Lessons learned from fostering tobacco taxes in the Americas and implications for other health taxes

Abstract

During the past decade progress has been made from a public health perspective in advancing tobacco taxation policies in the World Health Organization’s Region of the Americas, and there are important lessons to be learned from this experience. This report aims to systematize and distill the key lessons learned, both by documenting progress and paving the way toward a comprehensive approach to taxing other health-harming products, particularly those considered to be drivers of the noncommunicable disease epidemic, such as alcohol and sugar-sweetened beverages. A thorough review of publications and institutional documents was undertaken and discussions were held with experts about the experiences of the past decade. Broadly, the lessons can be characterized according to the main mechanisms that have fostered progress. These are the robust, consistent and standardized monitoring of tobacco taxes that has enabled comparisons between countries and across time; the setting of tax policy within a framework of multisectoral policy coherence; and the development of guidelines and the generation of independent evidence to support tobacco taxes and tackle harmful industry interference. Currently, progress in these areas is lagging for taxes on alcohol and sugar-sweetened beverages. Applying the lessons learned from the extensive experience with tobacco taxation can help advance progress in taxes on alcohol and sugar-sweetened beverages and capture the potential synergies to be gained from building a comprehensive approach. Although more work is needed in developing and implementing taxation policies across all three products, the findings from this report can assist in strengthening their public health objectives to tackle noncommunicable diseases and improve population health.

Framing, moral foundations and health taxes: interpretive analysis of Ethiopia’s tobacco excise tax policy passage

“…EFDA’s successful cultivation of an epistemic community and engagement of several policy entrepreneurs and policy champions—both from government agencies and civil society organisation—is one of the secrets behind its compelling affirmative policy narrative, and is an example of how alliances, argumentation, and policy levers can be streamlined to influence policy outcomes. A similar strategy was employed by public health camp in Argentina, where networking with strategic partners and policy champions and presenting a united front via an agreed on ‘communications strategy’ were effective in adopting an excise tax on tobacco products, leading to a 50% increase in average retail price of 43 44…”