The health and economic burden associated with sugar-sweetened beverage consumption in Trinidad and Tobago.

BACKGROUND: In Trinidad and Tobago, non-communicable diseases (NCDs) are the leading cause of death. Unhealthy diet is one modifiable NCD risk factor, which contributes to the NCD burden. The consumption of sugar-sweetened beverages (SSBs) has been associated with an increased risk of NCDs. AIM: The aim of this paper is to estimate the burden of disease and economic costs associated with the consumption of SSBs in Trinidad and Tobago as evidence to support the implementation of health and fiscal policies on SSB consumption. METHODS: The results of this study were obtained through the use of a mathematical model which used a comparative risk assessment approach to estimate the health and economic burden associated with SSB intake, by sex and age. RESULTS: Estimates for one year showed that SSB consumption was associated with approximately 15,000 cases of overweight and obesity in adults and 11,700 cases in children, 28% of all the cases of diabetes and overall, an estimated 387 deaths and 9000 years of healthy life were lost due to premature death and disability. Approximately US$23.1 million was spent in the public healthcare system to treat diseases associated with consumption of sugary beverages. CONCLUSIONS: The consumption of SSBs is associated with increases in diseases, deaths and rising healthcare costs in Trinidad and Tobago. It is hoped that the results of this study will provide an added rationale and impetus for the implementation of policies to reduce the consumption of SSBs.

Increased taxation on cigarettes in Grenada: potential effects on consumption and revenue.

OBJECTIVE: To investigate the feasibility of addressing the public health concerns of tobacco consumption through increased taxation, while preserving or augmenting government revenues in Grenada. METHODS: Purposive sampling methods were used to ensure data availability and geographical representativeness. Average price per 20-pack of the most-sold brands of cigarettes was calculated using data from three major supermarkets. The World Health Organization's Tax Simulation Model was used, with excise tax rates adjusted to effect 5%, 10%, and 15% consumption decreases. RESULTS: A 17% to 117% excise tax increase on the cost, insurance, and freight (CIF) value would achieve a 5% consumption decrease. Total government revenues would grow 8.7% and excise tax revenues would increase 11%. The average excise tax per 20-pack would move from EC$ 3.24 (2014 US$ 1.20) to EC$ 3.80 (US$ 1.41), while the average price per pack would increase to EC$ 9.21 (US$ 3.41) from EC$8.48 (US$ 3.14). In the 10% and 15% consumption reduction scenarios, excise taxes would have to be increased by 33% and 50% (to 133% and 150% of CIF, respectively), pushing the average excise tax per pack to EC$ 4.37 (US$ 1.62) and EC$ 4.90 (US$ 1.81), respectively. CONCLUSION: In Grenada, consumption can be reduced alongside growth in government revenues, making available additional resources for health. This aligns with the literature, which indicates that taxation can be effective in pursuing the public health objective of reduced incidence of smoking-related illnesses via reduced consumption.

Increased taxation on cigarettes in Grenada: potential effects on consumption and revenue

[ABSTRACT]. Objective. To investigate the feasibility of addressing the public health concerns of tobacco consumption through increased taxation, while preserving or augmenting government revenues in Grenada. Methods. Purposive sampling methods were used to ensure data availability and geographical representativeness. Average price per 20-pack of the most-sold brands of cigarettes was calculated using data from three major supermarkets. The World Health Organization’s Tax Simulation Model was used, with excise tax rates adjusted to effect 5%, 10%, and 15% consumption decreases. Results. A 17% to 117% excise tax increase on the cost, insurance, and freight (CIF) value would achieve a 5% consumption decrease. Total government revenues would grow 8.7% and excise tax revenues would increase 11%. The average excise tax per 20-pack would move from EC$ 3.24 (2014 US$ 1.20) to EC$ 3.80 (US$ 1.41), while the average price per pack would increase to EC$ 9.21 (US$ 3.41) from EC$8.48 (US$ 3.14). In the 10% and 15% consumption reduction scenarios, excise taxes would have to be increased by 33% and 50% (to 133% and 150% of CIF, respectively), pushing the average excise tax per pack to EC$ 4.37 (US$ 1.62) and EC$ 4.90 (US$ 1.81), respectively. Conclusion. In Grenada, consumption can be reduced alongside growth in government revenues, making available additional resources for health. This aligns with the literature, which indicates that taxation can be effective in pursuing the public health objective of reduced incidence of smoking-related illnesses via reduced consumption.

[RESUMEN]. Objetivo. Investigar la viabilidad de abordar los problemas de salud pública relacionados con el consumo de tabaco mediante un aumento de los impuestos, al tiempo que se conservan o aumentan los ingresos públicos del gobierno en Granada. Métodos. Se utilizaron métodos de muestreo intencional para garantizar la disponibilidad de datos y su representatividad geográfica. Se calculó el precio promedio del paquete de 20 cigarrillos de las marcas más vendidas a partir de los datos obtenidos en tres grandes supermercados. Se utilizó el Modelo de Simulación de Impuestos de la Organización Mundial de la Salud, con tasas de impuestos al consumo ajustadas para obtener reducciones del 5%, 10% y 15% en el consumo. Resultados. Un aumento del 17% al 117% en el impuesto al consumo sobre el valor del costo, seguro y flete (CSF) ocasionaría una disminución del 5% en el consumo. Los ingresos totales del gobierno crecerían un 8,7% y los ingresos por impuesto al consumo aumentarían un 11%. El impuesto al consumo promedio por paquete de 20 cigarrillos aumentaría de EC$ (dólar del Caribe oriental) 3,24 (USD 1,20 de 2014) a EC$ 3,80 (USD 1,41), y el precio promedio por paquete aumentaría de EC$ 8,48 (USD 3,14) a EC$ 9,21 (USD 3,41). En los escenarios de reducción del consumo del 10% y el 15%, los impuestos al consumo deberían aumentarse en un 33% y 50% (al 133% y 150% del CSF, respectivamente), lo que elevaría el promedio del impuesto al consumo por paquete a EC$ 4,37 (USD 1,62) y EC$ 4,90 (USD 1,81), respectivamente. Conclusión. En Granada, el consumo de tabaco puede reducirse y aumentarse a la vez los ingresos públicos, generando recursos adicionales disponibles para la salud. Esto coincide con la bibliografía publicada, que indica que los impuestos pueden ser eficaces para alcanzar el objetivo de salud pública de reducir la incidencia de enfermedades relacionadas con el hábito de fumar a través de una reducción del consumo.

[RESUMO]. Objetivo. Investigar a viabilidade de abordar problemas de saúde pública relacionados ao consumo de tabaco através de um aumento de impostos, enquanto conserva ou aumenta a receita do governo em Granada. Métodos. Métodos intencionais de amostragem foram utilizados para garantir a disponibilidade de dados e sua representatividade geográfica. O preço médio da embalagem de 20 cigarros das marcas mais vendidas foi calculado a partir dos dados obtidos em três grandes supermercados. Utilizou-se o Modelo de Simulação Tributária da Organização Mundial de Saúde, com taxas de imposto de consumo ajustadas para obter reduções de 5%, 10% e 15% no consumo. Resultados. Um aumento de 17% para 117% na taxa de consumo sobre o valor do custo, seguro e frete (CSF) causaria uma queda de 5% no consumo. As receitas totais do governo aumentariam em 8,7% e as receitas dos impostos sobre o consumo aumentariam em 11%. O imposto médio de consumo por pacote de 20 cigarros aumentaria de EC$ (dólar do Caribe Oriental) 3,24 (USD 1,20 de 2014) para EC$ 3,80 (USD 1,41), e o preço médio por pacote aumentaria de EC$ 8,48 (USD 3,14) para EC$ 9,21 (USD 3,41). Nos cenários de redução do consumo de 10% e 15%, os impostos sobre consumo devem ser aumentados em 33% e 50% (para 133% e 150% do CSF, respectivamente), o que elevaria a média do imposto sobre o consumo por pacote a EC$ 4,37 (USD 1,62) e EC$ 4,90 (USD 1,81), respectivamente. Conclusão. Em Granada, o consumo de tabaco pode ser reduzido e as receitas do governo aumentadas, gerando recursos adicionais disponíveis para a saúde. Isso coincide com a literatura publicada, que indica que os impostos podem ser efetivos para alcançar o objetivo de saúde pública de reduzir a incidência de doenças relacionadas ao tabagismo através da redução do consumo.

Increased taxation on cigarettes in Grenada: potential effects on consumption and revenue / Aumento de los impuestos a los cigarrillos en Granada: efectos potenciales sobre el consumo y los ingresos públicos / Aumento Dos Impostos Sobre Os Cigarros Em Granada: Efeitos Potenciais Sobre O Consumo E As Receitas Públicas

ABSTRACT Objective To investigate the feasibility of addressing the public health concerns of tobacco consumption through increased taxation, while preserving or augmenting government revenues in Grenada. Methods Purposive sampling methods were used to ensure data availability and geographical representativeness. Average price per 20-pack of the most-sold brands of cigarettes was calculated using data from three major supermarkets. The World Health Organization's Tax Simulation Model was used, with excise tax rates adjusted to effect 5%, 10%, and 15% consumption decreases. Results A 17% to 117% excise tax increase on the cost, insurance, and freight (CIF) value would achieve a 5% consumption decrease. Total government revenues would grow 8.7% and excise tax revenues would increase 11%. The average excise tax per 20-pack would move from EC$ 3.24 (2014 US$ 1.20) to EC$ 3.80 (US$ 1.41), while the average price per pack would increase to EC$ 9.21 (US$ 3.41) from EC$8.48 (US$ 3.14). In the 10% and 15% consumption reduction scenarios, excise taxes would have to be increased by 33% and 50% (to 133% and 150% of CIF, respectively), pushing the average excise tax per pack to EC$ 4.37 (US$ 1.62) and EC$ 4.90 (US$ 1.81), respectively. Conclusion In Grenada, consumption can be reduced alongside growth in government revenues, making available additional resources for health. This aligns with the literature, which indicates that taxation can be effective in pursuing the public health objective of reduced incidence of smoking-related illnesses via reduced consumption.

RESUMEN Objetivo Investigar la viabilidad de abordar los problemas de salud pública relacionados con el consumo de tabaco mediante un aumento de los impuestos, al tiempo que se conservan o aumentan los ingresos públicos del gobierno en Granada. Métodos Se utilizaron métodos de muestreo intencional para garantizar la disponibilidad de datos y su representatividad geográfica. Se calculó el precio promedio del paquete de 20 cigarrillos de las marcas más vendidas a partir de los datos obtenidos en tres grandes supermercados. Se utilizó el Modelo de Simulación de Impuestos de la Organización Mundial de la Salud, con tasas de impuestos al consumo ajustadas para obtener reducciones del 5%, 10% y 15% en el consumo. Resultados Un aumento del 17% al 117% en el impuesto al consumo sobre el valor del costo, seguro y flete (CSF) ocasionaría una disminución del 5% en el consumo. Los ingresos totales del gobierno crecerían un 8,7% y los ingresos por impuesto al consumo aumentarían un 11%. El impuesto al consumo promedio por paquete de 20 cigarrillos aumentaría de EC$ (dólar del Caribe oriental) 3,24 (USD 1,20 de 2014) a EC$ 3,80 (USD 1,41), y el precio promedio por paquete aumentaría de EC$ 8,48 (USD 3,14) a EC$ 9,21 (USD 3,41). En los escenarios de reducción del consumo del 10% y el 15%, los impuestos al consumo deberían aumentarse en un 33% y 50% (al 133% y 150% del CSF, respectivamente), lo que elevaría el promedio del impuesto al consumo por paquete a EC$ 4,37 (USD 1,62) y EC$ 4,90 (USD 1,81), respectivamente. Conclusión En Granada, el consumo de tabaco puede reducirse y aumentarse a la vez los ingresos públicos, generando recursos adicionales disponibles para la salud. Esto coincide con la bibliografía publicada, que indica que los impuestos pueden ser eficaces para alcanzar el objetivo de salud pública de reducir la incidencia de enfermedades relacionadas con el hábito de fumar a través de una reducción del consumo.

RESUMO Objetivo Investigar a viabilidade de abordar problemas de saúde pública relacionados ao consumo de tabaco através de um aumento de impostos, enquanto conserva ou aumenta a receita do governo em Granada. Métodos Métodos intencionais de amostragem foram utilizados para garantir a disponibilidade de dados e sua representatividade geográfica. O preço médio da embalagem de 20 cigarros das marcas mais vendidas foi calculado a partir dos dados obtidos em três grandes supermercados. Utilizou-se o Modelo de Simulação Tributária da Organização Mundial de Saúde, com taxas de imposto de consumo ajustadas para obter reduções de 5%, 10% e 15% no consumo. Resultados Um aumento de 17% para 117% na taxa de consumo sobre o valor do custo, seguro e frete (CSF) causaria uma queda de 5% no consumo. As receitas totais do governo aumentariam em 8,7% e as receitas dos impostos sobre o consumo aumentariam em 11%. O imposto médio de consumo por pacote de 20 cigarros aumentaria de EC$ (dólar do Caribe Oriental) 3,24 (USD 1,20 de 2014) para EC$ 3,80 (USD 1,41), e o preço médio por pacote aumentaria de EC$ 8,48 (USD 3,14) para EC$ 9,21 (USD 3,41). Nos cenários de redução do consumo de 10% e 15%, os impostos sobre consumo devem ser aumentados em 33% e 50% (para 133% e 150% do CSF, respectivamente), o que elevaria a média do imposto sobre o consumo por pacote a EC$ 4,37 (USD 1,62) e EC$ 4,90 (USD 1,81), respectivamente. Conclusão Em Granada, o consumo de tabaco pode ser reduzido e as receitas do governo aumentadas, gerando recursos adicionais disponíveis para a saúde. Isso coincide com a literatura publicada, que indica que os impostos podem ser efetivos para alcançar o objetivo de saúde pública de reduzir a incidência de doenças relacionadas ao tabagismo através da redução do consumo.

Epidemiology of human leptospirosis in Trinidad and Tobago, 1996-2007: a retrospective study.

A retrospective study to describe the epidemiology of human leptospirosis in Trinidad and Tobago during 1996-2007 was conducted. All confirmed cases of leptospirosis was analyzed according to age, sex, seasonality and geographic distribution. A total of 278 cases were recorded, with an average annual incidence rate of 1.84 per 100,000 population. Seventy-five percent of the cases occurred during the wet season, with the highest number of cases recorded in November. A positive correlation was found between number of cases and rainfall. Males constituted 80% of all cases, and the overall male:female ratio was 4.6:1. The total case fatality rate was 5.8%, with deaths among males four times more common than in females. Clinical leptospirosis was greatest in the 10-19 age group and lowest in the 0-9 age group. The total prevalence was 22 per 100,000 population, with the highest prevalence 41 per 100,000 recorded in the regional corporation of Sangre Grande and the lowest (6 per 100,000) in the city of Port of Spain. The lack of important information and active surveillance showed that the level of awareness of the disease is low in the country. The disease is still under-reported, and is considered to be of significant public health importance.