Objectives: Cigarette affordability considers the price smokers pay for cigarettes in relation to their incomes. Due to differential taxes levied on FM cigarettes and loose tobacco in the EU, RYO smokers may have greater ability to pay for cigarettes. This study estimated the affordability of FM and RYO cigarettes in 6 EU countries.

Methods: Data from Wave 1 (2016) and Wave 2 (2018) of the EUREST-PLUS ITC 6 European Country Survey were used to estimate affordability among current smokers from Germany (n=1155), Greece (n=1263), Hungary (n=1029), Poland (n=955), Romania (n=1312), and Spain (n=803). Affordability, defined as the cigarette price to daily income ratio (CPDIR), compares the price smokers paid for a daily dose of cigarettes to their daily household income. Average CPDIR within country over time across products was estimated using weighted linear generalized estimating equations (GEE). Models accounted for the multi-stage sampling design and controlled for sex, age, urbanization, education, smoking status (daily, non-daily), and time-in-sample.

Results: With the exception of Poland, RYO cigarettes were significantly more affordable than FM cigarettes in Germany, Greece (2018 only), Hungary, Romania, and Spain (all p<0.01). In Germany, RYO smokers spent 2.5% of their daily income on cigarettes while FM smokers spent 6.6% in 2016 (p<0.001). In that same year, RYO smokers from Spain spent 4.9% of their daily income on cigarettes while FM smokers spent 10% (p<0.001). FM smokers from Romania spent the largest share of daily income on cigarettes (26% in 2016; 22% in 2018). FM cigarettes became more affordable in Hungary from 2016 to 2018 (CPDIR=12% in 2016 and 8.8% in 2018, p<0.05). Across all countries, the affordability of RYO cigarettes did not change significantly from 2016 to 2018.