Trends in and correlates of use of roll-your-own cigarettes: a population study in England 2008-2017.

Abstract

INTRODUCTION\nUnderstanding the use of cheaper roll-your-own cigarettes may have implications for tobacco tax policy. We examined trends in RYO cigarette use in England between 2008 and 2017, and characterised users sociodemographic and smoking profiles.\n\n\nMETHODS\nWe used data from 211,469 respondents to a survey representative of the adult (≥16y) population. In current smokers across the entire study period (n=43,389), we assessed multivariable associations between cigarette type (RYO/FM) and sociodemographic and smoking characteristics. Among current smokers in 2008 and 2017 (n=7,685), we tested interactions between year and cigarette type to assess the stability of each characteristic.\n\n\nRESULTS\nBetween 2008 and 2017, FM cigarette use declined from 15.3% to 9.2% while RYO use increased from 6.7% to 8.1%. Greater odds of RYO use were observed among younger, male smokers from lower social grades, who were more addicted and used e-cigarettes (ORrange=1.28-1.86, p<0.001). Lower odds of RYO use were observed among non-daily smokers, those with high motivation to stop, and higher spending on smoking (ORrange=0.46-0.89, p≤0.001). The RYO smoker profile was relatively stable between 2008 and 2017. However, compared with FM use, RYO use increased in younger (p<0.001) and female (p=0.019) smokers, and there was a relatively smaller decline in the proportion cutting down or trying to quit (p=0.004).\n\n\nCONCLUSION\nIn England, RYO use increased when overall smoking prevalence and FM use decreased. The profile of RYO smokers remained relatively stable, with users typically younger, male, more addicted, deprived, spending less on smoking, and less inclined to quit than FM smokers.\n\n\nIMPLICATIONS\nThis population-based study provides novel insight into recent trends in RYO use in England, providing an up-to-date understanding of the profile of RYO smokers in England. Without the consistent application of tax across the range of combustible products, smokers who are more dependent are able to capitalise on the lower cost of RYO in order to continue smoking, undermining the potential benefit of taxation on cessation.