Effect of price on the decision to experiment with cigarette smoking among Gambian children: a survival analysis using the Gambia 2017 Global Youth Tobacco Survey data.

OBJECTIVES: To investigate the relationship between cigarette prices and smoking experimentation among children in the Gambia, and thereby expanding the evidence base of the likely impact of excise taxes on cigarette demand in low-income and middle-income countries. DESIGN: A survival analysis using the Gambia 2017 Global Youth Tobacco Survey data. SETTING: The Gambia. PARTICIPANTS: The survey sample was 12 585 youths, aged 12-17 years, but our analysis was restricted to 11 030 respondents with information on smoking status. PRIMARY AND SECONDARY OUTCOME MEASURES: Our outcome variable was smoking experimentation defined as the first time the respondent smoked (at least part of) a cigarette. RESULTS: A 1% increase in the price of cigarettes reduces the probability to experiment with smoking by 0.7%. We also found that children are more likely to experiment with smoking if they have at least one smoking parent, friends who smoke and see teachers who smoke. The probability to experiment with cigarette smoking increases with age and is higher among boys than girls. CONCLUSION: There is strong evidence that increasing excise taxes can play an effective role in discouraging children from experimenting with cigarette smoking. Considering the relatively low excise tax burden in the Gambia, the government should consider substantially increasing the excise tax burden.