Impact of tobacco prices and smoke-free policy on smoking cessation, by gender and educational group: Spain, 1993-2012

Int J Drug Policy. 2015 Dec;26(12):1215-21. doi: 10.1016/j.drugpo.2015.05.011. Epub 2015 Jun 5.


Background: To evaluate the effect of tobacco prices and the implementation of smoke-free legislation on smoking cessation in Spain, by educational level, across the period 1993-2012.

Methods: National Health Surveys data for the above two decades were used to calculate smoking cessation in people aged 25-64 years. The relationship between tobacco prices and smoking quit-ratio was estimated using multiple linear regression adjusted for time and the presence of smoke-free legislation. The immediate as well as the longer-term impact of the 2006 smoke-free law on quit-ratio was estimated using segmented linear regression analysis. The analyses were performed separately in men and women with high and low education, respectively.

Results: No relationship was observed between tobacco prices and smoking quit-ratio, except in women having a low educational level, among whom a rise in price was associated with a decrease in quit-ratio. The smoke-free law altered the smoking quit-ratio in the short term and altered also pre-existing trends. Smoking quit-ratio increased immediately after the ban - though this increase was significant only among women with a low educational level - and then decreased in subsequent years except among men with a high educational level.

Conclusion: A clear relationship between tobacco prices and smoking quit-ratio was not observed in a recent period. After the implementation of smoke-free legislation the trend in the quit ratio in most of the socio-economic groups was different from the trend observed before implementation, so existing inequalities in smoking quit-ratio were not widened or narrowed.

Keywords: Educational level; Smoke-free legislation; Smoking cessation; Spain; Tobacco prices.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Commerce / economics
  • Commerce / statistics & numerical data*
  • Educational Status
  • Female
  • Health Surveys
  • Humans
  • Male
  • Middle Aged
  • Sex Characteristics
  • Smoke-Free Policy / legislation & jurisprudence*
  • Smoking / economics
  • Smoking / legislation & jurisprudence*
  • Smoking Cessation / statistics & numerical data*
  • Spain
  • Tobacco Products / economics*