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Guindon GE, Abbas U, Trivedi R, Garasia S, Johnson S, John RM. Socioeconomic differences in the impact of prices and taxes on tobacco use in low- and middle-income countries-A systematic review. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002342. [PMID: 37756265 PMCID: PMC10529577 DOI: 10.1371/journal.pgph.0002342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 08/07/2023] [Indexed: 09/29/2023]
Abstract
There is indisputable evidence that increases in taxes that raise tobacco prices reduce tobacco use. Consumption taxes on manufactured tobacco products, however, can be regressive in socioeconomic status (e.g., when the ratio of tax paid to income is lower for higher-income groups than for lower-income groups). Nevertheless, if the poor or less educated are more price responsive, a change in tobacco tax may be progressive in socioeconomic status. Existing reviews clearly indicate that populations with lower income or education are more responsive to tobacco tax and price changes than higher-income and more educated populations in high-income countries. Research pertaining to low- and middle-income countries was, however, limited and inconclusive. We conducted a review of quantitative studies that examined if socioeconomic status modified the association between prices and taxes and tobacco use in low- and middle-income countries. We searched two electronic databases, two search engines, and two working paper repositories. At least two reviewers independently screened articles for inclusion, extracted detailed characteristics, and assessed the risk of bias of each included study. Thirty-two studies met our inclusion criteria. Overall, we found that the evidence in low- and middle-income countries was too limited and methodologically weak to make any conclusive statements. Our review highlights a number of data and methodological limitations in existing studies. The most important limitation was the lack of formal assessment of socioeconomic differences in price responsiveness. Only seven of 32 studies assessed statistically whether own-price effects were modified by socioeconomic status. Many modelling studies have examined the distributional effect of a tax increase on tobacco use, while assuming a strong own-price elasticity gradient in income. The poor were generally assumed to be more responsive to price by a factor of two to five, relative to the wealthy. Although there are theoretical reasons to expect poorer individuals to be more responsive to monetary prices than wealthy ones in low- and middle-income countries, our review provides little empirical support.
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Affiliation(s)
- G. Emmanuel Guindon
- Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Economics, McMaster University, Hamilton, Ontario, Canada
| | - Umaima Abbas
- Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada
| | - Riya Trivedi
- Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada
| | - Sophiya Garasia
- Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Sydney Johnson
- Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada
| | - Rijo M. John
- Rajagiri College of Social Sciences, Rajagiri PO, Kochi, Kerala, India
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Cruces G, Falcone G, Puig J. Differential price responses for tobacco consumption: implications for tax incidence. Tob Control 2022; 31:s95-s100. [PMID: 35017265 DOI: 10.1136/tobaccocontrol-2021-056846] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 12/11/2021] [Indexed: 01/02/2023]
Abstract
Increasing tobacco taxes is considered the most effective an cost-effective policy to reduce tobacco consumption. However, a common objection to tobacco taxes is that they tend to rely disproportionately on the poorest individuals since less affluent smokers incur proportionately greater expenditures on cigarettes compared with more affluent smokers. Such objections usually assume that all smokers throughout the income distribution react similarly to an increase in tobacco prices. But, if less affluent smokers are more sensitive to price changes (ie, they have a higher demand price elasticity), reductions in tobacco consumption should be higher at the bottom of the income distribution. This paper uses data from Argentina's Household Expenditure Survey to estimate demand price elasticities for tobacco by income and age groups. Results indicate that less affluent smokers present higher demand price elasticities for cigarettes than more affluent ones. A 10% increase in cigarette prices would decrease consumption by 8.5% (4.4%) for the poorest (richest) smokers. In addition, young people are the most elastic group. These differential elasticities have relevant implications in terms of the distributional incidence of increasing tobacco taxes. As less well-off individuals reduce consumption relatively more, they bear a relatively lower tax burden. Thus, tobacco tax increases may not be regressive as is often believed. As a whole, this paper provides policymakers with relevant arguments for policy discussion and the public debate on common objections to increasing tobacco taxes.
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Affiliation(s)
- Guillermo Cruces
- CEDLAS, Centro de Estudios Distributivos, Laborales y Sociales, IIE-FCE, Universidad Nacional de La Plata, La Plata, Argentina
| | - Guillermo Falcone
- CEDLAS, Centro de Estudios Distributivos, Laborales y Sociales, IIE-FCE, Universidad Nacional de La Plata, La Plata, Argentina
| | - Jorge Puig
- CEDLAS, Centro de Estudios Distributivos, Laborales y Sociales, IIE-FCE, Universidad Nacional de La Plata, La Plata, Argentina
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Cizmovic M, Mugosa A, Kovacevic M, Lakovic T. Effectiveness of tax policy changes in Montenegro: smoking behaviour by socio-economic status. Tob Control 2022; 31:s124-s132. [DOI: 10.1136/tobaccocontrol-2021-056876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 02/27/2022] [Indexed: 12/21/2022]
Abstract
BackgroundThe main goal of this study was to examine the responsiveness of smoking prevalence and cigarette consumption to price and income changes by income groups and the effectiveness of tax policy changes to reduce cigarette consumption in Montenegro.Data and methodsA two-part model was applied to estimate smoking participation, smoking intensity price and income elasticity. The first part of the model applies logit regression, while the second uses Deaton’s model to improve the validity and objectivity of conditional (smoking intensity) elasticity results. A generalised linear model (GLM) was applied to verify robustness. The reason for this is that Deaton’s model is commonly used in the analysis of Household Budget Survey (HBS) data, especially when households do not report the market price. Moreover, using this model, it is possible to capture the shading of quality to price change. The analysis used HBS data (2006–2017).ResultsThe estimates indicate that tobacco pricing policies had a much higher impact on smoking prevalence in the low-income group (price elasticity of −0.595) relative to the high-income group (price elasticity of −0.344). The same conclusion could be drawn for the smoking intensity elasticity: the high-income group was the least affected by changes in price (price elasticity of −0.258). At the same time, the most affected was the low-income group, with price elasticity of −0.424. Poorer households spent a larger share of their budget on cigarettes. The simulation results confirm that increases in the specific excise taxes of 58.3% on tobacco would reduce total cigarette consumption by 11.25% while increasing the collection of government revenue by 8.07%.ConclusionSmoking prevalence and consumption are very responsive to price and income changes, with considerable differences in elasticities between income groups. The taxation policy has a positive impact on changing patterns of consumption and public revenues across each income group. Low-income and middle-income households would benefit the most, while on the other hand, the highest revenue collection was generated from the wealthiest group. Our results align with results obtained so far for other low-income and middle-income countries. This paper contributes to the analysis of the smoking prevalence and cigarette consumption responsiveness to price and income changes, which was conducted for the first time in Montenegro.
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