment, main activity, economic situation and, for the working population, the activity sector. Other control variables were sociodemographic variables and healthy lifestyle habits (physical exercise, diet and alcohol consumption). The factors that relate to greater prevalence are: lower social class, not having university studies, being unemployed, having worse economic situation and working in hospitality industry. On the other hand, the variables related to higher intensity of cigarette consumption of the smoking population are: lower social class, not having university studies, and being neither a student nor on a permanent contract. Regarding control variables, those regressors associated with a higher prevalence and intensity of cigarette consumption are: being male, being aged between 36 and 65, being divorced, having fewer children at home and having worse lifestyle habits.

El objetivo del estudio fue analizar la relación entre las características socioeconómicas individuales y el consumo de cigarrillos en España. La muestra estaba formada por 19.931 individuos de 15 o más años de edad de la Encuesta Europea de Salud en España (EESE) de 2014. Variables: prevalencia y nivel de consumo. Se realizó análisis de regresión multivariante logística ordinal con las variables socioeconómicas clase social, nivel educativo, actividad principal, situación económica y sector de actividad (solo para población trabajadora). Otras variables de control incluidas fueron las características sociodemográficas y los hábitos de vida saludables (ejercicio físico, alimentación y consumo de alcohol). Los factores que se relacionan con mayor prevalencia en el consumo de cigarrillos son: inferior clase social, no tener estudios universitarios, ser desempleado, tener peor situación económica y trabajar en hostelería. Por su parte, las variables relacionadas con el nivel de consumo de la población fumadora son: inferior clase social, no tener estudios universitarios, y no ser estudiante ni trabajador indefinido. En cuanto a las variables de control, aquellos regresores asociados a mayor prevalencia y nivel de consumo son: sexo masculino, edad entre 36 y 65 años, ser divorciado, menor número de niños en el hogar y peores hábitos de vida.

[The influence of cigarette price on the cigarette consumption in Spain: a Logarithmic Mean Divisia Index analysis from 1957 to 2018.] / Influencia del precio de los cigarrillos en España: Un análisis de descomposición Logarithmic Mean Divisia Index desde 1957 hasta 2018.

OBJECTIVE: The price elasticity of tobacco emerges as an instrument for minimizing tobacco consumption, sustained by the idea that although tobacco has an addictive nature, an increase in its price causes a decrease in its consumption. However, the price is not the only component of tobacco consumption studied in the literature. Some studies include income as an explanatory component of tobacco consumption. These studies conclude that income affects tobacco consumption positively. METHODS: In this paper, the factors that affect the consumption of cigarettes are measured for the Spanish market using time series data from 1957 to 2018 and by applying the Logarithmic Mean Divisia Index LMDI method. The novel application of this method to this body of literature allows us to verify how effective the price policies that the government has implemented against the consumption of cigarettes have been. RESULTS: Our results reveal that income is a determining factor that sometimes nullifies the effect of policies when governments increase the price of cigarettes by taxes. In order to reduce the prevalence of smokers, the increase in the price of tobacco must consider the effect of income on consumption, so that it does not cancel the effects of health policy. CONCLUSIONS: It is strongly recommended that tax authorities consider these results before applying anti-smoking policies. If the authorities do not do so, it is possible that they will not obtain the expected results in terms of minimized the cigarette consumption.

OBJETIVO: La elasticidad precio de los productos de tabaco es un instrumento para minimizar su consumo. Esta idea se basa en que, aunque el tabaco tiene una naturaleza adictiva, un aumento en su precio provoca una disminución en su consumo. Sin embargo, el precio no es el único componente del consumo de tabaco estudiado en la literatura. Algunos estudios incluyen la renta como un componente explicativo del consumo de tabaco. Estos estudios concluyen que la renta de las personas afecta positivamente el consumo de tabaco. METODOS: En este artículo, se analizaron los factores que afectan al consumo de cigarrillos usando series temporales desde 1957 hasta 2018 y aplicando el método de descomposición LMDI (Logarithmic Mean Divisia Index). La novedosa aplicación de este método al citado conjunto de datos permitió verificar cómo de efectivas han sido las políticas de precios que el gobierno ha implementado para disminuir el consumo de cigarrillos. RESULTADOS: Los resultados sugieren que la renta de las personas es un factor determinante que a veces anula el efecto de las políticas cuando los gobiernos aumentan el precio de los cigarrillos vía impuestos. Para reducir la prevalencia de fumadores, el aumento en el precio del tabaco debe considerar también el efecto de la renta de las personas en el consumo, puesto que éstos a veces anulan los efectos de políticas sanitarias consistentes en aumentar el precio de los cigarrillos. CONCLUSIONES: Los gobiernos deben tener en cuenta que la renta de las personas es un factor clave cuando se aplican políticas de precio frente al tabaquismo.

The Price Elasticity of Cigarettes: New Evidence From Spanish Regions, 2002-2016.

INTRODUCTION: There is an agreement in the literature that tobacco price elasticity is around -0.4 for given location. Furthermore, works only focus separately, on the temporal dimension or the spatial dimension, however, there are studies that show the existence of spillovers between different geographical areas due to the spatial dependence in tobacco consumption. The novelty of this study is the measurement of the effect that neighboring regions have on the price elasticity of cigarettes. AIMS AND METHODS: This study simultaneously analyzed, first, a dynamic spatial model used to measure the price elasticity of cigarettes in the short term and long term of the 47 provinces that make up the Spanish territory, detailing the influence of neighbors. Second, given the spatial arrangement of the elasticities observed in the provinces, we can detect behaviors typical of large-scale illicit trade and cross-border purchasing since geographical location can be an important factor in smuggling, and politicians should take this into account when making price policies. RESULTS: Results reveal that the consumption of the regions is influenced by the consumption of the neighboring regions in the same period. The price elasticity of cigarettes in the long term exceeds in many cases, in absolute value, unity. This result is novel because tobacco has historically been treated as an inelastic demand good. Finally, we found that the regions that are most sensitive to price are those bordering France and Gibraltar or tourist regions, demonstrating the effect that smuggling has on the behavior of the regions. CONCLUSIONS: These results are important because the price in Spain is set by the central government and fiscal policies regarding the price of tobacco can have different effects in different regions. This study has shown that the consumption of cigarettes is influenced by the neighboring regions and also measured different sensitivities for each region. Regional cooperation in tobacco control policies may have better effects than the elaborated policies based on historical information. IMPLICATIONS: Policy makers should consider that tobacco could be an elastic good in the long term and that cooperation between countries in terms of price differential should be taken to avoid tobacco smuggling. The allocation of resources to control smoking should consider the special dependence shown in this report. Also, academics should account for spatial dependence to measure tobacco consumption instead of temporal analysis.