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We investigated the relationship between tobacco tax increases and PMBs, measuring whether PMBs intensify following tax increases, whether low\u2010income consumers with higher nicotine dependence are more likely to engage in PMBs and whether PMBs are negatively related to smoking cessation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>This was a systematic review with meta\u2010analysis of cross\u2010sectional and longitudinal studies from seven databases up to March 2023, using studies that reported any product\u2010 and purchasing\u2010related smoking behaviours post\u2010tobacco tax increase in a general representative population. Sixty\u2010eight\u00a0studies were quality\u2010assessed using the Newcastle\u2013Ottawa scale. All studies were narratively synthesized, with five studies involving 13\u2009068\u201326\u2009575 participants providing data for pooled analyses on PMBs [purchasing lower\u2010priced brands, roll\u2010your\u2010own (RYO) tobacco and cartons] pre\u2010 and post\u2010tax increases using a random effects meta\u2010analytical model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fifty\u2010seven studies reported on legal PMBs, and 17 studies reported illicit cigarette purchasing. Meta\u2010analysis showed that consecutive tax increases were positively associated with purchasing RYO [odds ratio (OR)\u2009=\u20091.60, 95% confidence interval (CI)\u2009=\u20091.04\u20132.46], especially in higher tobacco taxing environments, with substantial heterogeneity (\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u200996%). Lower income and higher nicotine dependence were associated with purchasing lower\u2010priced brands and RYO, whereas higher income and nicotine dependence were associated with purchasing cartons, large\u2010sized packs and cross\u2010border sales. Less evidence associated illicit tobacco purchases with tax increases or PMBs with smoking cessation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Tobacco purchasers\u2019 PMBs vary widely by state, country and time\u2010period within countries. Both legal and illegal PMBs, potentially influenced by industry pricing tactics, may exacerbate health inequalities and dilute the public health benefits of tobacco tax increases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/add.16618","type":"journal-article","created":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T19:13:41Z","timestamp":1721070821000},"page":"1923-1936","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["The effect of tobacco tax increase on price\u2010minimizing tobacco purchasing behaviours: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"119","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1430-4975","authenticated-orcid":false,"given":"Ara","family":"Cho","sequence":"first","affiliation":[{"name":"Faculty of Medicine, School of Public Health The University of Queensland  Herston Queensland Australia"},{"name":"The NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health The University of Queensland  Herston Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1595-6307","authenticated-orcid":false,"given":"Carmen","family":"Lim","sequence":"additional","affiliation":[{"name":"The NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health The University of Queensland  Herston Queensland Australia"},{"name":"The National Centre for Youth Substance Use Research The University of Queensland  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3939-9499","authenticated-orcid":false,"given":"Tianze","family":"Sun","sequence":"additional","affiliation":[{"name":"The NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health The University of Queensland  Herston Queensland Australia"},{"name":"The National Centre for Youth Substance Use Research The University of Queensland  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7569-1948","authenticated-orcid":false,"given":"Gary","family":"Chan","sequence":"additional","affiliation":[{"name":"The NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health The University of Queensland  Herston Queensland Australia"},{"name":"The National Centre for Youth Substance Use Research The University of Queensland  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6651-8035","authenticated-orcid":false,"given":"Coral","family":"Gartner","sequence":"additional","affiliation":[{"name":"The NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health The University of Queensland  Herston Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,7,15]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/tc.2010.039982"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/961724"},{"key":"e_1_2_10_4_1","unstructured":"US National Cancer Institute and World Health Organization.The economics of tobacco and tobacco control. 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