Cigarette smoking has fallen by a quarter since 2011 says report

By Dr. Ananya Mandal, MDAug 29 2019

Between 2011 and 2018 consumption of cigarettes has dropped by almost a quarter says a new study that compared sales data and also performed a survey. This translates into a drop of around 1.5 billion cigarettes a year says the study. Researchers from University College London published their study titled, “Comparison of Trends in Self-reported Cigarette Consumption and Sales in England, 2011 to 2018,” in the latest issue of JAMA Network Open this month.

The researchers wrote, “Cigarette smoking is one of the leading risk factors for morbidity and mortality worldwide and is associated with a large economic burden” Thus it is essential that there are accurate measures to estimate national cigarette consumption in order to “evaluate and plan policies aimed at reducing smoking”. They explain that, “estimates can be obtained from surveys or sales data, but each has potential biases.” They added that both survey and sales data has shown that there has been a steady decline in cigarette use in England and across the globe since the 1970’s. They wrote, “The decline has been greater in some years than others and varies from country to country and within sociodemographic groups within countries. This variation has been crucial to the evaluation of policies such as tax increases, smoking bans, and marketing restrictions and the rate of decline is being used in some countries to plan policies aimed at moving those countries to what has been termed the “end game” in tobacco control.”

The researchers write that the purpose of their study was to assess the consumption of cigarettes over the past few years in England. They also wanted to compare the sales data of cigarettes with actual survey data to understand the actual consumption of cigarettes.

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Results of the study showed that there was a close association and alignment in the data from surveys as well as from sales information. The team used survey data from the Smoking Toolkit Study that is a monthly survey to analyze the usage of cigarettes among the surveyed population. They used series of analysis over time between August 2011 and February 2018. The survey participants were representative of the whole nation’s population being 136,677 in number and aged 16 years and older. They were asked about their cigarette consumption each month at the survey. The main measurements of the Smoking Toolkit Study (STS) were, “(1) smoking prevalence and (2) cigarette consumption among those who reported smoking.” The team writes that they estimated prevalence by defining it as the percentage of participants who reported smoking cigarettes (including those that are rolled by hand) on a daily basis or at times during the past 12 months when the survey was taken. They also asked questions to determine the number of cigarettes smoked per day, per week or per month.

Further sales data were also gathered for analysis and comparison write the researchers. The team wrote that they obtained the cigarette sales data from a data agency that manages analytics and measures for the market research. They wrote, “Data were collected from electronic point of sale (EPOS) to estimate cigarette retail sales for the Great Britain (England, Scotland, and Wales) market.” They explained that data for the sales came from grocery stores on a weekly basis.

Broad results showed that there was a one quarter decline in cigarette consumption, and this meant a reduction of 117 million cigarettes monthly and around 1.4 billion cigarettes annually. Dr Sarah Jackson from UCL’s tobacco and alcohol research group, said, “It’s brilliant that over a billion fewer cigarettes are being sold and smoked in England every year. Studies like this help to give us an accurate picture of cigarette consumption so we know where we’re at and what more needs to be done.” The team explains that of the 136 677 individuals surveyed, there were around half women and the average age was around 46 years.

They noted from the survey that over a month average cigarette consumption across England was an average 2.85 billion (ranging between 2.78 billion and 2.93 billion). From sales data the cigarettes the team found that monthly average consumption of cigarettes was 3.08 billion (ranging between 3.03 billion and 3.13 billion). The decline in consumption over the period of study was 24.4 percent based on the survey data and 24.1 percent based on sales data. As can be seen, the percentage decline is significantly similar. The team writes that this decline translated into “118.4 million and 117.4 million fewer cigarettes consumed per month (or approximately 1.4 billion per year) based on survey data and sales data, respectively.”

Overall the team explained that there is coherence between the sales and survey data and either can be relied upon to understand the national picture of cigarette consumption. The researchers thus wrote in conclusion, “The alignment between the 2 methods provides increased confidence in the accuracy of parameters provided by the Smoking Toolkit Study and sales data. It indicates that estimated changes in cigarette consumption are robust and provide a meaningful basis for policy evaluation and planning.”

The study was funded by the Cancer Research UK. Senior policy manager at the Cancer Research, UK, George Butterworth said in a statement, “It’s great news that fewer cigarettes are being sold and smoked. Big tobacco said that introducing stricter regulation wouldn’t work and campaigned against it, but this is proof that smoking trends are heading in the right direction. But smoking is still the biggest preventable cause of cancer and certain groups have much higher rates of smoking, such as routine and manual workers, so we can’t stop here and think: ‘Job done.’” He said in addition, “Last month, the government committed to making the UK smoke-free by 2030. But stop-smoking services, which give smokers the best chance of quitting, have been subject to repeated cuts in recent years. We need the government to fix the funding crisis in local stop-smoking services. The tobacco industry could be made to pay for these services to clean up the mess their products have created.”