Importance  Raising the price of cigarettes by increasing taxation has been associated with improved perinatal and child health outcomes. Transnational tobacco companies have sought to undermine tobacco tax policy by adopting pricing strategies that maintain the availability of budget cigarettes.

Objective  To assess associations between median cigarette prices, cigarette price differentials, and infant mortality across the European Union.

Design, Setting, and Participants  A longitudinal, ecological study was conducted from January 1, 2004, to December 31, 2014, of infant populations in 23 countries (comprising 276 subnational regions) within the European Union.

Interventions  Median cigarette prices and the differential between these and minimum cigarette prices were obtained from Euromonitor International. Pricing differentials were calculated as the proportions (%) obtained by dividing the difference between median and minimum cigarette price by median price. Prices were adjusted for inflation.

Main Outcomes and Measures  Annual infant mortality rates. Associations were assessed using linear fixed-effect panel regression models adjusted for smoke-free policies, gross domestic product, unemployment rate, education, maternal age, and underlining temporal trends.

Results  Among the 53 704 641 live births during the study period, an increase of €1 (US $1.18) per pack in the median cigarette price was associated with a decline of 0.23 deaths per 1000 live births in the same year (95% CI, –0.37 to –0.09) and a decline of 0.16 deaths per 1000 live births the following year (95% CI, –0.30 to –0.03). An increase of 10% in the price differential between median-priced and minimum-priced cigarettes was associated with an increase of 0.07 deaths per 1000 live births (95% CI, 0.01-0.13) the following year. Cigarette price increases across 23 European countries between 2004 and 2014 were associated with 9208 (95% CI, 8601-9814) fewer infant deaths; 3195 (95% CI, 3017-3372) infant deaths could have been avoided had there been no cost differential between the median-priced and minimum-priced cigarettes during this period.

Conclusions and Relevance  Higher cigarette prices were associated with reduced infant mortality, while increased cigarette price differentials were associated with higher infant mortality in the European Union. Combined with other evidence, this research suggests that legislators should implement tobacco tax and price control measures that eliminate budget cigarettes.

重要性  通过增加税收来提高卷烟价格与改善围产期和儿童健康状况有关。跨国烟草公司试图通过采用维持廉价卷烟供应的定价策略来破坏烟草税收政策。

目的  评估整个欧盟的卷烟价格中位数，卷烟价格差异和婴儿死亡率之间的关联。

设计，环境和参与者  从2004年1月1日至2014年12月31日，对欧盟内23个国家（包括276个国家以下地区）的婴儿种群进行了纵向的生态研究。

干预措施  中烟价格以及这些价格与最低烟价之间的差额可从Euromonitor International获得。定价差异计算为通过将中位数和最低卷烟价格之间的差异除以中位数价格而获得的比例（％）。价格根据通货膨胀进行了调整。

主要成果和措施  婴儿的年死亡率。使用线性固定效应面板回归模型对协会进行评估，该模型针对无烟政策，国内生产总值，失业率，教育程度，产妇年龄和强调时间趋势进行了调整。

结果  在研究期间的53 704 641例活产婴儿中，每包卷烟中位数价格每包增加1欧元（1.18美元），导致同一年每1000例活产婴儿死亡0.23下降（95％CI，- 0.37至–0.09），第二年每千名活产婴儿死亡人数下降0.16（95％CI，-0.30至–0.03）。第二年，中位数价格和最低价格的卷烟之间的价格差异增加10％，导致每千名活产儿死亡0.07例（95％CI，0.01-0.13）。2004年至2014年间，欧洲23个国家/地区的卷烟价格上涨导致婴儿死亡人数减少了9208（95％CI，8601-9814）；如果在此期间中位数价格和最低价格的卷烟之间没有成本差异，则可以避免3195（95％CI，3017-3372）婴儿死亡。

结论与相关性  在欧盟，较高的卷烟价格与降低婴儿死亡率相关，而增加的卷烟价格差异与较高的婴儿死亡率相关。结合其他证据，这项研究表明，立法者应实施烟草税和价格控制措施，以消除廉价卷烟。