1
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Mostofsky E, Buring JE, Mukamal KJ. Beer taxes associate with lower alcohol and cigarette use; cigarette taxes associate with lower cigarette but higher alcohol use. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2024:1-9. [PMID: 38700943 DOI: 10.1080/00952990.2024.2321872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 02/19/2024] [Indexed: 05/05/2024]
Abstract
Background: There is a yet unmet opportunity to utilize data on taxes and individual behaviors to yield insight for analyzing studies involving alcohol and cigarette use.Objectives: To inform the direction and strength of their mutual associations by leveraging the fact that taxation can affect individual consumption, but individual consumption cannot affect taxation.Methods: We linked state-level data on cigarette and beer taxes in 2009-2020 with individual-level data on self-reported current cigarette and alcohol use from the Behavioral Risk Factor Surveillance System, a telephone survey by the Centers for Disease Control and Prevention that is representative of the population of each state in the United States. We constructed linear and logistic models to examine associations between a $1 increase in cigarette taxes per pack and a $1 increase in beer taxes per gallon and self-reported cigarette use and alcohol consumption (assessed as any current intake, average drinks/day, heavy drinking, and binge drinking), adjusting for survey year and individual characteristics.Results: Among 2,968,839,352 respondents (49% male), a $1 increase in beer taxes was associated with .003 (95% confidence interval [CI] -.013, .008) fewer drinks/day and lower odds of any drinking (odds ratio [OR] = .81 95%CI .80, .83), heavy drinking (OR = .96 95%CI .93, .99), binge drinking (OR = .82 95%CI .80, .83), and smoking (OR = .98 95%CI .96, 1.00). In contrast, a $1 increase in cigarette taxes was associated with lower odds of smoking (OR = .94 95%CI .94, .95) but .007 (95%CI .005, .010) more drinks/day, and higher odds of any drinking (OR = 1.10 95%CI 1.10, 1.11), heavy drinking (OR = 1.02 95%CI 1.01, 1.02), and binge drinking (OR = .82 95%CI .80, .83).Conclusion: Higher beer taxes were associated with lower odds of drinking and smoking, but higher cigarette taxes were associated with lower odds of smoking and higher alcohol consumption. These results suggest that alcohol intake may be a determinant of cigarette use rather than cigarette use as a determinant of alcohol intake.
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Affiliation(s)
- Elizabeth Mostofsky
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Julie E Buring
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Kenneth J Mukamal
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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2
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Lee B, Seo DC. A 114% Cigarette Tax Hike and Drinking Behavior: Results From Nationally Representative Longitudinal Panel Data in Korea. Asia Pac J Public Health 2022; 34:627-633. [DOI: 10.1177/10105395221096545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study investigated whether or not drinking behavior changed among Korean adult smokers after a 114% cigarette tax hike in 2015. Data were drawn from waves 9 to 12 (collected yearly from 2014 to 2017) of the nationally representative longitudinal study, the Korean Welfare Panel Study. Korean adults who were ≥19 years comprised the analysis sample (N = 10 875). We applied a difference-in-differences approach to compare drinking behavior before and after the tax increase among three groups (ie, quitters, continued smokers, and nonsmokers). We found that alcohol drinking significantly decreased among those who quit smoking after the tax increase, compared with nonsmokers ( P = .022). Our findings support that a cigarette tax increase may have the beneficial spillover influence of reduction in drinking as well as smoking if the tax increase can induce smokers to quit, but such positive spillover influence may be short-term or null for continued smokers.
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Affiliation(s)
- Boram Lee
- Health Policy Research Center, Mongan Institute, Massachusetts General Hospital, Boston, MA, USA
- Tobacco Treatment and Research Center, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Dong-Chul Seo
- Department of Applied Health Science, Indiana University School of Public Health, Bloomington, IN, USA
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3
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Jhuang JR, Su SY, Chiang CJ, Yang YW, Lin LJ, Hsu TH, Lee WC. Forecast of peak attainment and imminent decline after 2017 of oral cancer incidence in men in Taiwan. Sci Rep 2022; 12:5726. [PMID: 35388051 PMCID: PMC8987068 DOI: 10.1038/s41598-022-09736-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Accepted: 03/21/2022] [Indexed: 12/24/2022] Open
Abstract
Oral cancer is the fourth most common cancer among men in Taiwan. The age-standardized incidence rate of oral cancer among men in Taiwan has increased since 1980 and became six times greater in 2014. To enable effective public health planning for oral cancer, research on the projection of oral cancer burden is essential. We conducted an age-period-cohort analysis on the incidence of oral cancer among men in Taiwan from 1997 to 2017 and extrapolated the trend to 2025. We found that the period trends for young adults aged between 25 and 44 have already peaked before 2017; the younger, the earlier, and then the trends declined. The cohort trends have peaked roughly at the 1972 birth cohort and then declined for all ages. Despite the increasing trend in the age-standardized incidence rate for oral cancer among men in Taiwan from 1997 to 2017, we forecast a peak attained, an imminent decline after 2017, and a decrease of 8.4% in age-standardized incidence rate from 2017 to 2025. The findings of this study contribute to developing efficient and comprehensive strategies for oral cancer prevention and control.
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Affiliation(s)
- Jing-Rong Jhuang
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Rm. 536, No. 17, Xuzhou Rd., Taipei, 100, Taiwan.,Taiwan Cancer Registry, Taipei, Taiwan
| | - Shih-Yung Su
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Rm. 536, No. 17, Xuzhou Rd., Taipei, 100, Taiwan.,Innovation and Policy Center for Population Health and Sustainable Environment, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Chun-Ju Chiang
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Rm. 536, No. 17, Xuzhou Rd., Taipei, 100, Taiwan.,Taiwan Cancer Registry, Taipei, Taiwan
| | - Ya-Wen Yang
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Rm. 536, No. 17, Xuzhou Rd., Taipei, 100, Taiwan.,Taiwan Cancer Registry, Taipei, Taiwan
| | - Li-Ju Lin
- Health Promotion Administration, Taipei, Taiwan
| | | | - Wen-Chung Lee
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Rm. 536, No. 17, Xuzhou Rd., Taipei, 100, Taiwan. .,Innovation and Policy Center for Population Health and Sustainable Environment, College of Public Health, National Taiwan University, Taipei, Taiwan. .,Taiwan Cancer Registry, Taipei, Taiwan.
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4
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García-Pérez Á, Weidberg S, González-Roz A, Krotter A, Secades-Villa R. Effects of combined coffee and alcohol use over cigarette demand among treatment-seeking smokers. Behav Processes 2020; 174:104108. [PMID: 32198089 DOI: 10.1016/j.beproc.2020.104108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 02/18/2020] [Accepted: 03/16/2020] [Indexed: 01/10/2023]
Abstract
OBJECTIVE This study is aimed at comparing the relative reinforcing efficacy (RRE) of nicotine though CPT performance in function of alcohol and coffee consumption of treatment-seeking smokers. MATERIAL AND METHODS A total of 88 treatment-seeking smokers (60.2 % female) completed the CPT. A multivariate analysis of variance (MANOVA) was used to compare alcohol (consumers and abstainers of alcohol) and coffee intake (high coffee consumers and low coffee consumers) on CPT indices. RESULTS Univariate effects of coffee × alcohol use interaction were significant for elasticity [F (1, 83) = 4.9435, p = .038, η2 = .051] and intensity [F (1, 83) = 6.972, p = .01, η2 = .077]. CONCLUSIONS Alcohol and coffee use is associated with an elevated cigarette demand among treatment-seeking smokers. This finding suggests the need for specific interventions to reduce alcohol and coffee use in order to increase the effectiveness of treatments for smoking cessation.
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Affiliation(s)
- Ángel García-Pérez
- Department of Psychology, University of Oviedo, Plaza Feijoo s/n, 33003, Oviedo, Spain.
| | - Sara Weidberg
- Department of Psychology, University of Oviedo, Plaza Feijoo s/n, 33003, Oviedo, Spain
| | - Alba González-Roz
- Department of Psychology, University of Oviedo, Plaza Feijoo s/n, 33003, Oviedo, Spain
| | - Andrea Krotter
- Department of Psychology, University of Oviedo, Plaza Feijoo s/n, 33003, Oviedo, Spain
| | - Roberto Secades-Villa
- Department of Psychology, University of Oviedo, Plaza Feijoo s/n, 33003, Oviedo, Spain
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5
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Gao W, Sanna M, Branston JR, Chiou HY, Chen YH, Wu A, Wen CP. Exploiting a low tax system: non-tax-induced cigarette price increases in Taiwan 2011-2016. Tob Control 2019; 28:e126-e132. [PMID: 31164488 PMCID: PMC6996108 DOI: 10.1136/tobaccocontrol-2018-054908] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 04/11/2019] [Accepted: 04/26/2019] [Indexed: 11/20/2022]
Abstract
Introduction This study aims to analyse the non-tax-induced price increasing strategies adopted by tobacco industry in Taiwan, a high-income country with comprehensive tobacco control policies but low tobacco taxes and a declining cigarette market. Methods Using governmental tax, price and inflation data, we analysed cigarette sales volume, affordability, affordability elasticity of demand, market share, pricing and net revenue of the top five tobacco companies in Taiwan from 2011 to 2016 when no tax increases occurred. Results Total revenue after tax grew significantly for all the major transnational tobacco companies between 2011 and 2016 at the expense of the state-owned Taiwan Tobacco and Liquor Corporation. In terms of market share, Japan Tobacco (JT) was the leading company, despite experiencing a small decline, while British American Tobacco and Imperial Brands remained stable, and Philip Morris International increased from 4.7% to 7.0%. JT adopted the most effective pricing strategy by increasing the real price of its two most popular brands (Mevius and Mi-Ne) and, at the same time, doubling the sales of its cheaper and less popular brand Winston by leaving its nominal retail price unaltered. Conclusions Low and unchanged tobacco taxes enable tobacco companies to use aggressive pricing and segmentation strategies to increase the real price of cigarettes without making them less affordable while simultaneously maintaining customers’ loyalty. It is crucial to continue monitoring the industry’s pricing strategies and to regularly increase taxes to promote public health and to prevent tobacco industry from profiting at the expense of government revenues.
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Affiliation(s)
- Wayne Gao
- Master's Program in Global Health and Development, Taipei Medical University, Taipei, Taiwan
| | - Mattia Sanna
- Master's Program in Global Health and Development, Taipei Medical University, Taipei, Taiwan
| | | | - Hung-Yi Chiou
- School of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Yi-Hua Chen
- School of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Allison Wu
- Master's Program in Global Health and Development, Taipei Medical University, Taipei, Taiwan
| | - Chi Pang Wen
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan.,China Medical University Hospital, Taichung, Taiwan
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Barquera S, Pedroza-Tobias A, Medina C. Cardiovascular diseases in mega-countries: the challenges of the nutrition, physical activity and epidemiologic transitions, and the double burden of disease. Curr Opin Lipidol 2016; 27:329-44. [PMID: 27389629 PMCID: PMC4947537 DOI: 10.1097/mol.0000000000000320] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE OF REVIEW There are today 11 mega-countries with more than 100 million inhabitants. Together these countries represent more than 60% of the world's population. All are facing noncommunicable chronic disease (NCD) epidemic where high cholesterol, obesity, diabetes, and cardiovascular diseases are becoming the main public health concerns. Most of these countries are facing the double burden of malnutrition where undernutrition and obesity coexist, increasing the complexity for policy design and implementation. The purpose of this study is to describe diverse sociodemographic characteristics of these countries and the challenges for prevention and control in the context of the nutrition transition. RECENT FINDINGS Mega-countries are mostly low or middle-income and are facing important epidemiologic, nutrition, and physical activity transitions because of changes in food systems and unhealthy lifestyles. NCDs are responsible of two-thirds of the 57 million global deaths annually. Approximately, 80% of these are in low and middle-income countries. Only developed countries have been able to reduce mortality rates attributable to recognized risk factors for NCDs, in particular high cholesterol and blood pressure. SUMMARY Mega-countries share common characteristics such as complex bureaucracies, internal ethnic, cultural and socioeconomic heterogeneity, and complexities to implement effective health promotion and education policies across population. Priorities for action must be identified and successful lessons and experiences should be carefully analyzed and replicated.
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Affiliation(s)
- Simon Barquera
- National Institute of Public Health, Cuernavaca, Morelos, Mexico
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7
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Tsai YW, Chang HC, Chiou ST. The impact of multipolicy tobacco control legislation on smoking behavior. Public Health 2015; 129:1003-6. [PMID: 26116932 DOI: 10.1016/j.puhe.2015.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Revised: 01/30/2015] [Accepted: 05/13/2015] [Indexed: 10/23/2022]
Affiliation(s)
- Y-W Tsai
- Institute of Health and Welfare Policy, National Yang-Ming University, Taipei, Taiwan
| | - H-C Chang
- Institute of Health and Welfare Policy, National Yang-Ming University, Taipei, Taiwan
| | - S-T Chiou
- Health Promotion Administration, Ministry of Health and Welfare, New Taipei City, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
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8
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Blakely T, Cobiac LJ, Cleghorn CL, Pearson AL, van der Deen FS, Kvizhinadze G, Nghiem N, McLeod M, Wilson N. Health, Health Inequality, and Cost Impacts of Annual Increases in Tobacco Tax: Multistate Life Table Modeling in New Zealand. PLoS Med 2015; 12:e1001856. [PMID: 26218517 PMCID: PMC4517929 DOI: 10.1371/journal.pmed.1001856] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Accepted: 06/16/2015] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Countries are increasingly considering how to reduce or even end tobacco consumption, and raising tobacco taxes is a potential strategy to achieve these goals. We estimated the impacts on health, health inequalities, and health system costs of ongoing tobacco tax increases (10% annually from 2011 to 2031, compared to no tax increases from 2011 ["business as usual," BAU]), in a country (New Zealand) with large ethnic inequalities in smoking-related and noncommunicable disease (NCD) burden. METHODS AND FINDINGS We modeled 16 tobacco-related diseases in parallel, using rich national data by sex, age, and ethnicity, to estimate undiscounted quality-adjusted life-years (QALYs) gained and net health system costs over the remaining life of the 2011 population (n = 4.4 million). A total of 260,000 (95% uncertainty interval [UI]: 155,000-419,000) QALYs were gained among the 2011 cohort exposed to annual tobacco tax increases, compared to BAU, and cost savings were US$2,550 million (95% UI: US$1,480 to US$4,000). QALY gains and cost savings took 50 y to peak, owing to such factors as the price sensitivity of youth and young adult smokers. The QALY gains per capita were 3.7 times greater for Māori (indigenous population) compared to non-Māori because of higher background smoking prevalence and price sensitivity in Māori. Health inequalities measured by differences in 45+ y-old standardized mortality rates between Māori and non-Māori were projected to be 2.31% (95% UI: 1.49% to 3.41%) less in 2041 with ongoing tax rises, compared to BAU. Percentage reductions in inequalities in 2041 were maximal for 45-64-y-old women (3.01%). As with all such modeling, there were limitations pertaining to the model structure and input parameters. CONCLUSIONS Ongoing tobacco tax increases deliver sizeable health gains and health sector cost savings and are likely to reduce health inequalities. However, if policy makers are to achieve more rapid reductions in the NCD burden and health inequalities, they will also need to complement tobacco tax increases with additional tobacco control interventions focused on cessation.
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Affiliation(s)
- Tony Blakely
- Burden of Disease Epidemiology, Equity and Cost Effectiveness Programme, Department of Public Health, University of Otago, Wellington, New Zealand
| | - Linda J. Cobiac
- Burden of Disease Epidemiology, Equity and Cost Effectiveness Programme, Department of Public Health, University of Otago, Wellington, New Zealand
- British Heart Foundation Centre on Population Approaches to NCD Prevention, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Christine L. Cleghorn
- Burden of Disease Epidemiology, Equity and Cost Effectiveness Programme, Department of Public Health, University of Otago, Wellington, New Zealand
| | - Amber L. Pearson
- Burden of Disease Epidemiology, Equity and Cost Effectiveness Programme, Department of Public Health, University of Otago, Wellington, New Zealand
- Department of Geography, Michigan State University, East Lansing, Michigan, United States of America
| | - Frederieke S. van der Deen
- Burden of Disease Epidemiology, Equity and Cost Effectiveness Programme, Department of Public Health, University of Otago, Wellington, New Zealand
| | - Giorgi Kvizhinadze
- Burden of Disease Epidemiology, Equity and Cost Effectiveness Programme, Department of Public Health, University of Otago, Wellington, New Zealand
| | - Nhung Nghiem
- Burden of Disease Epidemiology, Equity and Cost Effectiveness Programme, Department of Public Health, University of Otago, Wellington, New Zealand
| | - Melissa McLeod
- Burden of Disease Epidemiology, Equity and Cost Effectiveness Programme, Department of Public Health, University of Otago, Wellington, New Zealand
| | - Nick Wilson
- Burden of Disease Epidemiology, Equity and Cost Effectiveness Programme, Department of Public Health, University of Otago, Wellington, New Zealand
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Barquera S, Pedroza-Tobías A, Medina C, Hernández-Barrera L, Bibbins-Domingo K, Lozano R, Moran AE. Global Overview of the Epidemiology of Atherosclerotic Cardiovascular Disease. Arch Med Res 2015; 46:328-38. [PMID: 26135634 DOI: 10.1016/j.arcmed.2015.06.006] [Citation(s) in RCA: 396] [Impact Index Per Article: 44.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 06/18/2015] [Indexed: 01/03/2023]
Abstract
Atherosclerotic cardiovascular disease (ACD) is the leading cause of mortality worldwide. The objective of this paper is to provide an overview of the global burden of ACD and its risk factors and to discuss the main challenges and opportunities for prevention. Publicly available data from the Global Burden of Disease Study were analyzed for ischemic heart disease (IHD), ischemic stroke and ACD risk factors. Data from the WHO Global Health Observatory were used to describe prevalence of diverse cardiometabolic risk factors. World Bank Gross Domestic Product per capita (GDPc) information was used to categorize countries according to income level. Cardiovascular mortality decreased globally from 1990-2010 with important differences by GDPc; during 1990 there was a positive association between IHD mortality and GDPc. Higher-income countries had higher rates compared to those of lower-income countries. High levels of body mass index (BMI), blood pressure, glucose and cholesterol have a differential contribution to mortality by income group over time; high-income countries have been able to reduce the contribution from these risk factors in the last 20 years, whereas lower/middle income countries show an increasing trend in mortality attributable to high BMI and glucose. Although age-adjusted ACD mortality rate trends decreased globally, the absolute number of ACD deaths is increasing in part due to the growth of the population and aging, as well as to important lifestyle and food-system changes that likely attenuate gains in prevention. Population and individual level preventable causes of ACD must be aggressively and efficiently targeted in countries of lower economic development in order to reduce the growing burden of disease due to ACD.
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Affiliation(s)
- Simon Barquera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico.
| | - Andrea Pedroza-Tobías
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - Catalina Medina
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - Lucía Hernández-Barrera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - Kirsten Bibbins-Domingo
- Division of General Medicine, University of California at San Francisco, San Francisco, California, USA
| | - Rafael Lozano
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - Andrew E Moran
- Division of General Medicine, Columbia University, Presbyterian Hospital, New York, New York, USA
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10
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Li Q, Babor TF, Zeigler D, Xuan Z, Morisky D, Hovell MF, Nelson TF, Shen W, Li B. Health promotion interventions and policies addressing excessive alcohol use: a systematic review of national and global evidence as a guide to health-care reform in China. Addiction 2015; 110 Suppl 1:68-78. [PMID: 25533866 PMCID: PMC4350681 DOI: 10.1111/add.12784] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2013] [Revised: 12/20/2013] [Accepted: 03/17/2014] [Indexed: 12/26/2022]
Abstract
AIMS Steady increases in alcohol consumption and related problems are likely to accompany China's rapid epidemiological transition and profit-based marketing activities. We reviewed research on health promotion interventions and policies to address excessive drinking and to guide health-care reform. METHODS We searched Chinese- and English-language databases and included 21 studies in China published between 1980 and 2013 that covered each policy area from the World Health Organization (WHO) Global Strategy to Reduce the Harmful Use of Alcohol. We evaluated and compared preventive interventions to the global alcohol literature for cross-national applicability. RESULTS In contrast with hundreds of studies in the global literature, 11 of 12 studies from mainland China were published in Chinese; six of 10 in English were on taxation from Taiwan or Hong Kong. Most studies demonstrated effectiveness in reducing excessive drinking, and some reported the reduction of health problems. Seven were randomized controlled trials. Studies targeted schools, drink-driving, work-places, the health sector and taxation. CONCLUSIONS China is the world's largest alcohol market, yet there has been little growth in alcohol policy research related to health promotion interventions over the past decade. Guided by a public health approach, the WHO Global Strategy and health reform experience in Russia, Australia, Mexico and the United States, China could improve its public health response through better coordination and implementation of surveillance and evidence-based research, and through programmatic and legal responses such as public health law research, screening and early intervention within health systems and the implementation of effective alcohol control strategies.
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Affiliation(s)
- Qing Li
- Michigan State University, Department of Epidemiology & Biostatistics, East Lansing, Michigan
- San Diego State University, Graduate School of Public Health, Center for Behavioral Epidemiology and Community Health, San Diego
| | - Thomas F. Babor
- University of Connecticut Health Center, Department of Community Medicine and Health Care, Farmington, Connecticut
| | - Donald Zeigler
- University of Illinois at Chicago, School of Public Health, Chicago
| | - Ziming Xuan
- Boston University, School of Public Health, Community Health Sciences, Boston
| | - Donald Morisky
- University of California, Los Angeles, Community Health Sciences, Los Angeles
| | - Melbourne F. Hovell
- San Diego State University, Graduate School of Public Health, Center for Behavioral Epidemiology and Community Health, San Diego
| | - Toben F. Nelson
- University of Minnesota, School of Public Health, Division of Epidemiology & Community Health, Minneapolis
| | - Weixing Shen
- Tsinghua University, School of Law, Center for Public Health Law Research, Beijing, China
| | - Bing Li
- Peking University, Sixth Hospital, Institute of Mental Health, Beijing, China
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11
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Krauss MJ, Cavazos-Rehg PA, Plunk AD, Bierut LJ, Grucza RA. Effects of state cigarette excise taxes and smoke-free air policies on state per capita alcohol consumption in the United States, 1980 to 2009. Alcohol Clin Exp Res 2014; 38:2630-8. [PMID: 25257814 DOI: 10.1111/acer.12533] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Accepted: 07/24/2014] [Indexed: 01/09/2023]
Abstract
BACKGROUND Increasing state cigarette excise taxes and strengthening smoke-free air (SFA) laws are known to reduce smoking prevalence. Some studies suggest that such policies may also reduce alcohol use, but results for cigarette taxes have been mixed, and associations with smoke-free air policies have been limited to some demographic subgroups. To shed further light on the potential secondary effects of tobacco control policy, we examined whether increases in cigarette taxes and strengthening of SFA laws were associated with reductions of per capita alcohol consumption and whether any reductions were specific to certain beverage types. METHODS State per capita alcohol consumption from 1980 to 2009 was modeled as a function of state price per pack of cigarettes and SFA policy scores while controlling for secular trends and salient state covariates. Both policy measures also accounted for local policies. Total alcohol, beer, wine, and spirits consumption per capita were modeled separately. For each type of beverage, we used a nested models approach to determine whether the 2 policies together were associated with reduced consumption. RESULTS For total alcohol consumption, and for beer or spirits (but not wine), one or both tobacco policies were associated with reductions in consumption. A 1% increase in cigarette price per pack was associated with a 0.083% decrease in per capita total alcohol consumption (95% confidence interval [CI] 0.0002 to 0.166, p = 0.0495), and a 1-point increase in SFA policy score, measured on a 6-point scale, was associated with a 1.1% decrease in per capita total alcohol consumption (95% CI 0.4 to 1.7, p = 0.001; p < 0.001 for the hypothesis that the 2 policies are jointly associated with reduced alcohol consumption). CONCLUSIONS The public health benefits of increasing cigarette taxes and smoke-free policies may go beyond the reduction of smoking and extend to alcohol consumption, specifically beer and spirits.
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Affiliation(s)
- Melissa J Krauss
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
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12
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Yeh CY, Ho LM, Lee JM, Hwang JY. The possible impact of an alcohol welfare surcharge on consumption of alcoholic beverages in Taiwan. BMC Public Health 2013; 13:810. [PMID: 24010885 PMCID: PMC3847341 DOI: 10.1186/1471-2458-13-810] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2012] [Accepted: 09/04/2013] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The abuse of alcoholic beverages leads to numerous negative consequences in Taiwan, as around the world. Alcohol abuse not only contributes to cardiovascular disease, hypertension, diabetes and cancer, but it is also an underlying cause of many other serious problems, such as traffic accidents, lost productivity, and domestic violence. International leaders in health policy are increasingly using taxation as an effective tool with which to lower alcohol consumption. In this study, we assessed how consumption patterns in Taiwan would be affected by levying a welfare surcharge on alcoholic beverages of 20%, 40% or 60% in accordance with the current excise tax. We also assessed the medical savings Taiwan would experience if consumption of alcoholic beverages were to decrease and how much additional revenue a welfare surcharge would generate. METHODS We estimated the elasticity of four types of alcoholic beverages (beer, wine, whisky and brandy) using the Central Bureau of Statistics (CBS) Demand Model. Specifically, we estimated alcohol's price elasticity by analyzing the sales prices and time statistics of these products from 1974 to 2009. RESULTS Alcoholic beverages in Taiwan have the following price elasticities: beer (-0.820), wine (-0.955), whisky (-0.587), brandy (-0.958). A welfare surcharge tax of 40% in accordance with the excise tax would decrease overall consumption of beer, wine, whisky and brandy between 16.24% and 16.42%. It would also generate New Taiwan Dollar (NT$) revenues of 5.782 billion to 5.993 billion. Savings in medical costs would range from NT$871.07 million to NT$897.46 million annually. CONCLUSIONS A social and welfare surcharge of 40% on alcoholic beverages in Taiwan would successfully lower consumption rates, decrease medical costs, and generate revenue that could be used to educate consumers and further decrease consumption rates. Consequently, we strongly recommend that such a tax be imposed in Taiwan.
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Affiliation(s)
- Chun-Yuan Yeh
- Department of International Trade & Logistics, Overseas Chinese University, 100, Chiao-Kwang Rd., Taichung, Taiwan
| | - Li-Ming Ho
- Department of Marine Leisure Management, National Kaohsiung Marine University, 142, Hai-Chuan Rd., Kaohsiung, Nan-Tzu, Taiwan
| | - Jie-Min Lee
- Department of Shipping and Transportation Management, National Kaohsiung Marine University, 142, Hai-Chuan Rd. Nan-Tzu, Kaohsiung, Taiwan
| | - Jhe-Yo Hwang
- Department of International Trade & Logistics, Overseas Chinese University, 100, Chiao-Kwang Rd., Taichung, Taiwan
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Young-Wolff KC, Kasza KA, Hyland AJ, McKee SA. Increased cigarette tax is associated with reductions in alcohol consumption in a longitudinal U.S. sample. Alcohol Clin Exp Res 2013; 38:241-8. [PMID: 23930623 DOI: 10.1111/acer.12226] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Accepted: 05/23/2013] [Indexed: 12/18/2022]
Abstract
BACKGROUND Cigarette taxation has been recognized as one of the most significant policy instruments to reduce smoking. Smoking and drinking are highly comorbid behaviors, and the public health benefits of cigarette taxation may extend beyond smoking-related outcomes to impact alcohol consumption. The current study is the first to test whether increases in cigarette taxes are associated with reductions in alcohol consumption among smokers using a large, prospective U.S. sample. METHODS Our sample included 21,473 alcohol consumers from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC). Multiple linear regression analyses were conducted to evaluate whether increases in cigarette taxes between Waves 1 (2001 to 2002) and 2 (2004 to 2005) were associated with reductions in quantity and frequency of alcohol consumption, adjusting for demographics, baseline alcohol consumption, and alcohol price. Stratified analyses were conducted by sex, hazardous drinking status, and age and income group. RESULTS Increases in cigarette taxes were associated with modest reductions in typical quantity of alcohol consumption and frequency of binge drinking among smokers. Cigarette taxation was not associated with changes in alcohol consumption among nonsmokers. In analyses stratified by sex, the inverse associations of cigarette taxes with typical quantity and binge drinking frequency were found only for male smokers. Further, the inverse association of cigarette taxation and alcohol consumption was stronger among hazardous drinkers (translating into approximately 1/2 a drink less alcohol consumption per episode), young adult smokers, and smokers in the lowest income category. CONCLUSIONS Findings from this longitudinal, epidemiological study suggest increases in cigarette taxes are associated with modest to moderate reductions in alcohol consumption among vulnerable groups. Additional research is needed to further quantify the public health benefits of cigarette taxation on alcohol consumption and to evaluate the potential broader crossover effects of cigarette taxation on other health behaviors.
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Affiliation(s)
- Kelly C Young-Wolff
- Stanford Prevention Research Center , Stanford University School of Medicine, Stanford, California
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Latkin C. Carl Latkin on Mukta Sharma and Anindya Chatterjee's "Failure of substance use interventions: perspectives from Asia". Subst Use Misuse 2012. [PMID: 23186491 DOI: 10.3109/10826084.2012.723542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Carl Latkin
- Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205-2414, USA.
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15
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Schwappach D, Popova S, Mohapatra S, Patra J, Godinho A, Rehm J. Strategies for evaluating the economic value of drugs in alcohol dependence treatment. Drug Alcohol Depend 2012; 122:165-73. [PMID: 21924845 DOI: 10.1016/j.drugalcdep.2011.08.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2011] [Revised: 08/18/2011] [Accepted: 08/20/2011] [Indexed: 11/28/2022]
Abstract
BACKGROUND To assess existing health economic strategies, which are used to evaluate the economic value of drugs to treat alcohol dependence (AD) such as acamprosate, naltrexone and any other pharmaceuticals. METHODS A systematic literature search on AD treatment economic evaluation studies was performed in multiple electronic bibliographic and economic databases. RESULTS A total of seven studies were found that involved economic evaluations of pharmacotherapy treatment of AD. It was seen that all individual pharmacotherapy treatment programs including acamprosate, naltrexone and combined treatments have resulted in a net benefit or cost savings. However, the examined studies used different methods to estimate the costs, cost savings, and cost effectiveness of the treatments. CONCLUSIONS Pharmacotherapy treatment of AD produced marked economic benefits. However, the number of studies on the economic evaluation of pharmacotherapy for AD treatment is limited. The gaps in these studies have also been identified as necessitating more research.
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Affiliation(s)
- David Schwappach
- Research Institute for Public Health and Addiction, WHO Collaborating Centre for Substance Abuse, Switzerland.
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Wu TY, Chie WC, Lai MS, Chen CC, Kuo KL, Majeed A. Knowledge of the New Tobacco Hazards Prevention Act Is Associated With Smokers’ Behavior of Seeking Help in Smoking Cessation in Taiwan. Asia Pac J Public Health 2012; 27:NP212-22. [DOI: 10.1177/1010539512436545] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Evidence that smoking area restrictions and raising cigarette taxes affect smokers’ behavior of seeking help in cessation is limited. The authors conducted a case-control study of 200 participants in Taipei City, Taiwan, from December 2008 to June 2009 to evaluate the association between knowledge on legislation and the behavior of seeking help in smoking cessation. They compared smokers who sought assistance in clinics/classes and smokers who did not, matching for age, gender, and recruitment time. In a univariate model, both banning smoking and increasing prices had positive effects on smokers’ behavior, but the effect size of the latter was larger ( P = .021). A better knowledge of the regulations was associated with cessation effort (odds ratio [OR] = 2.74; 95% confidence interval [CI] = 1.44-5.23), as were being more influenced by increased prices (OR = 2.44; 95% CI = 1.38-4.34) and by smoking bans (OR = 2.32; 95% CI = 1.29-4.16). Increased knowledge of the regulations is associated with seeking help for smoking.
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Affiliation(s)
- Tai-Yin Wu
- National Taiwan University, Taipei City, Taiwan
- Taipei City Hospital, Taipei City, Taiwan
| | | | - Mei-Shu Lai
- National Taiwan University, Taipei City, Taiwan
| | | | | | - Azeem Majeed
- Imperial College London, Charing Cross Campus, London, UK
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Turkson AJ, Wang XJ, Gobah FFK. Salient latent constructs underlying smoking initiation and continuous use by student-smokers of Huazhong University of Science and Technology, China. Asia Pac J Public Health 2011; 27:NP2587-601. [PMID: 22186389 DOI: 10.1177/1010539511430341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The factor analysis model was used to parsimoniously reduce the number of variables that influence smoking among students to salient factors that cut across continents, race, and sociocultural settings among university students in China. Stratified random sampling and snowball techniques were employed to obtain the sample. A Likert-type questionnaire was used to collect data. The results revealed that of the 39 variables identified to influence smoking, 34 were retained and regrouped in terms of common features they share into 13 salient factors that accounted for 58% of variances in the original variables. The predominant hidden construct was influence by association. The other 12 factors were labeled and ordered as follows: emotional needs, family history, addiction, peer pressure, lack of full realization of the consequences of their action as regards the expense of smoking, social needs, advertisement, psychological needs, self-image, environmental factors, ineffective policies, and underestimation of health risks. Irrespective of regional demarcations, factors that influence smoking initiation and continuous use are same.
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Affiliation(s)
| | - Xiang J Wang
- Huazhong University of Science and Technology, Wuhan, China
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Mackie P, Sim F. Leaving a legacy. Public Health 2010; 124:427-8. [DOI: 10.1016/j.puhe.2010.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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