OBJECTIVES:This study sought to identify instances of brand-switching behavior amongsmokers in Taiwan following a large tax increase. We also investigated the factors underlying the observed behavioral changes.

METHODS:Data were obtained from a nationwide survey monitoring tobacco use among individuals over age 15 in Taiwan. The dependent variable was cigarette brand-switching, defined as the ability to report on the prices of two different brands before and after the 2017 tax increase. Smokers who reported switching to a more expensive brand (1.46%) were excluded, as this was deemed irrational behavior. Analysis was conducted using logistic regression adjusted for gender, age, personal monthly income, marital status, educational attainment, work, knowledge of smoking hazards, quitting experience, main cigarette price before tax increase, exposure to second-hand smoke in the household, advice from medical staff to quit, smoking volume, and awareness of services to assist in quitting.

RESULTS:We found that 4.48% of current smokers switched to a less expensive cigarette brand following the tax increase. Smokers who were using relatively expensive cigarettes before the tax increase (OR=2.46) were more likely than those using moderately priced cigarettes to switch to a less expensive brand after the tax increase. The sub-groups that were more likely to switch to a less expensive brand included current smokers who were male (OR=3.57), had exposure to secondhand smoke (OR=3.61), or were aware of services to assist in quitting (OR=3.61). Those who were less likely to switch included current smokers who were married (OR=0.24), had college or graduate degree (OR=0.40), or received advice from medical staff to quit (OR=0.56).

CONCLUSIONS:We found that relatively few individuals switched to less expensive products after a substantial increase in tobacco tax. Those who switched were from all walks of life; i.e., not only the economically disadvantaged.