The Fatal Toll of Cheap Cigarettes

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A new study suggests that the availability of cheaper, off-brand cigarettes is associated with an increase in infant mortality.

Researchers writing in JAMA Pediatrics studied the link between cigarette prices and infant mortality in 23 European countries from 2004 through 2014. During this time, there were more than 53 million live births.

After controlling for other factors, they found that a $1.18 increase in average price per pack was associated with a decline of 0.23 deaths per 1,000 babies in the first year of life and 0.16 deaths per 1,000 babies in the second year.

But when a cheap enough brand was available, the number of infant deaths increased. A 10 percent difference between the median price and the price of an off-brand bargain pack was associated with an increase of .07 deaths per 1,000 live births, the researchers found.

Increases in average price between 2004 and 2014, which generally followed increases in tobacco taxes, were associated with 9,208 fewer infant deaths. But if there had been no bargain cigarettes available, 3,195 more deaths could have been avoided.

“Tobacco companies can load price increases onto premium brands and sell cheaper cigarettes at a loss so that poor people and young people can still take up smoking,” said the lead author, Filippos Filippidis, a lecturer in public health at Imperial College London.

“This is an effective marketing practice, but it’s terrible for public health. We would like to see government make increases in price happen across the board.”