Cheap cigarettes may save smokers money at the expense of infant lives, new research suggests. Researchers found that high cigarette prices were associated with reduced infant mortality in the European Union, whereas increased price differences between premium and “budget” cigarettes were linked with more infant deaths.
“We wanted to see if the availability of budget cigarettes can be linked to infant mortality,” study coauthor Filippos T. Filippidis of the Imperial College London, England told Fatherly. Cheap or budget cigarettes, he explains, are brands tobacco companies keep purposely low even in expensive markets, by manipulating taxes. “This is the first study to show that the price difference between ‘budget’ and average-priced brands is associated with infant mortality.”
Past studies have demonstrated that the taxation of tobacco can reduce smoking prevalence. But whether higher tobacco prices mean that fewer people are harmed by secondhand smoke is less clear. In theory, pricey cigarettes should mean that fewer people smoke, which should mean fewer pregnant women and new mothers are exposed. The upshot, studies suggest, is that fewer cigarettes should translate into healthier babies, especially since smoking around pregnant women is linked to premature birth and birth defects, and smoking around infants is linked to Sudden Infant Death Syndrome.
While cigarettes have become less affordable in the EU since 2003, it has not been uniform because transnational tobacco companies have dealt with increased taxation by loading tax increases onto premium brands. This keeps budget brands cheap, and undermines the smoking reduction that taxes help to facilitate.“There have been some studies that looked directly into the link between cigarette prices and infant mortality, but most researchers focus on average cigarette prices,” Filippidis says.
So Filippidis and his team analyzed data on cigarette prices and infant mortality rates among 53,704,641 live births in 23 EU countries between 2004 and 2014. After adjusting for price inflation, smoke-free policies, gross domestic product, unemployment rate, education, and maternal age, Filippidis and his team found that an increase in cost of $1.18 per pack was associated with a decline of 0.23 deaths per 1000 live births—in other words, the results suggest that 1 out of every 4,000 otherwise healthy infants who died in Europe between 2004 and 2014 would not have died had cigarette prices been $1 more expensive. Overall, Filippidis and colleagues found that cigarette price hikes across the EU saved more than 9,000 infant lives between 2004 and 2014. Had these countries weeded out budget cigarettes, an additional 3,000 lives could have been saved.
The findings, though compelling, are not without caveats. Filippidis notes the importance of being cautious with causal associations. “There is always the chance that there may be another factor that is responsible for the observed association,” he says. Filippidis recommends future research look more closely into how budget cigarettes impact smoking during pregnancy specifically, in addition to studies that look at all tobacco products, not just cigarettes.
Christopher F. Baum, a professor of economics at Boston University who has studied the impact of tobacco taxes on infant mortality (but was not involved in this study), told Fatherly that follow-up studies should also look at individual-level data in order to get more information on how prices, price differentials, and infant mortality relate to one another. Still, he praises the work, “which allows analysis of smokers’ behavioral changes in seeking less expensive ways to feed their habit,” Baum says. “Their computed estimates of reduction in infant deaths are plausible and statistically significant.”
The implications are clear—capping the minimum cost of cigarettes could save lives. “As a father myself,” Filippidis says, “I can confidently say that protecting your child from smoking is one of the most important things you will ever do as a parent.”