Impact of tobacco price and taxation on affordability and consumption of tobacco products in the South-East Asia Region: A systematic review

Abstract

INTRODUCTION The objective of the review was to study the impact of tobacco taxes or prices on affordability and/or consumption of tobacco products in WHO South-East Asia Region (SEAR) countries, overall and by socioeconomic status; and change in consumption of one tobacco product for a given change in price/tax on another tobacco product. METHODS The searches were made in five databases (Medline, Embase, Cinahl, EconLit, Tobacconomics) using keywords such as 'tobacco', 'tax', 'price', 'impact' with their synonyms. Additionally, the first 100 articles through google search and e-reports from targeted sources were also reviewed. Studies illustrating the impact of prices/taxes on consumption/affordability of tobacco products in SEAR, in English and with no limitation on year, were included in the review. After two steps of screening, data from 28 studies were extracted using a structured and pre-tested data extraction form. RESULTS Of the 28 studies, 12 studies reported an inverse association between price and consumption/affordability, while 11 studies reported no or positive association between price and consumption/affordability of tobacco products. Five studies had unclear interpretations. The majority of studies estimated that the less affluent group were more price responsive compared to the more affluent group. Some studies indicated increased consumption of one product in response to price rise of another product, although, the findings were inconsistent. CONCLUSIONS The findings of our review support the use of tobacco tax and price measures as effective tools to address the tobacco epidemic. Our findings, however, also emphasize the importance of increasing tobacco product taxes and prices sufficiently to outweigh the effects of income growth, in order for the measures to be effective in reducing the affordability and consumption of tobacco products.

As countries improve their cigarette tax policy, cigarette consumption declines

“…5 Previous studies have examined the effects of each cigarette tax component on cigarette smoking. Higher cigarette prices have been shown to decrease overall tobacco consumption, [6][7][8][9][10] cause…”

“…Previous studies have examined the effects of each cigarette tax component on cigarette smoking. Higher cigarette prices have been shown to decrease overall tobacco consumption,6–10 cause current smokers to quit11–14 and prevent young people from starting smoking 8 15–17. Similarly, studies have shown that as cigarettes become less affordable, consumption decreases 9 18–20.…”

“…Higher cigarette prices have been shown to decrease overall tobacco consumption,6–10 cause current smokers to quit11–14 and prevent young people from starting smoking 8 15–17. Similarly, studies have shown that as cigarettes become less affordable, consumption decreases 9 18–20. Affordability is often measured as relative income price (RIP)—the percentage of per-capita income required to purchase 100 packs of cigarettes.…”

Real-world, anti-tobacco environmental impact upon priceinduced smoking reduction among urban Chinese men: Evidence from China’s 2015 cigarette tax increase

“…The researchers found that although some WHO South-East Asia Region (SEAR) countries have sought to raise the price of tobacco products, their tobacco control policies have not kept pace with rapid economic growth. Consequently, to reduce the affordability and consumption of tobacco products, it is important to increase taxes on tobacco products and raise their prices sufficiently to outweigh the effects of income growth 16 . Only when recognizing the high economic burden incurred by smoking do smokers quit in order to enjoy better health and more disposable income 17 .…”

Socioeconomic differences in the impact of prices and taxes on tobacco use in low- and middle-income countries–A systematic review

“…Recent reviews that examined the impact of price or tax on tobacco typically focused solely on high-income countries [ 20 – 22 ] or pointed to a dearth of studies that used data from LMICs [ 23 ]. A 2021 review of south-eastern Asian countries included only five studies that had examined socioeconomic differences in price responsive, and only one published after 2010 [ 24 ]. Similarly, a 2015 review of Latin America and the Caribbean countries identified a single study that had reported price effects by SES categories [ 6 ].…”