The price of nicotine dependence: A comparison of the cost of nicotine across products in Switzerland, Germany, USA, Sweden, France and the UK, in 2019 [short report].

Jakob, Julian; Joss, Sandra; Meier, Armando N; Tal, Kali; Schoeni, Anna; Marti, Joachim; Diethelm, Pascal; Auer, Reto (2022). The price of nicotine dependence: A comparison of the cost of nicotine across products in Switzerland, Germany, USA, Sweden, France and the UK, in 2019 [short report]. Tobacco prevention and cessation, 8, p. 42. European Publishing 10.18332/tpc/156052

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Tobacco cigarette taxes aim at reducing smoking, but smokers are still dependent on nicotine and need safe and cheap alternatives. As the costs play a role in the product chosen, we compared standardized nicotine costs across products and countries.


We gathered prices of tobacco cigarettes, heated tobacco products (HTP), pharmaceutical nicotine replacement therapy (pNRT) gums, snus, and open and closed electronic nicotine delivery systems (ENDS) in 6 countries (Switzerland, Germany, USA, Sweden, France, UK) in 2019. We compared the cost of a pack of cigarettes in Switzerland to the cost of equivalent doses of nicotine delivered by other products and across countries, normalizing to purchasing power GDP per capita to compute relative adjusted costs (RACs).


Adjusted tobacco cigarette cost was lowest in Switzerland, Germany, and Sweden; RAC for pNRT was 1.1 in Switzerland and 1.0 in Germany. In France and the UK, RACs for cigarettes were 1.5 and 2.1, while for pNRT they were cheaper (RAC: 0.04). In Switzerland, snus/nicotine pouches were the cheapest form of nicotine delivery (RAC: 0.2), open ENDS were a low-cost option for nicotine delivery in all countries (RAC: 0.2-0.3), and HTP cost more than regular tobacco products in most countries.


We found broad differences in costs of nicotine according to countries and products. This should be considered in future studies on smoking prevalence and in public health efforts.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM)
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine

Graduate School:

Graduate School for Health Sciences (GHS)

UniBE Contributor:

Jakob, Julian, Joss, Sandra, Tal, Kali, Schöni, Anna, Auer, Reto


600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services




European Publishing


[4] Swiss National Science Foundation ; [220] Swiss Academy of Medical Sciences = Schweizerische Akademie der Medizinischen Wissenschaften ; [234] Tabakpräventionsfonds = Tobacco Control Fund




Pubmed Import

Date Deposited:

08 Dec 2022 10:57

Last Modified:

02 Mar 2023 23:36

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

health economics health equity nicotine replacement smoking cessation tobacco




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