Impact of cigarette price and tobacco control policies on youth smoking experimentation in Albania

Background Albania has one of the highest smoking prevalences in Europe and it is particularly high among the youth population. There is a dearth of evidence in Albania, most of Eastern Europe and most middle-income countries on the effect of price on smoking experimentation. Objective The study aimed to assess the effect of price and tobacco control policies on youth smoking experimentation in Albania. Methods We used microdata from the Global Youth Tobacco Survey in Albania for 2004, 2009, 2015 and 2020. We constructed a pseudo-longitudinal dataset and estimated a split-population model to assess the hazard of smoking initiation. Results Price is a significant predictor of smoking experimentation among teenagers in Albania for both males and females (p<0.001). Being male increases the odds for smoking experimentation by more than 50% as compared with females (p<0.001), whereas females appear to be more price sensitive. Peer and parent smoking are also important determinants for smoking experimentation. Introducing penalties for smokers and legal entities violating smoke-free policies implemented in 2014 is also associated with a lower hazard of smoking experimentation. Conclusion Price is a significant predictor of smoking experimentation among teenagers in Albania for both males and females. A combination of increasing taxes and strengthening the rule of law to control tobacco use in public spaces, in addition to public awareness campaigns targeting both youth and smoking parents, could help to significantly reduce the probability of smoking experimentation.