• Research Review
• Journal Review

Authors: JF Thrasher, V Villalobos, A Dorantes-Alonso, et al.

Reference: Tobacco Control 2009;18:431-437 (open access) http://tobaccocontrol.bmj.com/content/18/6/431.full

Reviewer: Joaquin Barnoya, MD, MPH, Contributing Editor, ProCor; Research Assistant Professor of Surgery, Washington University in St. Louis, Missouri, USA; Director, Research and Education, Unidad de Cirugia Cardiovascular de Guatemala, Guatemala

Reviewer comments: Single cigarette sales, which are banned in most countries, still continue primarily in developing countries. In Mexico, as this paper shows, it is still highly prevalent and even though most smokers surveyed did not report purchasing single cigarettes, many of them did so intending to quit or as a harm reduction strategy. These results should be highlighted as single cigarettes sales might undermine serious quit attempts.

Purpose of study: In Mexico, since 1999, it is illegal to sell single cigarettes. However, it has been found that this practice is still highly prevalent in Mexico City. This study sought to assess perceptions, prevalence, and correlates of single-cigarette purchase behavior and its relation to harm reduction.

Location of study: Mexico

Study design: Focus groups were conducted in 2006. In addition, survey data were drawn from the 2006 International Tobacco Control Policy Evaluation Project. Participants (n=1079) were asked about frequency of single cigarette purchases, when purchases were made to reduce smoking frequency, when single cigarettes were available for purchase, and if they experienced any cravings when seeing single cigarettes on sale.

Results: Seventy-five adults participated in the focus groups. One or more participants in the focus group said they had purchased single cigarettes and described that they had done it as a method for quitting, cutting down, or keeping from smoking too many cigarettes. Most survey respondents were male and daily smokers (79%). Most (90%) bought a cigarette pack at their last cigarette purchase and 9% bought single cigarettes. Average cost per single cigarette was 1.68 pesos ($0.15), which is more than double the unit cost of a cigarette when purchased in a pack of 20. Most single cigarettes were bought in small neighborhood stores. The likelihood of purchasing single cigarettes was positively associated with low income, smoking less regularly, intending to quit, smoking single cigarettes to control consumption, and frequency of cues to smoke after seeing a single cigarette for sale. Those who most frequently purchased single cigarettes to reduce consumption were more likely than those who did not to intend to quit.