In Mexico, there are strong arguments for increasing cigarette taxes. Revenue raised could be used to further prevent tobacco consumption and to finance current funding shortages for the treatment of diseases related to smoking.

Aim Mexico implemented annual tax increases between 2009 and 2011. We examined among current smokers the association of price paid per cigarette and daily cigarette expenditure with smoking-induced deprivation (SID) and whether the association of price or expenditure with SID varies by income. Methods We used data (n = 2410) from three waves of the International Tobacco Control Mexico survey (ie, 2008, 2010, 2011) and employed logistic regression to estimate the association of price paid per cigarette and daily cigarette expenditure with the probability of SID (‘In the last 6 months, have you spent money on cigarettes that you knew would be better spent on household essentials like food?’). Results Price paid per cigarette increased from Mex $1.24 in 2008, to Mex$1.36 in 2010, to Mex$1.64 in 2011. Daily cigarette expenditure increased from Mex $6.9, to Mex$7.6 and to Mex$8.4 in the 3 years. There was no evidence of an association between price and SID. However, higher expenditure was associated with a higher probability of SID. There was no evidence that the association of price or expenditure with SID varied by income. Conclusion Tax increases in Mexico have resulted in smokers paying more and spending more for their cigarettes. Those with higher cigarette expenditure experience more SID, with no evidence that poorer smokers are more affected.

The association of insurance expansions and the distribution of health status is still a matter we know little about. This paper draws upon new measures of pure (univariate) inequality and mobility which accommodate categorical data to understand how an expansion of public insurance may be related to both health inequality and mobility. These measures require a definition of individual's status that is either "downward looking" or "upward looking". Using data from the Mexican Family Life Survey, a nationally representative longitudinal survey, we find that the distribution of health has worsened in Mexico between 2002 and 2009, although the change is only consistent for an upward looking definition status. Together with the lack of mobility in self-reported health, we can thus conclude that Mexico has become more rigid over time despite the rapid public health expansion that took place over the 2000s decade. While further research on the potential drivers of health inequalities is needed, our findings suggest that insurance coverage alone may be not enough to reduce health disparities and promote health mobility. Indeed, health inequality and mobility likely depend on a myriad of factors beyond health care.

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