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Making tobacco products less affordable is one of the best ways to control tobacco use. Studies on the effect of relative income price (RIP (ie, affordability)) of cigarettes on smoking initiation are scarce in low-income and middle-income countries, especially in Sub-Saharan Africa where data are limited. The goal of this study is to examine the effect of cigarette RIP on adolescent smoking initiation in Ghana.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The study uses a pseudo-longitudinal data set constructed from the Global Youth Tobacco Surveys (GYTS (2000\u20132009 and 2017)) and RIP for the most sold cigarette brand in Ghana.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>The GYTS is a national survey on adolescents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome<\/jats:title>\n                    <jats:p>Effect of RIP on adolescent smoking initiation in Ghana.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Using the GYTS 2000\u20132009 data, we find that the probability of smoking initiation falls significantly in response to a higher RIP, with an elasticity of \u22120.372 (95% CI \u22120.701 to \u22120.042) for the unmatched sample and \u22120.490 (95% CI \u22120.818 to \u22120.161) for the matched sample. The RIP elasticity for women ((\u22120.888) (95% CI \u22121.384 to \u22120.392) and (\u22120.928) (95% CI \u22121.434 to \u22120.422)) is statistically significant at 1% in both the unmatched and the matched samples, respectively, while the RIP elasticity for men is statistically insignificant in the 2000\u20132009 surveys. Analysis of the 2017 GYTS shows a similar outcome: a negative relationship between RIP and smoking initiation, and the results are statistically significant for both men and women, and for both matched and unmatched samples.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The affordability (RIP) of cigarettes is negatively related to the probability of smoking initiation among adolescents in Ghana. Raising tobacco taxes in line with income growth would make cigarettes less affordable and dissuade adolescents from initiating smoking.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-054367","type":"journal-article","created":{"date-parts":[[2022,3,16]],"date-time":"2022-03-16T12:18:36Z","timestamp":1647433116000},"page":"e054367","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Effect of relative income price on smoking initiation among adolescents in Ghana: evidence from pseudo-longitudinal data"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1062-889X","authenticated-orcid":false,"given":"Micheal Kofi","family":"Boachie","sequence":"first","affiliation":[{"name":"SAMRC\/Wits Centre for Health Economics and Decision Science \u2014 PRICELESS SA, School of Public Health, University of the Witwatersrand, Johannesburg, Gauteng, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mustapha","family":"Immurana","sequence":"additional","affiliation":[{"name":"Institute of Health Research, University of Health and Allied Sciences, Ho, Volta Region, Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ernest Ngeh","family":"Tingum","sequence":"additional","affiliation":[{"name":"Department of Economics, University of Namibia, Windhoek, Namibia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noreen Dadirai","family":"Mdege","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of York, York, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5799-1915","authenticated-orcid":false,"given":"Hana","family":"Ross","sequence":"additional","affiliation":[{"name":"Research Unit on the Economics of Excisable Products (REEP), School of Economics, University of Cape Town, Rondebosch, Western Cape, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,3,16]]},"reference":[{"key":"2025121407512220000_12.3.e054367.1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.38142.554479.AE"},{"key":"2025121407512220000_12.3.e054367.2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2014-006993"},{"key":"2025121407512220000_12.3.e054367.3","unstructured":"World Health Organization . 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