The Influence of Cigarette Ingredients on Smoking Cessation Rates

It has been suggested that the common practice of adding ingredients to cigarette tobacco might affect patterns of smoking initiation, consumption or cessation. These suggestions have themselves prompted claims that regulation of such ingredients may contribute to reducing the prevalence of tobacco use and dependence among new and continuing smokers. In order to investigate the evidential basis for such claims, we performed a cross-sectional statistical analysis of smoking quit ratios across a sample of 80 countries, comparing those with high market shares of traditional blended cigarettes and those with high market shares of Virginia-style cigarettes, utilizing the fact that traditional blended cigarettes contain added ingredients whereas Virginia-style cigarettes contain no or very few added ingredients. Our results support the findings of our previous study performed in 2012 (across a sample of 46 countries), showing no evidence that the hypothesised effects exist with regard to quit ratios, and find that the use of ingredients can account for virtually none of the crosscountry variation in quit behaviour. This conclusion is robust to alternative specifications of variables, and to controlling for a variety of socio-economic indicators in a multivariate regression setting. We find socio-economic variables - notably income, education and internet access - exert a significant effect on the quit ratio, inducing higher cessation rates as standards in medical care and information improve as societies develop. We also find various tobacco control measures induce high quit ratios across countries. Both of these findings are in line with existing international evidence on smoking patterns.