Effects of tobacco taxation and pricing on smoking behavior in high risk populations: a knowledge synthesis.

Pearl Bader,Roberta Ferrence,David Boisclair

doi:10.3390/ijerph8114118

Abstract

Tobacco taxation is an essential component of a comprehensive tobacco control strategy. However, to fully realize the benefits it is vital to understand the impact of increased taxes among high-risk subpopulations. Are they influenced to the same extent as the general population? Do they need additional measures to influence smoking behavior? The objectives of this study were to synthesize the evidence regarding differential effects of taxation and price on smoking in: youth, young adults, persons of low socio-economic status, with dual diagnoses, heavy/long-term smokers, and Aboriginal people. Using a better practices approach, a knowledge synthesis was conducted using a systematic review of the literature and an expert advisory panel. Experts were involved in developing the study plan, discussing findings, developing policy recommendations, and identifying priorities for future research. Most studies found that raising cigarette prices through increased taxes is a highly effective measure for reducing smoking among youth, young adults, and persons of low socioeconomic status. However, there is a striking lack of evidence about the impact of increasing cigarette prices on smoking behavior in heavy/long-term smokers, persons with a dual diagnosis and Aboriginals. Given their high prevalence of smoking, urgent attention is needed to develop effective policies for the six subpopulations reviewed. These findings will be of value to policy-makers and researchers in their efforts to improve the effectiveness of tobacco control measures, especially with subpopulations at most risk. Although specific studies are needed, tobacco taxation is a key policy measure for driving success.

Highlights

If it were totally up to me, I would raise the cigarette tax so high the revenues from it would go to zero.– Michael Bloomberg (New York mayor)Significant gains have been made in reducing the prevalence of smoking for the general population in North America and other high-income countries
We systematically reviewed and synthesized evidence regarding the effects of tobacco taxation and pricing on smoking behavior in six high-risk subpopulations
19 studies were identified for young adults, 25 for persons with low socio-economic status, three for persons with a dual diagnosis, one for heavy and/or long-term smokers and two for Aboriginal people (7 studies examined both youth and young adults, 1 both youth and low Socio-Economic Status (SES), for a total of 108 discrete studies)

Summary

Introduction

Significant gains have been made in reducing the prevalence of smoking for the general population in North America and other high-income countries. Responses to tobacco control interventions and pathways to change in smoking behavior can vary substantially among subgroups of smokers. Even for those who benefit from these measures, they do not gain and major disparities exist. Tobacco taxation, passed on to consumers in the form of higher cigarette prices, has been recognized as one of the most effective population-based strategies for decreasing smoking and its adverse health consequences [1,2,3,4]. A price increase of 10% on a pack of cigarettes would reduce demand for cigarettes by about 4% for the general adult population in high income countries [4]

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Conclusion