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1.
JAMA Netw Open ; 5(6): e2215276, 2022 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-35648398

RESUMO

Importance: More than 45 countries and several local jurisdictions have implemented sugar-sweetened beverage (SSB) taxes to improve nutrition and population health, and evidence on their outcomes to date is essential to inform policy discussions. Responding to this need, the World Health Organization commissioned a systematic literature review on the outcomes of fiscal policies, including SSB taxes. Objective: To assess the associations of implemented SSB taxes with prices, sales, consumption, diet, body weight, product changes, unintended consequences, health, and pregnancy outcomes. Data Sources: Searches of 8 bibliographic databases (Business Source Complete, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, CINAHL, EconLit, PsycINFO, PubMed, and Scopus) were performed from database inception through June 1, 2020, with no language or setting restrictions. Grey literature was assessed using 14 sources and government websites. Study Selection: The review included primary studies of implemented SSB taxes. Data Extraction and Synthesis: The review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. For prices, sales and consumption, results were meta-analyzed using a 3-level random-effects model. Study quality was assessed at the outcome level. Main Outcomes and Measures: Tax pass-through rate for prices, percentage reduction in SSB demand, and price elasticity of demand for sales and consumption. Heterogeneity was assessed using τ2 and the I2 statistic. Results: A total of 86 articles were eligible, with 62 studies contributing to the meta-analysis. The overall tax pass-through rate was 82% (95% CI, 66% to 98%; P < .001, I2 = 99%), suggesting tax undershifting. The demand for SSBs was highly sensitive to tax-induced price increases, with the price elasticity of demand of -1.59 (95% CI, -2.11 to -1.08; P < .001; I2 = 100%) and a mean reduction in SSB sales of 15% (95% CI, -20% to -9%; P < .001; I2 = 100%). There was no evidence of substitution to untaxed beverages, and changes in SSB consumption were not significant. The narrative synthesis found reformulation and reduced sugar content of taxed beverages for tiered taxes, cross-border shopping in most studies of local-level taxes, and no negative changes in employment. Data on the heterogeneity of SSB tax outcomes across subpopulations were limited. Conclusions and Relevance: In this systematic review and meta-analysis of implemented SSB taxes worldwide, SSB taxes were associated with higher prices and lower sales of taxed beverages.


Assuntos
Bebidas Adoçadas com Açúcar , Bebidas , Peso Corporal , Comércio , Humanos , Impostos
2.
JAMA Netw Open ; 5(6): e2214371, 2022 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-35648401

RESUMO

Importance: Fiscal policy is a promising approach to incentivizing better food choices and reducing the burden of chronic disease. To inform guidelines on using fiscal policies, including taxes and subsidies, to promote health, the World Health Organization commissioned a systematic review and meta-analysis of the worldwide literature on the outcomes of such policies for food products. Objective: To assess the outcomes of implemented food taxes and subsidies for prices, sales, consumption, and population-level diet and health. Data Sources: Eight bibliographic databases were searched for peer-reviewed literature and 14 data sources along with governmental websites were searched for grey literature that were published from database inception through June 1, 2020. There were no language and setting restrictions. Study Selection: Only primary studies of implemented food taxes and subsidies were considered for inclusion. Data Extraction and Synthesis: The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline was followed. A 3-level random-effects model was used to conduct a meta-analysis of sales and consumption outcomes of fruit and vegetable subsidies. Other outcomes were analyzed in a narrative synthesis. Main Outcomes and Measures: Study estimates in the meta-analysis were combined using a price elasticity measure for sales and consumption outcomes. Heterogeneity was assessed using the I2 statistic and τ2. Studies varied in how diet and health were measured. Results: A total of 54 articles were included in the systematic review, of which 15 studies were included in the meta-analysis. Most food subsidies targeted fruits and vegetables and populations with low income, whereas the evidence on food taxes was primarily from the nonessential energy-dense food tax in Mexico. Sales of subsidized fruits and vegetables increased significantly, with an estimated price elasticity of demand of -0.59 (95% CI, -1.04 to -0.13 [P = .02]; 95% prediction interval, -2.07 to 0.90; I2 = 92.4% [95% CI, 89.0%-94.8%; P < .001]), suggesting inelastic demand. There was no significant change in the consumption of subsidized fruits and vegetables, with an estimated price elasticity of demand of -0.17 (95% CI, -0.49 to 0.15 [P = .26]; 95% prediction interval, -1.01 to 0.67; I2 = 76.2% [95% CI, 54.3%-87.6%; P < .001]). Food excise taxes were associated with higher prices and reduced sales. Evidence was limited on the differential outcomes of food taxes and subsidies across subpopulations. Conclusions and Relevance: Results of this systematic review and meta-analysis indicated that fruit and vegetable subsidies were associated with a moderate increase in fruit and vegetable sales. Further research is warranted to understand the implications of food taxes and subsidies for population-level consumption, diet, and health outcomes.


Assuntos
Promoção da Saúde , Impostos , Dieta , Humanos , Avaliação de Resultados em Cuidados de Saúde , Verduras
4.
Health Aff (Millwood) ; 41(6): 883-892, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35666971

RESUMO

Although stable, high-quality housing improves children's physical and social-emotional health, little is known about the health of children living in buildings financed by the federal government's primary tool for constructing and renovating affordable rental housing: the Low-Income Housing Tax Credit (LIHTC). Using data from the National Health Interview Survey (2004-16) linked to data on LIHTC properties (1987-2016), this study provides national estimates for health care access and health status among low-income children living in LIHTC properties compared with low-income children not living in LIHTC properties. Children living in LIHTC properties were more likely to have had a well-child visit in the past twelve months and a dental visit in the past six months. These children also had a higher likelihood of chronic school absenteeism and current asthma. These exploratory findings suggest that policy makers should consider features of LIHTC policy as possible mechanisms to improve low-income children's health care access and health status while addressing the shortage of affordable housing in the US.


Assuntos
Habitação , Pobreza , Acesso aos Serviços de Saúde , Nível de Saúde , Humanos , Impostos
5.
Health Aff (Millwood) ; 41(6): 814-820, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35666974

RESUMO

Two decades ago Congress enabled Americans to open tax-favored health savings accounts (HSAs) in conjunction with qualifying high-deductible health plans (HDHPs). This HSA tax break is regressive: Higher-income Americans are more likely to have HSAs and fund them at higher levels. Proponents, however, have argued that this regressivity is offset by reductions in wasteful health care spending because consumers with HDHPs are more cost-conscious in their use of care. Using published sources and our own analysis of National Health Interview Survey data, we argue that HSAs no longer appreciably achieve this cost-consciousness aim because cost sharing has increased so much in non-HSA-qualified plans. Indeed, people who have HDHPs with HSAs are becoming less likely than others with private insurance to report financial barriers to care. In sum, promised gains in efficiency from HSAs have not borne out, so it is difficult to justify maintaining this regressive tax break.


Assuntos
Planos de Assistência de Saúde para Empregados , Poupança para Cobertura de Despesas Médicas , Estado de Consciência , Dedutíveis e Cosseguros , Humanos , Seguro Saúde , Impostos , Estados Unidos
6.
Int J Behav Nutr Phys Act ; 19(1): 69, 2022 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-35705983

RESUMO

BACKGROUND: Beverage and food taxes have become a popular 'best buy' public health intervention in the global battle to tackle noncommunicable diseases. Though many countries have introduced taxes, mainly targeting products containing sugar, there is great heterogeneity in tax design. For taxes levied as import tariffs, there is limited evidence of effectiveness in changing the price and sale of taxed products, while the evidence base is stronger for excise taxes levied as a fixed amount per quantity of product. This paper examines the effect of the Bermuda Discretionary Foods Tax, which was based on import tariff changes, on retail prices and sales of sugar-sweetened beverages (SSBs), and on selected fruits and vegetables that benefited from a tariff reduction. METHODS: We used weekly electronic point-of-sale data from a major food retailer in Bermuda. We assessed historical weekly sales and price data using an interrupted time series design on 2,703 unique products between the dates of January 2018 through January 2020, covering 103 weeks. RESULTS: By January 2020, the average price per ounce of SSBs increased by 26.0%, while the price of untaxed beverages (including waters and non-added sugar drinks) remained constant. The increasing price of SSBs was the sole observable structural driver of SSB market share, responsible for a decrease in the market share by nearly eight percentage points by the end of the study period. The subsidy on fruits and vegetables was ineffective in changing prices and sales, due to the relatively small 5% import tax decrease. CONCLUSIONS: The tax was largely passed through to consumers. However, several factors mitigated the impact of the tax on the prices paid for SSBs by consumers, including the specific design of the tax, price promotions and consumer responses. The experience of Bermuda provides important lessons for the planning of similar taxes in the future.


Assuntos
Bebidas Adoçadas com Açúcar , Açúcares , Bebidas , Comércio , Humanos , Análise de Séries Temporais Interrompida , Impostos
7.
BMJ Open ; 12(5): e054060, 2022 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-35636785

RESUMO

BACKGROUND AND AIMS: In 2012, the Philippines passed a law popularly known as the 'Sin Tax Reform'. This law increased excise tax on both tobacco and alcohol. While a victory for public health, the total amount of taxes paid by the tobacco and alcohol industries was an uneven 69-31 split. The primary aim of this study is to explore why collective action of Sin Tax proponents resulted in greater advances for tobacco control as compared with alcohol control. METHODS: A case study approach was used. Key informant interviews were carried out with 25 individuals from academic, governmental, non-governmental and international organisations and industry who had first-hand knowledge of the Sin Tax policy process, led an organisation that participated in the process and/or possessed expert knowledge of Sin Taxes in the Philippines. Interviews were subsequently transcribed then analysed using inductive coding. RESULTS: Four factors contributed to the varying tax treatment of the two industries: (1) absence of advocacy-oriented alcohol control groups, (2) the proponents' 'divide and conquer' strategy, which aimed to prevent the alcohol and tobacco industries from joining forces, (3) the perception that moderate drinking is acceptable among some of the Sin Tax proponents, public and medical community and (4) a weaker global push for alcohol control. CONCLUSIONS: Our findings suggest the need to cultivate advocacy-oriented alcohol control civil society organisations, generate consensus at the local and global level regarding the problem definition and policy solutions for alcohol control and consider global instruments to strengthen norms and standards for alcohol control. Given that proponents also negotiated for a lower alcohol tax compared with tobacco due to the concern that the two industries might join forces, it also raises the question of whether or not a health tax bill should tackle more than one health harming product at a time.


Assuntos
Indústria do Tabaco , Produtos do Tabaco , Etanol , Humanos , Filipinas , Impostos , Tabaco
8.
Washington, D.C.; OPS; 2022-05-03.
Não convencional em Espanhol | PAHO-IRIS | ID: phr-55952

RESUMO

La gravedad de la epidemia de tabaquismo y sus daños sostenidos para la salud y las economías son justificaciones claras de los gobiernos para intervenir activamente y corregir las fallas del mercado. La dimensión de la carga y la cantidad de vidas que se están destruyendo requieren de una acción urgente y dinámica para controlar el tabaco, con medidas que la mayoría de los países se han comprometido a ejecutar y que son de comprobada eficacia para reducir el consumo de tabaco. Este manual presenta una descripción de las estrategias para la formulación, diseño, implantación y administración eficaces de las políticas de impuestos al tabaco. Además, esta edición actualizada incorpora los últimos adelantos en materia de ciencia, tecnología y políticas, y proporciona ejemplos recientes de diversos países. Las mejores prácticas que contiene se diseñaron para asistir a los gobiernos en la formulación de sus políticas de impuestos al tabaco, con miras a facilitar el logro de sus objetivos de salud y recaudación tributaria y al mismo tiempo apoyar su estrategia general de desarrollo.


Assuntos
Tabaco , Nicotina , Fatores de Risco , Financiamento dos Sistemas de Saúde , Controle e Fiscalização de Produtos Derivados do Tabaco , Impostos
9.
Artigo em Inglês | MEDLINE | ID: mdl-35627788

RESUMO

To analyze the impact of government carbon tax and subsidy policies on the manufac turing industry in the context of carbon peaking and carbon neutrality. This paper constructs a game model based on two government policies: a "carbon tax" policy for the original product and a "subsidy" policy for the remanufactured product, taking the original product and the remanufactured product as the objects. The policy game model is used to study the impact of carbon taxes, government subsidies, and carbon emissions on product quality, sales, and corporate profits. The results show that under the carbon tax and government subsidy policies, the price of remanufactured products will decrease, the quality will increase, sales will improve, and remanufacturers' profits will increase; these outcomes are conducive to the development of remanufacturing enterprises. Meanwhile, the price of original products will increase, quality will decrease, sales will decline, and original equipment manufacturers will have to develop and adopt low-carbon technologies to achieve sustainable development. This paper provides decision support for the formulation of government carbon emission policy, and theories and methods for the sustainable development of the manufacturing industry.


Assuntos
Carbono , Impostos , Comércio , Financiamento Governamental , Políticas
10.
Health Policy ; 126(7): 585-591, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35570062

RESUMO

In 2016, the World Health Organization officially recommended sugar-sweetened beverage (SSB) taxation as a strategy to reduce purchases, stimulate product reformulation and generate revenues for health-related programmes. Four years before, France had been one of the first countries to tax SSBs. However, the design of this tax was not considered optimal: its rate was flat, low, identical for SSBs and artificially-sweetened drinks containing no added sugars, and its initial public health justification was set aside in favour of budgetary concerns. In 2018, a new taxation scheme was enacted. Integrated in the Social Security Finance Bill, the tax on SSBs is now linearly indexed to the quantity of added sugars in the drink. In this article, we summarize the lessons learnt from the 2012 soda tax and offer insights on the potential public health benefits of the new tax enacted in 2018. A multidimensional framework aimed at gathering evidence about SSB taxation for public health drove our rational so that we address: (1) the soda tax policy-change process; (2) its impact on price and purchases; (3) the consumer receptiveness to the tax and; (4) its legal framework. We also discuss the potential application of the tax to other foods/nutrients.


Assuntos
Bebidas , Impostos , Bebidas Gaseificadas , Comércio , Humanos , Saúde Pública , Açúcares
11.
Artigo em Inglês | MEDLINE | ID: mdl-35627457

RESUMO

Private-label cigarettes are cigarettes that belong to the retailer itself. Private-label cigarettes from discounters or supermarkets are cheaper than brand-name cigarettes, and their lower price has allowed them to garner an ever-increasing share of the tobacco product market, especially among lower socioeconomic groups. Particulate matter (PM), a considerable component of air pollution, is a substantial health-damaging factor. Smoking is the primary source of PM in smokers' homes. In a 2.88 m3 measuring chamber, the PM emission fractions PM10, PM2.5, and PM1 from three private-label cigarette brands and three brand-name cigarette brands with identical nicotine, tar, and carbon monoxide content were measured and compared to those of a reference cigarette by laser aerosol spectroscopy. All cigarette brands emitted PM in health-threatening quantities. The measurement results ranged from 1394 µg/m3 to 1686 µg/m3 PM10, 1392 µg/m3 to 1682 µg/m3 PM2.5, and 1355 µg/m3 to 1634 µg/m3 PM1, respectively. Only one private-label brand differed significantly (p < 0.001) from the other cigarette brands, which were tested with slightly lower PM levels. All other brands differed only marginally (not significant, p > 0.05) from one another. Significant (p < 0.05) negative correlations between private-label and brand-name cigarettes were found for PM10, PM2.5, and PM1 when accounting for tobacco filling densities, and for PM1 when accounting for filter lengths. The especially health-hazardous fraction PM1 accounted for the largest proportion of PM emissions from the cigarettes tested. The results of this study suggest that- cheaper tobacco products are as harmful as more expensive ones, at least regarding PM emissions. This highlights the importance of anti-smoking campaigns, especially for lower socioeconomic groups, where smoking is more widespread. Governments should reduce the price gap between cheap and more expensive tobacco products by implementing specific tobacco taxes. In such a case, at increasing prices of tobacco products, a downward shift to private-label cigarettes would probably decrease.


Assuntos
Material Particulado , Produtos do Tabaco , Aerossóis/análise , Material Particulado/análise , Análise Espectral , Impostos , Tabaco/química
12.
Global Health ; 18(1): 52, 2022 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-35597943

RESUMO

BACKGROUND: The Miller Brewing Company (MBC) was wholly owned by Phillip Morris (PM), between 1970 and 2002. Tobacco industry document studies identify alliances between the alcohol and tobacco industries to counter U.S. policies in the 1980s and 1990s. This investigation sought to study in-depth inter-relationships between MBC and PM, with a particular focus on alcohol policy issues. We used the Truth Tobacco Industry Documents library to trace the evolution of corporate affairs and related alcohol policy orientated functions within and between MBC and PM. RESULTS: MBC was structured and led by PM senior executives from soon after takeover in 1970. Corporate Affairs sought to influence public perceptions of alcohol to align them with business interests. Alcohol education was specifically designed to prevent the adoption of policies inimical to those interests (e.g., raising excise taxes). Strategic consideration of alcohol policy issues was integrated within company-wide thinking, which sought to apply lessons from tobacco to alcohol and vice versa. PM directly led key alcohol industry organisations nationally and globally, which have successfully delayed the adoption and implementation of known effective policy measures in the U.S. and worldwide. CONCLUSIONS: PM has been a key architect of alcohol industry political strategies. This study builds on earlier work on alcohol companies in the tobacco documents, and offers historical data on how tobacco companies have used commercial involvements in other sectors to influence wider public health policy. We are only beginning to appreciate how multi-sectoral companies internally develop political strategies across product categories. Global health and national governmental policy-making needs to be better protected from business interests that fundamentally conflict with public health goals.


Assuntos
Indústria do Tabaco , Produtos do Tabaco , Comércio , Humanos , Percepção , Impostos , Tabaco
13.
Ned Tijdschr Geneeskd ; 1662022 03 03.
Artigo em Holandês | MEDLINE | ID: mdl-35499551

RESUMO

The new Dutch government has the ambition to implement several health-related food taxes. We provide an evidence-based agenda for improving population health with these policy ambitions. First, we argue that a sugary drinks tax should be at least 10, preferably 20%, comparable to the UK sugar industry levy. The new government omits alcohol, whereas Minimum Unit Pricing provides a proportionate measure for decreasing alcohol abuse. A broader tax on unhealthy foods, such as a tax on foods high in added sugar, and a zero rate on value-added taxes for fruits and vegetables, are effective in improving overall diet. However, these policies will encounter more legal and technical hurdles, although there are proofs of success in other countries. The listed policy ambitions will have a higher chance of success if implementation issues are seriously considered, and if public health goals are coupled to goals of public finance and environmental sustainability.


Assuntos
Governo , Impostos , Alimentos , Humanos , Saúde Pública , Açúcares
14.
BMC Public Health ; 22(1): 946, 2022 05 11.
Artigo em Inglês | MEDLINE | ID: mdl-35546230

RESUMO

BACKGROUND: The UCSF Industry Documents Library has provided public health researchers with key insights into the organization of political activities in the tobacco industry. Much less is known about the alcohol industry. In the US, there is some existing evidence of cooperation between the two industries, particularly in areas where there are mutual interests and/or policy goals at stake. Efforts to raise excise taxes on tobacco and alcohol products are one such example. METHODS: We systematically searched the UCSF Industry Documents Library for data on alcohol industry actors and their political activities. Using content generated by alcohol and tobacco actors, we sought to identify new evidence of collaborations to shape excise tax policy debates in the US in the 1980s and 1990s. RESULTS: We uncover evidence of the alcohol industry's efforts to shape excise tax policy debates, both at the national and state level. Excise taxes were defined by both alcohol and tobacco companies and related organisations as a key threat to profits. We show how the alcohol industry confronted this challenge in the late 1980s in the US, uncovering the range of monitoring, coordinating, and public-facing activities used to defeat proposed tax increases at both state and federal levels. The former draws particular attention to Oregon, where alcohol industry actors were not simply operating at the behest of the tobacco industry, but actively led a campaign to advance both brewing and tobacco interests. CONCLUSIONS: The tobacco documents offer a key resource for studying economic interests beyond that of the tobacco industry, operating in collaboration with tobacco companies. Here, brewers advanced shared interests with tobacco, and these findings have implications for advancing understanding of alcohol and tobacco industry political strategies. The findings also suggest that financial documents from other public repositories could be used to generate new inferences about corporate political activities.


Assuntos
Indústria do Tabaco , Produtos do Tabaco , Humanos , Impostos , Tabaco , Uso de Tabaco
15.
PLoS One ; 17(5): e0267328, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35544549

RESUMO

Understanding the determinants of the shadow economy plays a vital role in formulating policies for economic growth and development, particularly for the Southeast Asian countries-a new economic force for a global economy. The key drivers of a shadow economy, such as institutional quality, taxation, government expenditure, are widely examined. However, the effect of national intellectual capital, which affects macroeconomic indicators, on the shadow economy has largely been ignored in the existing literature. Our paper examines this critical link and its causality relationship for eight Southeast Asian countries from 2000 to 2017. This paper uses the dynamic ordinary least squares (DOLS) and fully modified ordinary least squares (FMOLS), which allow cross-sectional dependence and slope homogeneity in panel data analysis. Empirical findings from this paper indicate that national intellectual capital impacts negatively and significantly the shadow economy size. This finding implies that enhancing national intellectual capital reduces the shadow economy size. These two forces lead to enhanced economic growth. Our Granger causality tests confirm a bi-directional relationship between national intellectual capital and the shadow economy. As a result, policies targeted to reduce the shadow economy size can now include the accumulation of national intellectual capital, particularly for Southeast Asian Countries.


Assuntos
Dióxido de Carbono , Desenvolvimento Econômico , Estudos Transversais , Políticas , Impostos
16.
Artigo em Inglês | MEDLINE | ID: mdl-35564685

RESUMO

An improved understanding of how policies can promote the diffusion of electric vehicles (EVs) is critical to achieving sustainable development. Previous studies of EV diffusion dynamics have paid insufficient attention to consumer preferences. In this paper, a network-based evolutionary game model considering dynamic consumer preference is constructed to study EV diffusion. Through numerical experiments, the evolutionary processes and results of various promotion policies, including carbon taxes, production subsidies, purchase subsidies, and information policy on EV diffusion, are simulated. In particular, this paper explores the differentiated effects of supply-side policies and demand-side policies. The simulation results indicate that: (1) The effectiveness of promotion policies is sensitive to the size of the manufacturer network, and large networks can dampen periodical fluctuations in diffusion rates. (2) Supply-side carbon taxes and subsidies facilitate a steady diffusion of EVs. However, compared with the sustained effectiveness of subsidies, carbon taxes may inhibit the rapid penetration of EVs. (3) Implementing purchase subsidies in the early stages of diffusion is more effective than production subsidies, but the potential uncertainty of demand-side subsidies should be noted. (4) The impact of information policy on the evolutionary trend of EV diffusion is pronounced but is a longer-term impact, requiring a long enough implementation horizon.


Assuntos
Comportamento do Consumidor , Políticas , Carbono , China , Impostos
17.
Artigo em Inglês | MEDLINE | ID: mdl-35564917

RESUMO

Many governments have imposed methods such as a carbon tax that aim to even out the negative effects of carbon emissions. The taxes levied on different agents lead to different make-buy decisions for production structures and different environmental outcomes. Some original equipment manufacturers (OEMs) outsource remanufacturing to independent remanufacturers (IRs). Thus, a question arises: What are the implications of carbon taxes levied on different agents on remanufacturing outsourcing decisions? To answer this question, we developed two models: (1) acting as common brand owners, OEMs can be taxed for both new and remanufactured products, or (2) acting as different emitters for production and remanufacturing, OEMs are taxed for new products; however, all carbon taxes related to remanufacturing are levied on IRs. Our analysis reveals that, regarding economic performance, firms should undertake a carbon emission tax on their own initiative because this allows the taxpayer to choose more units for its preferred products and leaves its rivals at a huge disadvantage. Moreover, regarding environmental sustainability, carbon emission taxes indeed lead to mitigating the effects of carbon emissions per unit; however, environmental agencies should also pay attention to reducing the total carbon emissions by limiting the volume effects.


Assuntos
Serviços Terceirizados , Carbono , Comércio , Financiamento Governamental , Impostos
18.
BMJ Open ; 12(5): e055483, 2022 05 04.
Artigo em Inglês | MEDLINE | ID: mdl-35508336

RESUMO

OBJECTIVES: Indonesia implemented its first e-cigarette regulation in 2018, a 57% tax on the retail price of e-cigarette liquid (e-liquid), exceeding the 40% average tax on cigarettes. Economic research suggests that this tax could unintentionally increase cigarette smoking among dual users, but this has not been examined in a low-income or middle-income country. We therefore investigated the effects of the e-liquid tax among adults in Indonesia. DESIGN: Pre-post study. SETTING: Indonesia. PARTICIPANTS: Adults who currently used e-cigarettes and either currently or occasionally smoked cigarettes or recently quit were recruited using Facebook and Instagram ads. Our follow-up response rate was 79%. A final sample of 1039 adults participated. PRIMARY OUTCOME MEASURES: E-cigarette and cigarette use. RESULTS: Following the e-liquid tax, participants reported paying a 4.4% higher price for e-liquid (p=0.02). Participants also reported an average 0.5-day decrease in the number of days they used e-cigarettes in the past week (p<0.001), and the proportion of daily e-cigarette users decreased (75.9% to 63.6%; p<0.001). Overall, reported use of cigarettes also declined, on average, by nine cigarettes per week. Participants who reported decreasing their e-cigarette use had higher odds of reporting increasing their cigarette use rather than reporting no change (adjusted OR: 2.99; 95% CI: 1.95 to 4.59). Further, as participants reported using e-cigarettes less frequently, they reported using cigarettes more frequently (ß=-2.41, p=0.007). CONCLUSIONS: Following an e-liquid tax in Indonesia, prices of e-liquid increased slightly, e-cigarette and cigarette use declined, and people who reported decreasing their e-cigarette use reported increasing their cigarette use. To avoid encouraging cigarette use, a prudent approach would be to raise cigarette taxes concurrently with e-cigarette taxes.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina , Produtos do Tabaco , Vaping , Adulto , Comércio , Humanos , Indonésia/epidemiologia , Impostos
19.
Am J Nurs ; 122(6): 18, 2022 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-35617556
20.
BMJ ; 377: o1297, 2022 05 25.
Artigo em Inglês | MEDLINE | ID: mdl-35613717

Assuntos
Pensões , Impostos , Humanos
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