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1.
Artigo em Inglês | MEDLINE | ID: mdl-34444117

RESUMO

Tobacco taxation and price policies are considered the most effective for lowering demand for tobacco products. While this statement is based on research from numerous countries, scant evidence exists on this topic for Israel. Accordingly, we assessed the association between cigarette prices and smoking prevalence and intensity from a national sample of adults in Israel (2002-2017). Data on smoking behavior were derived from the Israeli Knowledge Attitudes and Practices (KAP) survey, a repeated cross-sectional survey. Price information is from the Economist Intelligence Unit (EIU) since it was not collected in the KAP survey. We used the price of a pack of 20 cigarettes for Marlboro and the local brand. These two price variables were the primary independent variables, and we adjusted for inflation. The dependent variables were current smoking (yes/no) and smoking intensity, defined as the number of cigarettes smoked per week. Multivariable analysis was employed using a two-part model while adjusting for covariates. The first step of the model utilized logistic regression with current smoking as the dependent variable. The second step examining smoking intensity as the dependent variable, used OLS regression. Price elasticity was estimated as well. Analysis revealed that a one-unit increase (Israeli currency) in the price of local brand of cigarettes was related to 2.0% (OR = 0.98; 95%CI 0.98, 0.99) lower odds of being a current smoker, adjusting for covariates including household income. Moreover, a one unit increase in the price of the local brand of cigarettes was related to consuming 1.49 (95% CI -1.97, -1.00) fewer weekly cigarettes, controlling for household income and covariates. Similar results were found with the Marlboro cigarette prices. The total price elasticity of cigarette demand, given by the sum of price elasticities of smoking prevalence and intensity, showed that a 10.0% increase in the price is associated with a 4.6-9.2% lower cigarette consumption among Israeli adults. Thus, increasing cigarette prices will likely lead to a reduction in cigarette smoking thereby improving public health in Israel.


Assuntos
Comércio , Produtos do Tabaco , Adulto , Estudos Transversais , Humanos , Israel/epidemiologia , Fumar/epidemiologia , Impostos
2.
Tob Control ; 2021 Apr 08.
Artigo em Inglês | MEDLINE | ID: mdl-33833092

RESUMO

OBJECTIVE: To estimate the prevalence of illicit tobacco trade (ITT) and different ITT modes-tax stamp counterfeiting and smuggling-in Argentina. DESIGN: Cross-sectional study using an empty tobacco pack survey with a simple random cluster sampling design. Classification as licit/illicit using forensic analysis of tax stamps and packs and econometric modelling. SETTING: Cities of Buenos Aires, La Matanza, Cordoba, Rosario, Mendoza, Neuquen, Posadas, Salta; January-June 2019. RESULTS: Of a total sample of 15 658 packs, 83.2% were manufactured in Argentina and 16.8% were foreign packs. Overall ITT prevalence-weighted by district population size-was estimated at 13.7%, where 6.1% was attributable to stamp counterfeiting-that is, a forged stamp not issued by the national tax authority-and 7.6% to contraband smuggling of foreign cigarette packs-that is, illicit trade of packs across national borders. CONCLUSIONS: The ITT problem in Argentina seems to be equally represented by counterfeiting of tobacco tax stamps on packs with domestic features and smuggling of foreign cigarette packs. Foreign cigarettes represent a minor component of the pack sampled in most of the country, except in Salta and Posadas, which are located close to the border with Paraguay. It is essential to implement an effective track-and-trace system including the monitoring of tax stamp authenticity and increase border control to block the entry of smuggled products, particularly from Paraguay. Reducing ITT is necessary to ensure the effectiveness of tobacco taxation measures.

3.
Cancer Epidemiol ; 71(Pt A): 101893, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33477084

RESUMO

BACKGROUND: Alcohol consumption is an established risk factor for several cancer types, but there are no contemporary published estimates of the state-level burden of cancer attributed to alcoholic beverage consumption. Such estimates are needed to inform public policy and cancer control efforts. We estimated the proportion and number of incident cancer cases and cancer deaths attributable to alcohol consumption by sex in adults aged ≥30 years in all 50 states and the District of Columbia in 2013-2016. METHODS: Age-, sex-, and state-specific cancer incidence and mortality data (2013-2016) were obtained from the US Cancer Statistics database. State-level, self-reported age and sex stratified alcohol consumption prevalence was estimated using the 2003-2006 Behavioral Risk Factor Surveillance System surveys and adjusted with state sales data. RESULTS: The proportion of alcohol-attributable incident cancer cases ranged from 2.9 % (95 % confidence interval: 2.7 %-3.1 %) in Utah to 6.7 % (6.4 %-7.0 %) in Delaware among men and women combined, from 2.7 % (2.5 %-3.0 %) in Utah to 6.3 % (5.9 %-6.7 %) in Hawaii among men, and from 2.7 % (2.4 %-3.0 %) in Utah to 7.7 % (7.2 %-8.3 %) in Delaware among women. The proportion of alcohol-attributable cancer deaths also varied considerably across states: from 1.9 % to 4.5 % among men and women combined, from 2.1% to 5.0% among men, and from 1.4 % to 4.4 % among women. Nationally, alcohol consumption accounted for 75,199 cancer cases and 18,947 cancer deaths annually. CONCLUSION: Alcohol consumption accounts for a considerable proportion of cancer incidence and mortality in all states. Implementing state-level policies and cancer control efforts to reduce alcohol consumption could reduce this cancer burden.


Assuntos
Consumo de Bebidas Alcoólicas/efeitos adversos , Neoplasias/epidemiologia , Neoplasias/mortalidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Consumo de Bebidas Alcoólicas/epidemiologia , Sistema de Vigilância de Fator de Risco Comportamental , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Estados Unidos/epidemiologia
4.
Nicotine Tob Res ; 23(1): 40-47, 2021 01 07.
Artigo em Inglês | MEDLINE | ID: mdl-32697827

RESUMO

INTRODUCTION: Tobacco product prices and consumers' income are the two major economic determinants of tobacco demand. The affordability of tobacco products is dependent on the price of tobacco products relative to consumer income. Increase in tobacco tax is expected to lead to higher price, lower affordability, and reduced consumption. Price elasticity and affordability elasticity are used in analyzing the effect of tobacco tax increases on tobacco consumption and public health. The availability of both parameters raises the question of which one to apply in policy discussions. AIMS AND METHODS: Using global data on cigarette consumption, price, income, and tobacco control measures for 169 countries over 2007-2016, this study estimated the price elasticity and affordability elasticity of cigarette consumption by country income classification using country-specific fixed effects model for panel data. RESULTS: The estimates show that the restriction of equal strength of the effects of price and income changes on tobacco consumption maintained in affordability elasticity estimation is valid for low- and middle-income countries, while it is rejected for high-income countries. CONCLUSIONS: Affordability elasticity may prove to be a useful parameter to explain and predict the sensitivity of consumers to tobacco tax and price policy changes under conditions of robust economic growth, which are more likely to be observed in countries with initial low- or middle-income setting. It can provide a reasonable benchmark for tobacco tax and price increase necessary to effectively reduce affordability and consumption of tobacco, which can form a basis for building systematic tax and price increases into the tobacco tax policy mechanism. IMPLICATIONS: Price elasticity measures the sensitivity of consumers to changes in real prices, holding real income constant. Affordability elasticity measures the sensitivity of consumers to price changes adjusted for inflation and income changes. Existing scientific literature on tobacco demand abounds in both price and affordability elasticity estimates, without providing a clear explanation of the theoretical and policy implications of using one parameter over the other. By estimating and comparing price and affordability elasticities for high-income and low-and-middle-income countries separately, this article offers a guide to the practitioners in tobacco taxation for evaluating the effectiveness of tax-induced price increases on tobacco consumption.


Assuntos
Comércio/economia , Custos e Análise de Custo , Renda , Impostos/economia , Produtos do Tabaco/economia , Uso de Tabaco/economia , Uso de Tabaco/epidemiologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Saúde Pública , Uso de Tabaco/psicologia , Estados Unidos/epidemiologia , Adulto Jovem
5.
Tob Control ; 30(2): 125-131, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-32139405

RESUMO

OBJECTIVE: To compare two methods to estimate the magnitude of the illicit cigarette trade in Mexico and to contrast these results with tobacco industry figures. METHODS: We used two survey methods: a smoker survey and a discarded pack survey. Data were collected in eight major cities in Mexico between November and December 2017. A total of 2396 face-to-face interviews to adult smokers were conducted and 8204 discarded packs were collected. To determine whether cigarette packs were intended for the Mexican market, we analysed pack features required by Mexican regulations and self-reported brands of the last purchase. Standard statistical tests to compare proportions were employed. Correlates of illicit cigarette use were also analysed. RESULTS: The share of cigarettes not intended for the Mexican market was 8.8% based on the analysis of discarded packs and 7.6% based on the survey of smokers, that is, the difference was small and only borderline significant overall (p=0.055). Also, both results were lower than those presented by the tobacco industry (16.6%). However, differences across methods were statistically significant for various cities. CONCLUSION: Our results suggest that the optimal practice for the study of illicit trade is to cross validate estimates using both the smoker survey and the littered pack survey. If resources are limited, however, our findings indicate that either method could be used because both yield similar overall results, as longs as the potential biases are considered. Also, consistent with findings from other studies, our results suggest that the tobacco industry exaggerates the scope of illicit cigarette trade.

6.
Tob Control ; 2020 Dec 03.
Artigo em Inglês | MEDLINE | ID: mdl-33273055

RESUMO

INTRODUCTION: Policies raising the minimum age of sale of tobacco products to 21 (T21) proliferated at state and local levels across the USA before a federal policy was adopted. Evidence of the effectiveness of these policies is building and lags implementation. This study exploits demographic patterns of cigarette brand purchasing to evaluate the effectiveness of T21. METHODS: To capture the effect of T21 implementation on cigarette sales, we used universal product code-level data from Nielsen Scantrack data covering January 2015 to October 2019. We used the 2015 to 2018 National Survey on Drug Use and Health to identify cigarette brands where smokers under 21 comprised a disproportionately high (young) and low (old) share of consumption. We fit fixed-effects linear regressions in Nielsen designated market areas to test if sales of young or old cigarette brands were changed by T21. Unadjusted models controlled for time and T21 implementation date. Adjusted models controlled for price, seasonality and unemployment. A permutation test of 5000 randomised placebo T21 policies were fit to determine how well the true date of implementation fit sales data stratified by brand group. RESULTS: Sales of disproportionately young brands declined after T21 implementation. T21 policy implementation dates fit disproportionately young brand sales trends better than 99% of adjusted randomised placebo models. T21 implementation fit disproportionately old brand sales trends better than just 1% of adjusted randomised placebo models. CONCLUSION: This study adds compelling empirical evidence that T21 decreased purchases of the cigarette brands consumed disproportionately by young people, the policy's target demographic.

7.
Tob Control ; 2020 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-33188148

RESUMO

OBJECTIVE: To cross-validate estimates of the size of the illicit cigarette trade based on the results of four different survey methods. METHODS: In 2018/2019, four non-industry-funded, large-scale studies were conducted in selected Brazilian cities: packs discarded in household garbage/PDG (1 city), packs littered in the streets/PLS (5 cities), a phone survey of tobacco users' purchase behaviors/VIGITEL (5 cities), and a face-to-face household survey of tobacco users' purchase behaviors/FTF-household (2 cities). The proportions of illicit cigarettes consumed were based on the price paid by smokers in their last purchase (VIGITEL or FTF-household) and/or direct observation of brand names and health warnings (PDG, PLS or FTF-household). RESULTS: Based on PLS, the share of packs that avoided taxation ranged from 30.4% (95% CI 25.6% to 35.7%) in Rio de Janeiro to 70.1% (95% CI 64.6% to 75.0%) in Campo Grande; and PDG conducted in Rio de Janeiro found an even lower proportion point estimate of illicit cigarette use (26.8%, 95% CI 25.1% to 28.6%). In FTF-household, the share of illicit cigarette consumption based on the self-reported price ranged from 29.1% (95% CI 22.4% to 35.7%) in Rio de Janeiro to 37.5% (95% CI 31.2% to 43.7%) in São Paulo, while estimates based on pack observation ranged from 29.9% (95% CI 23.3% to 36.5%) in Rio de Janeiro to 40.7% (95% CI 34.3% to 47.0%) in São Paulo. For all cities, VIGITEL presented the lowest levels of illicit consumption, and most illicit brands were produced in Paraguay. CONCLUSIONS: Small differences in the estimated levels of illicit trade across methods were found, except for the phone survey. The cross-validation of estimates from independent studies is important to help effectively implement tobacco excise tax policy in Brazil and other low-income and middle-income countries.

8.
Artigo em Inglês | MEDLINE | ID: mdl-32244873

RESUMO

The threat of tobacco tax evasion and avoidance is the most commonly mentioned argument against tax hikes. Increasingly, the focus of legislators is on leaks in the tobacco crop supply chain, in which raw or cured tobacco that was never taxed finds its way to smokers. To study the process undertaken by Poland to secure the tobacco supply chain, we analyzed the 2013-2018 legislation around tobacco supply and interviewed a key stakeholder in the Government of Poland. We found that farmers and intermediary entities can trade tobacco only if registered with the government. Farmers are required to report the size of their fields and the weight of their crops to the state authorities. Each purchase within the supply chain is also reported by both the seller and the buyer for cross-validation. This has prevented manipulation within the system, while the mere threat of heavy fines related to an excise tax law violation and/or the administrative burden associated with becoming an excise tax payer (had the violation been prosecuted) has significantly contributed to securing the tobacco supply chain. The experience of Poland demonstrates that securing the tobacco supply chain is complicated but also a tractable problem. This case can be widely applicable to other countries.


Assuntos
Indústria do Tabaco , Produtos do Tabaco , Comércio , Polônia , Fumar , Impostos , Tabaco
9.
Artigo em Inglês | MEDLINE | ID: mdl-32272763

RESUMO

In accordance with the provisions of the WHO Framework Convention on Tobacco Control (FCTC), each country shall promote and strengthen public awareness of tobacco control issues (Article 12). Many parties to the FCTC have adopted national tobacco control programs to organize their tobacco control activities. The aim of our study was to analyze the organization and funding of the Polish Tobacco Control Program in years 2000-2018. Document analysis of The Program and reports from its implementation were performed in accordance to the Agency for Health Technology Assessment in Poland (AHTAPol) recommendations and the WHO FCTC guidelines for Article 12 implementation. Spending was also analyzed. The study showed both inadequate planning of and funding for Polish Tobacco Control Program. The Program was developed without use of best practices detailed in the WHO FCTC guidelines as well as in national guidelines prepared by AHTAPol. The experience of Poland shows that although earmarking tobacco taxes has existed in the law, it has been largely ineffective due to the poor Tobacco Control Program design and insufficient funding resulting from a poor execution of the earmarking law. This may be a warning to other countries to strive to create law, compliance with which can be verified and controlled.


Assuntos
Prevenção do Hábito de Fumar/economia , Prevenção do Hábito de Fumar/organização & administração , Indústria do Tabaco/legislação & jurisprudência , Polônia , Fumar , Tabaco , Organização Mundial da Saúde
10.
Tob Control ; 29(4): 381-387, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-31209129

RESUMO

BACKGROUND: Philip Morris International, one of the largest transnational cigarette manufacturers, has heavily invested in its new heated tobacco product, IQOS, marketing it aggressively as a less harmful alternative to cigarette smoking. The company's assertions that the product replaces cigarettes in a market have never been independently tested. The objective of this study is to determine whether introduction of IQOS affected cigarette sales in a large economy. DATA AND METHODS: Using 2014 to 2018 monthly retailer panel data from Japan, we analyse whether different dates of IQOS introduction across Japan's regions are reflected in the patterns of cigarette sales in those regions. A series of placebo models are estimated to test if events other than IQOS introduction could have better explained the observed trends in cigarette sales. RESULTS: Cigarette sales begin to substantially decline at the time of the introduction of IQOS in each of 11 Japanese regions (Chow tests p<0.001). IQOS introduction, which varied across regions, better predicted the timing of cigarette sales decline than any one time applied to all regions simultaneously (a national-level exogenous shock) and than nearly all possible rearrangements of the true IQOS introduction months among the regions (exact permutation test's p value from 0.02 to 0.13, depending on the study approach). CONCLUSIONS: The introduction of IQOS likely reduced cigarette sales in Japan. The net population health impact, however, cannot be assessed without resolving several key uncertainties related to the direct harms of IQOS and the precise patterns of both smoking and IQOS use.


Assuntos
Fumar Cigarros/economia , Fumar Cigarros/legislação & jurisprudência , Comércio/economia , Comércio/estatística & dados numéricos , Comércio/tendências , Produtos do Tabaco/economia , Produtos do Tabaco/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Previsões , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Modelos Estatísticos
11.
Tob Control ; 29(1): 55-60, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-30545966

RESUMO

BACKGROUND: Previous studies of cross-border cigarette purchases in the European Union (EU) relied on survey-reported data. Results of those studies might be affected by under-reporting of tax avoidance in those surveys. This study aims to shed light on the effects of cigarette price differences between EU Member States on cross-border cigarette purchases using a method that is free from potential reporting bias. DATA AND METHODS: 2004-2017 pooled time-series data and econometric modelling are used to examine cross-border shopping in the EU. Incentives for cross-border shopping are measured as a function of differences in cigarette prices between bordering countries, controlling for population density near borders. Separate incentive variables are calculated for EU internal versus EU external borders and for terrestrial versus maritime borders. Tax-paid cigarette sales are modelled as a function of cigarette price, per capita income, non-price measures and the incentive variables using fixed-effects models. RESULTS: The estimated price elasticity of cigarette demand varies, depending on the model, from -0.47 to -0.35. The estimated income elasticity varies from 0.66 to 0.70. Between-country price differences are not significantly associated with purchases across maritime borders and across borders with non-EU neighbours. In an average EU Member State, reducing incentives from cross-border shopping down to zero would increase sales by 1.5% in an importing country and reduce sales by about 6% in an exporting country, ceteris paribus. CONCLUSION: An upward convergence of cigarette prices across EU Member States would reduce cross-border cigarette purchasing and improve public health by contributing to decreases in cigarette consumption.


Assuntos
Comércio , União Europeia/economia , Modelos Econométricos , Impostos , Produtos do Tabaco/economia , Comportamento do Consumidor/economia , Humanos , Estudos Longitudinais
12.
Artigo em Inglês | MEDLINE | ID: mdl-31461885

RESUMO

Background: Population growth in the African region is set to outpace the rate of decline in smoking prevalence, leading to a projected increase in the total number of smokers. As most tobacco users initiate during their adolescent years, tobacco prevention strategies targeting youth will be particularly important. Methods: This study estimated the impact of cigarette prices on youth cigarette smoking and tobacco use initiation in Ghana and Nigeria using the Global Youth Tobacco Survey data. First, we used cross-section data and logit models to estimate the effects of prices on youth cigarette smoking. Second, we created pseudo longitudinal data and used continuous-time hazard models to evaluate the impact of cigarette prices on tobacco use initiation. Results: We found that higher cigarette prices decreased both 30-day cigarette smoking and tobacco use onset significantly in both Ghana and Nigeria. Additionally, the price elasticity of cigarette smoking and tobacco use initiation ranged from -0.44 to -1.13, and -1.04 to -3.66, respectively. Conclusions: As one of the first studies on youth tobacco consumption in Sub-Saharan Africa, this study strongly suggests that policies that increase real cigarette prices can lower both cigarette smoking and tobacco use initiation among youth in Ghana and Nigeria.


Assuntos
Fumar Cigarros/epidemiologia , Comércio/estatística & dados numéricos , Tabagismo/epidemiologia , Tabaco , Adolescente , Feminino , Gana/epidemiologia , Humanos , Modelos Logísticos , Estudos Longitudinais , Masculino , Nigéria/epidemiologia , Prevalência , Inquéritos e Questionários , Impostos
13.
Tob Control ; 28(6): 702-704, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-30309981

RESUMO

BACKGROUND: In May 2015, the Canadian province of Nova Scotia became the first jurisdiction in the world to ban menthol cigarettes specifically. The tobacco industry warned that 'the primary effect of this law will be to increase the illegal tobacco market in Nova Scotia'. This is the first attempt to examine the impact of the menthol ban on trends in illicit cigarettes. DATA AND METHODS: Data on the number of illicit cigarettes seized in Nova Scotia covering the period from 2007/2008 to 2017/2018 was obtained from the Provincial Tax Commission. Data from before and after the ban are compared. RESULTS: According to the local authorities, while the enforcement efforts in Nova Scotia have not declined, the number of seized illicit cigarettes declined significantly, from >60 000 cartons in 2007/2008 to <10 000 cartons in 2017/2018. Since the menthol ban, the seizure volume remained stable, with no statistically significant difference in the number of cigarettes seized before and after the menthol ban (t=-0.71, p=0.55). There were only a few small seizures of menthol cigarettes in the year following the ban, after which there have been no further seizures of menthol cigarettes. DISCUSSION: Contrary to the tobacco industry's assertions, there was no surge in illicit cigarettes after the 2015 ban on menthol cigarette sales in Nova Scotia. Credible, industry-independent evidence on illicit cigarette trade is desperately needed to support the implementation of tobacco control policies.


Assuntos
Comércio/legislação & jurisprudência , Mentol , Produtos do Tabaco/legislação & jurisprudência , Crime/estatística & dados numéricos , Humanos , Nova Escócia , Indústria do Tabaco/legislação & jurisprudência , Produtos do Tabaco/economia
14.
Tob Control ; 28(4): 434-439, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30120201

RESUMO

OBJECTIVES: The European Commission has formally opened a process of revision of its tobacco tax directive. The purpose of this study is to analyse the evolution of cigarette and roll-your-own (RYO) tobacco prices in order to identify avenues for the improvement of public health goals. METHODS: Pooled cross-sectional data on prices and taxes on cigarettes and RYO tobacco in the Member States over 2004-2015 is used to track the distributions of the most popular price category and the weighted average price of these products and to relate them to the underlying tax structure. RESULTS: The inflation-adjusted prices for the two products have increased over the period, but the dispersion of prices across Member States has remained constant. Throughout the period, there was a pervasive price gap between cigarettes and RYO tobacco within the Member States. Such features are explained by the underlying tax design. DISCUSSION: The current tax stance has been successful at increasing both cigarette and RYO tobacco prices. To further enhance the public health impact of the European Union tax directive, the revision should promote the convergence of prices across Member States and aim at closing the price gap between cigarettes and RYO tobacco. These objectives call for increasing the mandatory minimum levels of excise duty on the two products, preferably linking them to the evolution of a European weighted average price. The pace of increase should be faster for RYO tobacco in order to close the gap with respect to cigarette prices.


Assuntos
Comércio/estatística & dados numéricos , União Europeia/estatística & dados numéricos , Impostos , Produtos do Tabaco/economia , Comércio/tendências , Estudos Transversais , Humanos
15.
Tob Control ; 28(Suppl 1): s20-s30, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-29674513

RESUMO

BACKGROUND: The price of tobacco products in relation to the income of tobacco users-affordability-is recognised as a key determinant of tobacco use behaviour. The effectiveness of a price increase as a deterrent to tobacco use depends on how much price increases in relation to the income of the potential users. The aim of this paper is to examine the distribution of and trends in the affordability of tobacco products in Bangladesh. METHOD: Using four waves of International Tobacco Control Survey data on Bangladesh, this study measures affordability of tobacco products at the individual level as the ratio of self-reported price and self-reported income. The trends in affordability by brand categories of cigarettes and of bidi and smokeless tobacco are estimated using multivariate linear regression analysis. RESULTS: Despite significant increase in price, the affordability of cigarettes increased between 2009 and 2014-2015 due to income growth outpacing price increase. The increase was disproportionately larger for more expensive brands. The affordability of bidis increased over this period as well. The affordability of smokeless tobacco products remained unchanged between 2011-2012 and 2014-2015. CONCLUSION: The tax increases that were implemented during 2009-2015 were not enough to increase tobacco product prices sufficiently to outweigh the effect of income growth, and to reduce tobacco consumption. The findings from this research inform policymakers that in countries experiencing rapid economic growth, significant tax increases are needed to counteract the effect of income growth, in order for the tax increases to be effective in reducing tobacco use.


Assuntos
Comércio/tendências , Custos e Análise de Custo/tendências , Renda/tendências , Produtos do Tabaco/economia , Adolescente , Adulto , Bangladesh , Comércio/estatística & dados numéricos , Custos e Análise de Custo/estatística & dados numéricos , Estudos Transversais , Feminino , Humanos , Renda/estatística & dados numéricos , Masculino , Fatores Socioeconômicos , Adulto Jovem
16.
Tob Control ; 28(Suppl 1): s45-s52, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-29574449

RESUMO

BACKGROUND: In Zambia, the number of cigarette users is growing, and the lack of strong tax policies is likely an important cause. When adjusted for inflation, levels of tobacco tax have not changed since 2007. Moreover, roll-your-own (RYO) tobacco, a less-costly alternative to factory-made (FM) cigarettes, is highly prevalent. DATA AND METHODS: We modelled the probability of FM and RYO cigarette smoking using individual-level data obtained from the 2012 and 2014 waves of the International Tobacco Control (ITC) Zambia Survey. We used two estimation methods: the standard estimation method involving separate random effects probit models and a method involving a system of equations (incorporating bivariate seemingly unrelated random effects probit) to estimate price elasticities of FM and RYO cigarettes and their cross-price elasticities. RESULTS: The estimated price elasticities of smoking prevalence are -0.20 and -0.03 for FM and RYO cigarettes, respectively. FM and RYO are substitutes; that is, when the price of one of the products goes up, some smokers switch to the other product. The effects are stronger for substitution from FM to RYO than vice versa. CONCLUSIONS: This study affirms that increasing cigarette tax with corresponding price increases could significantly reduce cigarette use in Zambia. Furthermore, reducing between-product price differences would reduce substitution from FM to RYO. Since RYO use is associated with lower socioeconomic status, efforts to decrease RYO use, including through tax/price approaches and cessation assistance, would decrease health inequalities in Zambian society and reduce the negative economic consequences of tobacco use experienced by the poor.


Assuntos
Comércio/estatística & dados numéricos , Impostos/estatística & dados numéricos , Produtos do Tabaco/economia , Adolescente , Adulto , Fumar Cigarros/epidemiologia , Comportamento do Consumidor/economia , Comportamento do Consumidor/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Zâmbia/epidemiologia
17.
PLoS One ; 13(10): e0204903, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30281668

RESUMO

BACKGROUND: One of the major obstacles to the full implementation of the World Health Organization (WHO) Framework Convention of Tobacco Control (FCTC) tobacco control measures is the lack of sustainable financing resources. GOAL: To update and simulate country-specific indicators that are highly relevant to the costs and financial resources of the treaty policy implementation. We also developed an Excel tool for simulation and assessed the aggregated-level indicators by the 2016 World Bank income groups. APPROACHES: Using mostly 2016 data or 2014-15 data if 2016 one are not available, we updated five indicators relevant to the treaty implementation, which are the gap between current and desirable policy implementation, cigarette affordability, the costs of implementing best- buy tobacco control policies, the number of smoking-attributable deaths, and the simulated tax revenue resulting from a $1 tax increase. We also aggregated indicators and simulation results by the World Bank income groups, encompassing the five indicators and the reduction in smoking and in attributable deaths due to a hypothetical 1I$ tax increase. Finally, the policy implementation cost was compared with tax revenue and revenue increases. FINDINGS: As of 2016, smoking remains one of the leading causes of premature deaths worldwide while the implementation of best-buy tobacco control policies was below the recommended levels. Meanwhile, there was room to further increase cigarette taxes and prices, as cigarettes remained affordable in many countries. The total costs of implementing best-buy policies in the next 15 years merely account for 8.3% of the 2016 excise tax revenue, indicating that a small proportion of annual tax revenue could fund the implementation of tobacco control policies recommended by the WHO FCTC. CONCLUSIONS: Increasing taxes could have a multiplier impact on curbing tobacco use through aiding the implementation of the WHO FCTC.


Assuntos
Prevenção do Hábito de Fumar/economia , Fumar/mortalidade , Impostos/legislação & jurisprudência , Produtos do Tabaco/economia , Custos e Análise de Custo , Humanos , Cooperação Internacional , Política Pública , Fumar/economia , Prevenção do Hábito de Fumar/métodos , Impostos/economia , Indústria do Tabaco/legislação & jurisprudência , Organização Mundial da Saúde
18.
CA Cancer J Clin ; 68(2): 106-115, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29384589

RESUMO

The continuing high prevalence of cigarette smoking among specific subpopulations, many of them vulnerable, is one of the most pressing challenges facing the tobacco control community. These populations include individuals in lower education and/or socioeconomic groups; from certain racial/ethnic groups; in the lesbian, gay, bisexual, and transgender community; with mental illness; and in the military, particularly among those in the lowest pay grades. Although traditional tobacco control measures are having positive health effects for most groups, the effects are not sufficient for others. More attention to and support for promising novel interventions, in addition to new attempts at reaching these populations through conventional interventions that have proven to be effective, are crucial going forward to find new ways to address these disparities. CA Cancer J Clin 2018;68:106-115. © 2018 American Cancer Society.


Assuntos
Disparidades nos Níveis de Saúde , Fumar/epidemiologia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores Socioeconômicos , Estados Unidos/epidemiologia , Populações Vulneráveis
19.
Econ Hum Biol ; 28: 92-106, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29294461

RESUMO

Previous research has found that impatient time preferences and self-control problems (present bias) are related to increased obesity risk. However, scant evidence exists pertaining to whether parents' impatience and self-control problems impact the obesity status of their children, too. Accordingly, we explore this study question among a large national sample of US adults and their children. Study results confirm previous findings indicating that intertemporal preferences are related to adults' obesity status. Moreover, these results extend the literature by finding that children of impatient or present-biased parents have a significantly higher likelihood of being obese, too. Specifically, parents' low levels of patience and present bias were each independently related to a five-percentage point increase in the likelihood of obesity of their children. These findings were more pronounced when all children were combined in analyses and for the first child; however, they varied for the second and third child. Thus, findings suggest that parents' time preferences and self-control problems likely affect not only their own weight status but that of their children.


Assuntos
Obesidade/epidemiologia , Obesidade/psicologia , Pais/psicologia , Autocontrole/psicologia , Adulto , Índice de Massa Corporal , Peso Corporal , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Estados Unidos/epidemiologia
20.
Global Health ; 13(1): 81, 2017 Nov 14.
Artigo em Inglês | MEDLINE | ID: mdl-29137678

RESUMO

BACKGROUND: In principle, trade and investment agreements are meant to boost economic growth. However, the removal of trade barriers and the provision of investment incentives to attract foreign direct investments may facilitate increased trade in and/or more efficient production of commodities considered harmful to health such as tobacco. We analyze existing evidence on trade and investment liberalization and its relationship to tobacco trade in Sub-Saharan African countries. METHODS: We compare tobacco trading patterns to foreign direct investments made by tobacco companies. We estimate and compare changes in the Konjunkturforschungsstelle (KOF) Economic Globalization measure, relative price measure and cigarette prices. RESULTS: Preferential regional trade agreements appear to have encouraged the consolidation of cigarette production, which has shaped trading patterns of tobacco leaf. Since 2002, British American Tobacco has invested in tobacco manufacturing facilities in Nigeria, Kenya and South Africa strategically located to serve different regions in Africa. Following this, British America Tobacco closed factories in Ghana, Rwanda, Uganda, Mauritius and Angola. At the same time, Malawi and Tanzania exported a large percentage of tobacco leaf to European countries. After 2010, there was an increase in tobacco exports from Malawi and Zambia to China, which may be a result of preferential trade agreements the EU and China have with these countries. Economic liberalization has been accompanied by greater cigarette affordability for the countries included in our analysis. However, only excise taxes and income have an effect on cigarette prices within the region. CONCLUSIONS: These results suggest that the changing economic structures of international trade and investment are likely heightening the efficiency and effectiveness of the tobacco industry. As tobacco control advocates consider supply-side tobacco control interventions, they must consider carefully the effects of these economic agreements and whether there are ways to mitigate them.


Assuntos
Comércio/organização & administração , Cooperação Internacional , Indústria do Tabaco/organização & administração , Produtos do Tabaco/economia , África ao Sul do Saara , Comércio/economia , Humanos , Investimentos em Saúde , Indústria do Tabaco/economia
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