Impact of smoke-free legislation on cigarette price and affordability in Wuhan, China: a repeated cross-sectional study
- 1Wuhan Center for Disease Control & Prevention, No. 288, Machang Road, Changqing Street, Jianghan District, Wuhan, China
- 2Medical Department, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
Abstract
Background: The smoke-free legislation (SFL) in Wuhan, China was adopted in January 2020. While its health benefits are documented, the impact on cigarette prices and affordability among smokers remains unclear. This study assessed the impact of Wuhan’s SFL on cigarette prices and affordability.
Methods: Three rounds of repeated cross-sectional surveys were conducted in 2019 (pre-legislation), 2022 and 2024 (post-legislation), following the Global Adult Tobacco Survey (GATS) protocol. A multistage cluster sample design selected representative samples of non-institutionalized permanent residents aged ≥ 15 years. Analysis was restricted to current manufactured cigarette smokers. Cigarette prices were adjusted for inflation and purchasing power parity (PPP) to constant 2024 US dollars. Cigarette affordability was measured as the average cost of 100 packs as a percentage of GDP per capita. Complex sampling designs, ordered logit models and marginal effects analyses were employed.
Results: A total of 8,424 participants were interviewed, with response rates of 94.5% (2019), 92.8% (2022) and 100% (2024). The average amount spent on 20 cigarettes did not change significantly from $5.3 (95%CI: 4.7–5.8) in 2019 to $5.2 (95%CI: 4.2–5.9) in 2024. A wide price range persisted, with mean prices in the lowest quintile ranging from $1.88 to $3.73 and in the highest quintile from $10.72 to $13.60. Cigarette affordability increased significantly. The cost of 100 packs as a percentage of GDP per capita decreased from 2.8% (95%CI: 2.5–3.1) in 2019 to 2.2% (95%CI: 1.8–2.5) in 2024. Compared to 2019, the odds of being in the higher-affordability category increased by 18.2% points in 2024 (p < 0.05). The overall odds of choosing different price-tiers did not change significantly. Smokers who were male, younger (15–24 years), highly educated (college and above), employed in government/corporate sectors, or had no intention to quit had higher odds of choosing upper price-tier cigarettes and having higher cigarette affordability.
Conclusions: Following SFL implementation in Wuhan, cigarette prices remained stable while affordability increased significantly. The wide price range enables potential substitution to cheaper brands. SFL alone is insufficient to curb consumption. National tobacco control legislation should integrate robust tax and floor pricing policies.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12889-026-28693-3.
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BibTeX
@article{mei2026impact,
title = {{Impact of smoke-free legislation on cigarette price and affordability in Wuhan, China: a repeated cross-sectional study}},
author = {Xin Mei and Gong Chen and Yuting Zuo and Fanjie Zeng and Yuanxia Huang and Ling Zhang},
journal = {BMC Public Health},
year = {2026},
month = aug,
doi = {10.1186/s12889-026-28693-3},
url = {https://doi.org/10.1186/s12889-026-28693-3},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Impact of smoke-free legislation on cigarette price and affordability in Wuhan, China: a repeated cross-sectional study
AU - Xin Mei
AU - Gong Chen
AU - Yuting Zuo
AU - Fanjie Zeng
AU - Yuanxia Huang
AU - Ling Zhang
PY - 2026
DA - 2026/08/13
JO - BMC Public Health
DO - 10.1186/s12889-026-28693-3
UR - https://doi.org/10.1186/s12889-026-28693-3
AB - Background: The smoke-free legislation (SFL) in Wuhan, China was adopted in January 2020. While its health benefits are documented, the impact on cigarette prices and affordability among smokers remains unclear. This study assessed the impact of Wuhan’s SFL on cigarette prices and affordability. Methods: Three rounds of repeated cross-sectional surveys were conducted in 2019 (pre-legislation), 2022 and 2024 (post-legislation), following the Global Adult Tobacco Survey (GATS) protocol. A multistage cluster sample design selected representative samples of non-institutionalized permanent residents aged ≥ 15 years. Analysis was restricted to current manufactured cigarette smokers. Cigarette prices were adjusted for inflation and purchasing power parity (PPP) to constant 2024 US dollars. Cigarette affordability was measured as the average cost of 100 packs as a percentage of GDP per capita. Complex sampling designs, ordered logit models and marginal effects analyses were employed. Results: A total of 8,424 participants were interviewed, with response rates of 94.5% (2019), 92.8% (2022) and 100% (2024). The average amount spent on 20 cigarettes did not change significantly from $5.3 (95%CI: 4.7–5.8) in 2019 to $5.2 (95%CI: 4.2–5.9) in 2024. A wide price range persisted, with mean prices in the lowest quintile ranging from $1.88 to $3.73 and in the highest quintile from $10.72 to $13.60. Cigarette affordability increased significantly. The cost of 100 packs as a percentage of GDP per capita decreased from 2.8% (95%CI: 2.5–3.1) in 2019 to 2.2% (95%CI: 1.8–2.5) in 2024. Compared to 2019, the odds of being in the higher-affordability category increased by 18.2% points in 2024 (p < 0.05). The overall odds of choosing different price-tiers did not change significantly. Smokers who were male, younger (15–24 years), highly educated (college and above), employed in government/corporate sectors, or had no intention to quit had higher odds of choosing upper price-tier cigarettes and having higher cigarette affordability. Conclusions: Following SFL implementation in Wuhan, cigarette prices remained stable while affordability increased significantly. The wide price range enables potential substitution to cheaper brands. SFL alone is insufficient to curb consumption. National tobacco control legislation should integrate robust tax and floor pricing policies. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12889-026-28693-3.
SN - 1471-2458
ER -