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Bonnet C, Coinon M. Environmental co-benefits of health policies to reduce meat consumption: A narrative review. Health Policy 2024; 143:105017. [PMID: 38503172 DOI: 10.1016/j.healthpol.2024.105017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 02/06/2024] [Accepted: 02/09/2024] [Indexed: 03/21/2024]
Abstract
Global meat consumption has risen steadily in recent decades, with heterogeneous growth rates across regions. While meat plays a critical role in providing essential nutrients for human health, excessive consumption of meat, particularly red and processed meat, has also been associated with a higher risk of certain chronic diseases. This has led public authorities, including the World Health Organization, to call for a reduction in meat consumption. How governments can effectively reduce the health costs of meat consumption remains a challenge as implementing effective policy instruments is complex. This paper examines health-related policy instruments and potential economic mechanisms that could reduce meat consumption. Health-related taxation could be the most effective instrument. Other policy instruments, such as informational and behavioral instruments, along with regulations, could discourage meat consumption depending on the policy design. We also provide evidence on the link between meat consumption and the environment, including climate, biodiversity, water use, and pollution. Promoting healthy behaviors by reducing meat consumption can then have environmental co-benefits and promote broader sustainable development goals. We also discuss the policy-related challenges that need to be addressed to meet environmental co-benefits.
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Affiliation(s)
- Céline Bonnet
- Toulouse School of Economics, INRAE, University of Toulouse Capitole, Toulouse, France.
| | - Marine Coinon
- Toulouse School of Economics, INRAE, University of Toulouse Capitole, Toulouse, France
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Manthey J, Gobiņa I, Isajeva L, Neneman J, Reile R, Štelemėkas M, Rehm J. The Impact of Raising Alcohol Taxes on Government Tax Revenue: Insights from Five European Countries. Appl Health Econ Health Policy 2024; 22:363-374. [PMID: 38386271 PMCID: PMC11021250 DOI: 10.1007/s40258-024-00873-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/18/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND AND OBJECTIVE Reducing the affordability of alcoholic beverages by increasing alcohol excise taxation can lead to a reduction in alcohol consumption but the impact on government alcohol excise tax revenue is poorly understood. This study aimed to (a) describe cross-country tax revenue variations and (b) investigate how changes in taxation were related to changes in government tax revenue, using data from Estonia, Germany, Latvia, Lithuania and Poland. METHODS For the population aged 15 years or older, we calculated the annual per capita alcohol excise tax revenue, total tax revenue, gross domestic product and alcohol consumption. In addition to descriptive analyses, joinpoint regressions were performed to identify whether changes in alcohol excise taxation were linked to changes in alcohol excise revenue since 1999. RESULTS In 2022, the per capita alcohol excise tax revenue was lowest in Germany (€44.2) and highest in Estonia (€218.4). In all countries, the alcohol excise tax revenue was mostly determined by spirit sales (57-72% of total alcohol tax revenue). During 2010-20, inflation-adjusted per capita alcohol excise tax revenues have declined in Germany (- 22.9%), Poland (- 19.1%) and Estonia (- 4.2%) and increased in Latvia (+ 56.8%) and Lithuania (+ 49.3%). In periods of policy non-action, alcohol consumption and tax revenue showed similar trends, but tax level increases were accompanied by increased revenue and stagnant or decreased consumption. CONCLUSIONS Increasing alcohol taxation was not linked to decreased but increased government revenue. Policymakers can increase revenue and reduce alcohol consumption and harm by increasing alcohol taxes.
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Affiliation(s)
- Jakob Manthey
- Department of Psychiatry and Psychotherapy, Center for Interdisciplinary Addiction Research (ZIS), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.
- Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany.
| | - Inese Gobiņa
- Department of Public Health and Epidemiology, Riga Stradiņš University, Riga, Latvia
- Institute of Public Health, Riga Stradiņš University, Riga, Latvia
| | - Laura Isajeva
- Department of Public Health and Epidemiology, Riga Stradiņš University, Riga, Latvia
- Institute of Public Health, Riga Stradiņš University, Riga, Latvia
| | - Jarosław Neneman
- Institute of Economics, Faculty of Economics and Sociology, University of Lodz, Lodz, Poland
| | - Rainer Reile
- Department for Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia
| | - Mindaugas Štelemėkas
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Jürgen Rehm
- Department of Psychiatry and Psychotherapy, Center for Interdisciplinary Addiction Research (ZIS), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
- Institute for Mental Health Policy Research and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Program on Substance Abuse, Program on Substance Abuse and WHO CC, Public Health Agency of Catalonia, Barcelona, Spain
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Mena AC, Paraje G. Tobacco price elasticity by socioeconomic characteristics in Ecuador. PLoS One 2024; 19:e0302293. [PMID: 38640122 PMCID: PMC11029633 DOI: 10.1371/journal.pone.0302293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 04/01/2024] [Indexed: 04/21/2024] Open
Abstract
Smoking is a worldwide epidemic and increased prices are one of the most cost-effective measures to reduce tobacco consumption. This article aims to estimate the price and income elasticity of cigarettes for different population groups in Ecuador. The National Survey of Urban and Rural Household Income and Expenditures (ENIGHUR) 2011-2012 was used, which has information on household cigarette consumption and its sociodemographic characteristics. Deaton's Almost Ideal Demand System, which decouples the effect of quality on the price of the good, was applied. The elasticities were calculated for several groups: urban/rural, income levels (tertiles), education level, sex and age ranges of the household head, and frequency of cigarette purchases in households. The estimated price elasticity nationwide is -0.89 and the income elasticity is 0.41, both statistically significant. Households headed by women (-2.22) are more sensitive to an increase in cigarette prices than those headed by men (-0.65) and households headed by people between 20 and 40 years of age (-2.32) have a higher price elasticity compared to country-level estimations. Differences within other groups are not statistically significant.
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Affiliation(s)
- Ana Cristina Mena
- Business School, Universidad de Las Américas, Escuela de Negocios, Quito, Ecuador
| | - Guillermo Paraje
- Business School, Universidad Adolfo Ibanez, Santiago de Chile, Chile
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Bui WKT, Ross H, Mohamed Nor N. Magnitude of illicit cigarette trade in Malaysia: empirical evidence compared with industry studies. Tob Control 2024; 33:341-345. [PMID: 36207128 DOI: 10.1136/tc-2021-057210] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 09/14/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND The tobacco industry contends that the illicit market in Malaysia occupies 62.3% of the total cigarette market. If this is true, Malaysia has one of the largest shares of illicit cigarettes in the world. METHODS This study employs a rigorous gap analysis to measure the size of the illicit cigarette trade in Malaysia and compare it with the industry estimates. FINDINGS We found that in 2019, the illicit cigarette market share ranged from 38.2% to 52.5%, depending on assumptions with respect to consumption under-reporting, which is substantially less than the industry estimates. We found that the size of the illicit cigarette market was not driven by higher excise tax: doubling the excise tax rate from RM0.20 to RM0.40 per stick in November 2015 resulted in only a slight increase in the illicit cigarette market share and no increase in the number of illicit cigarettes in the market. CONCLUSIONS Therefore, a reduction in cigarette excise taxes, as suggested by the industry, will not solve the problem of illicit cigarette trade in Malaysia. Instead, the government should ratify the Framework Convention on Tobacco Control's Protocol to Eliminate Illicit Trade in Tobacco Products and implement the strategies outlined in the protocol.
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Affiliation(s)
- Wency Kher Thinng Bui
- School of Business and Economics, Universiti Putra Malaysia, Serdang, Malaysia
- School of Government, Ateneo de Manila University, Quezon City, Philippines
| | - Hana Ross
- Research Unit on the Economics of Excisable Products, University of Cape Town, Rondebosch, South Africa
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Jokirinta J, Päkkilä J, Mourelatos E, Sipola S, Laitala ML, Karki S. Trend in basic oral treatment needs in relation to taxation of sweets, ice cream, and sugar-sweetened beverages in Finland: a registry-based study. Acta Odontol Scand 2024; 83:160-165. [PMID: 38628100 DOI: 10.2340/aos.v83.40335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 02/14/2024] [Indexed: 04/19/2024]
Abstract
OBJECTIVE The aims were to explore the trend in basic oral treatment needs and total operating cost of public dental services (PDS) in relation to total excise tax revenue generated from sugary products during 2011-2020 and to evaluate the impact of tax policy in excise tax revenue of sugary products and average sugar consumption. METHODS The study comprised longitudinal data retrieved from Finnish registries during the years 2011-2020. Basic oral treatment needs, and total operating cost of PDS, total excise tax revenue generated from sugary products and average sugar consumed (kg per capita) during the years 2011-2020 were obtained. Simplified panel analyses and sensitivity analyses were used to evaluate the effects of explanatory variables on outcomes. Results: An approximate one EUR 1,000,000 increase in total excise tax revenue generated from sugary products corresponds to a 0.4% increase in total operating cost of PDS. There was a significant positive trend in total operating cost of PDS in Finland over the study period. Similarly, an approximate one EUR 1,000,000 rise in total excise tax revenue corresponds to a 0.2% increase in basic oral treatment needs. Additionally, there was a statistically significant difference in the average excise tax revenue for sugary products between the periods before and after 2017. CONCLUSION No change in average sugar consumption was observed despite implementing the new sugar policy. Therefore, it may be worthwhile to reconsider the excise tax on sweets and ice cream as it will significantly increase the total national revenues.
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Affiliation(s)
- Jesse Jokirinta
- Research Unit of Population Health, University of Oulu, Oulu, Finland
| | - Jari Päkkilä
- Research Unit of Mathematical Sciences, University of Oulu, Oulu, Finland
| | | | - Sakari Sipola
- Oulu Business School, University of Oulu, Oulu, Finland
| | - Marja-Liisa Laitala
- Research Unit of Population Health, University of Oulu, Oulu, Finland; Medical Research Center Oulu and Oulu University Hospital, Oulu, Finland.
| | - Saujanya Karki
- Research Unit of Population Health, University of Oulu, Oulu, Finland
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Xue Y. The impacts of environmental protection tax reform in resource-based regions based on the CGE model. Environ Res 2024; 247:118211. [PMID: 38237758 DOI: 10.1016/j.envres.2024.118211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 01/01/2024] [Accepted: 01/13/2024] [Indexed: 01/23/2024]
Abstract
Economic transformation and development serve as effective strategies for resource-based regions to avoid the "resource curse." By optimizing industrial structure and enhancing energy efficiency through government macro-regulation, these regions can achieve sustainable and environment-friendly growth. The general equilibrium model is widely employed to assess the effectiveness of economic transformation and development. In this study, we constructed a provincial social accounting matrix based on macro data from Shanxi, China, to examine the impact of different environmental protection tax rates on the macro economy, industrial structure, and energy consumption. The findings reveal that the implementation of environmental protection tax has successfully optimized the industrial structure and improved energy utilization efficiency. However, it has also led to a slight decline in total output. Hence, it is imperative to establish a more balanced and reasonable environmental protection tax rate to further promote economic transformation and development in resource-based areas. Consequently, this paper puts forth policy recommendations aimed at achieving a harmonious balance between ecological preservation and economic progress in resource-based regions, ultimately enhancing the overall quality of economic development in such areas.
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Affiliation(s)
- Yaozu Xue
- Department of Economics, Shanghai Party Institute of CCP, Shanghai, 200233, China.
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Willits-Smith A, Taillie LS, Jaacks LM, Frank SM, Grummon AH. Effects of red meat taxes and warning labels on food groups selected in a randomized controlled trial. Int J Behav Nutr Phys Act 2024; 21:39. [PMID: 38622655 PMCID: PMC11020801 DOI: 10.1186/s12966-024-01584-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 03/15/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND High consumption of red and processed meat contributes to both health and environmental harms. Warning labels and taxes for red meat reduce selection of red meat overall, but little is known about how these potential policies affect purchases of subcategories of red meat (e.g., processed versus unprocessed) or of non-red-meat foods (e.g., cheese, pulses) relevant to health and environmental outcomes. This study examined consumer responses to warning labels and taxes for red meat in a randomized controlled trial. METHODS In October 2021, we recruited 3,518 US adults to complete a shopping task in a naturalistic online grocery store. Participants were randomly assigned to one of four arms: control (no warning labels or tax), warning labels only (health and environmental warning labels appeared next to products containing red meat), tax only (prices of products containing red meat were increased 30%) or combined warning labels + tax. Participants selected items to hypothetically purchase, which we categorized into food groups based on the presence of animal- and plant-source ingredients (e.g., beef, eggs, pulses), meat processing level (e.g., processed pork versus unprocessed pork), and meat species (e.g., beef versus pork). We assessed the effects of the warning labels and tax on selections from each food group. RESULTS Compared to control, all three interventions led participants to select fewer items with processed meat (driven by reductions in processed pork) and (for the tax and warning labels + tax interventions only) fewer items with unprocessed meat (driven by reductions in unprocessed beef). All three interventions also led participants to select more items containing cheese, while only the combined warning labels + tax intervention led participants to select more items containing processed poultry. Except for an increase in selection of pulses in the tax arm, the interventions did not affect selections of fish or seafood (processed or unprocessed), eggs, or plant-based items (pulses, nuts & seeds, tofu, meat mimics, grains & potatoes, vegetables). CONCLUSIONS Policies to reduce red meat consumption are also likely to affect consumption of other types of foods that are relevant to both health and environmental outcomes. TRIAL REGISTRATION NCT04716010 on www. CLINICALTRIALS gov .
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Affiliation(s)
- Amelia Willits-Smith
- Carolina Population Center, University of North Carolina at Chapel Hill, 27516, Chapel Hill, NC, USA
| | - Lindsey Smith Taillie
- Carolina Population Center, University of North Carolina at Chapel Hill, 27516, Chapel Hill, NC, USA
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 27516, Chapel Hill, NC, USA
| | - Lindsay M Jaacks
- Global Academy of Agriculture and Food Systems, The University of Edinburgh, Midlothian, UK
| | - Sarah M Frank
- Global Academy of Agriculture and Food Systems, The University of Edinburgh, Midlothian, UK
| | - Anna H Grummon
- Department of Pediatrics, Stanford University School of Medicine, 3145 Porter Drive, A103, 94034, Palo Alto, CA, USA.
- Department of Health Policy, Stanford University School of Medicine, 94305, Stanford, CA, USA.
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Huque R, Azad AK, Ahmed N. Own price elasticities of the demand for sugar-sweetened beverages in Bangladesh. BMC Public Health 2024; 24:1020. [PMID: 38609956 PMCID: PMC11010358 DOI: 10.1186/s12889-024-18544-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 04/07/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Consumption of sugar-sweetened beverages (SSB) is a major global public health problem. Increasing the price of SSBs through taxation is an effective tool to reduce SSB consumption. Price-elasticity estimates are useful in measuring the effect of taxation on consumption. We estimated the own price elasticities of demand for SSBs in Bangladesh, which will inform how SSB taxes could affect behaviour. METHODS We used Household Income and Expenditure Survey (HIES) 2016 data, which is a nationally representative dataset at the household level across the country and is conducted using stratified random sampling method. Deaton's method was used to estimate the price elasticities for SSBs in Bangladesh. RESULTS We found that the own price elasticity for SSBs varied between - 0.53% to -1.17% by types of SSBs in Bangladesh. The price elasticity for soft drinks was - 1.17, indicating that if the price of soft drinks increases by 10% via taxes, the quantity consumed of these beverages would reduce by 11.7%. CONCLUSION This is the first study that estimates the own price elasticities of demand for SSBs in Bangladesh. Our results suggest to raise SSB prices through increased taxation in order to reduce SSB consumption and ensure public health gains in Bangladesh.
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Affiliation(s)
- Rumana Huque
- ARK Foundation, Flat C3 and C4, House # 6; Road # 109 Gulshan 2, Dhaka, 1212, Bangladesh.
| | - Abul Kalam Azad
- Department of Economics, Social Science Building, University of Dhaka, Nilkhet, Dhaka-1000, Bangladesh
| | - Nasiruddin Ahmed
- ARK Foundation, Flat C3 and C4, House # 6; Road # 109 Gulshan 2, Dhaka, 1212, Bangladesh
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Tangcharoensathien V, Vathesatogkit P, Buasai S. Tying health taxes to health promotion is popular and effective in Thailand. BMJ 2024; 385:q540. [PMID: 38589033 DOI: 10.1136/bmj.q540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
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Hong S, Woo S, Kim S, Park J, Lee M, Kim S, Koyanagi A, Smith L, Kim MS, López Sánchez GF, Dragioti E, Rahmati M, Fond G, Boyer L, Oh J, Lee H, Yon DK. National prevalence of smoking among adolescents at tobacco tax increase and COVID-19 pandemic in South Korea, 2005-2022. Sci Rep 2024; 14:7823. [PMID: 38570551 PMCID: PMC10991517 DOI: 10.1038/s41598-024-58446-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 03/29/2024] [Indexed: 04/05/2024] Open
Abstract
Prior research has predominantly focused on the overall effects of the tobacco tax increase and the COVID-19 pandemic on adolescent smoking behavior. However, there is a need to examine both the immediate and sustained associations of these two factors on subgroups of adolescents, employing an interrupted time-series model. We aimed to investigate the immediate and sustained association of tobacco tax increase and the COVID-19 pandemic on adolescent smoking prevalence. This study utilized data from the Korea Youth Risk Behavior Web-Based Survey to analyze the prevalence of current smoking among all participants (CSP) and the prevalence of daily smoking among current smokers (DSP) of Korean adolescents (n = 1,159,995; mean, age 14.99; male 51.5%) over 18 years from 2005 to 2022. The study examined 18-year trends in CSP and DSP among Korean adolescents, emphasizing the influences of the 2015 tobacco tax increase and the COVID-19 pandemic, using β coefficients and their differences (βdiff) from an interrupted time-series ARIMA model. While CSP exhibited a decreasing trend, DSP exhibited an increasing trend. Tobacco tax increase was associated with both the short and long terms in smoking prevalence, however, the short-term association on prevalence (CSP, - 3.076 [95% CI, - 3.707 to - 2.445]; DSP, - 4.112 [95% CI, - 6.488 to - 1.735]) was stronger. The pandemic was associated with an immediate increase in DSP (9.345 [95% CI, 5.285-13.406]). These effects were strongest among adolescents from low economic status and those exposed to familial secondhand smoking. Supportive programs for adolescents in low-income families will help overcome the effects associated with the pandemic. As a tobacco tax increase was associated with a reduction in smoking prevalence, this could be one method to overcome the effects of the pandemic.
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Affiliation(s)
- Seohyun Hong
- Department of Medicine, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Selin Woo
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Seokjun Kim
- Department of Medicine, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Jaeyu Park
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea
- Department of Regulatory Science, Kyung Hee University, Seoul, South Korea
| | - Myeongcheol Lee
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea
- Department of Regulatory Science, Kyung Hee University, Seoul, South Korea
| | - Sunyoung Kim
- Department of Family Medicine, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Deu, Barcelona, Spain
| | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Min Seo Kim
- Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Guillermo F López Sánchez
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia, Spain
| | - Elena Dragioti
- Pain and Rehabilitation Centre, and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
- Research Laboratory Psychology of Patients, Families, and Health Professionals, Department of Nursing, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Masoud Rahmati
- Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khoramabad, Iran
- Department of Physical Education and Sport Sciences, Faculty of Literature and Humanities, Vali-e-Asr University of Rafsanjan, Rafsanjan, Iran
- CEReSS-Health Service Research and Quality of Life Center, Assistance Publique Des Hôpitaux de Marseille, Aix-Marseille University, Marseille, France
| | - Guillaume Fond
- CEReSS-Health Service Research and Quality of Life Center, Assistance Publique Des Hôpitaux de Marseille, Aix-Marseille University, Marseille, France
| | - Laurent Boyer
- CEReSS-Health Service Research and Quality of Life Center, Assistance Publique Des Hôpitaux de Marseille, Aix-Marseille University, Marseille, France
| | - Jiyeon Oh
- Department of Medicine, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Hojae Lee
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea
- Department of Regulatory Science, Kyung Hee University, Seoul, South Korea
| | - Dong Keon Yon
- Department of Medicine, Kyung Hee University College of Medicine, Seoul, South Korea.
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea.
- Department of Regulatory Science, Kyung Hee University, Seoul, South Korea.
- Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, South Korea.
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Ku LJE, Moo CC, Li YC, Chang YH, Hsu YH, Huang YC, Lu CL, Li CY. Support for a hypothetical sugar-sweetened beverage tax in Taiwan. Health Promot Int 2024; 39:daae028. [PMID: 38568731 DOI: 10.1093/heapro/daae028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024] Open
Abstract
Sugar-sweetened beverages (SSBs) are drinks that contain added sugar or sweeteners and provide calories with no additional nutrients, and some countries have imposed additional taxes on the SSBs to reduce consumption, which is considered an SSB tax policy. This study used a cross-sectional online survey to examine the patterns of public support for an SSB tax in Taiwan. The sample included 1617 adults aged ≥ 20 years, who answered the survey questionnaire between May 2020 and April 2021. The respondents were recruited using convenience sampling, but sampling weights were applied to represent the Taiwanese population. Generalized ordered logit models with sampling weights were used to examine the correlates of public support for an SSB tax. Results showed that ~60% of the respondents supported the SSB tax and 47% perceived the tax to be effective. The respondents who were aware of the perceived health risks of SSBs or those who believed that one should be partly responsible for the health impact of SSBs were more likely to show support for the SSB tax. In adjusted regression models, both one's perceived risk and perceived responsibility of SSBs were positively associated with the perceived effectiveness of the SSB tax after sociodemographic characteristics were controlled. These research findings show evidence that there is public support for implementing an SSB tax to reduce SSB consumption in Taiwan.
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Affiliation(s)
- Li-Jung Elizabeth Ku
- Department of Public Health, College of Medicine, National Cheng Kung University, No. 1, University Rd., East Rd., Tainan, 701, Taiwan
| | - Cherl Cy Moo
- Department of Public Health, College of Medicine, National Cheng Kung University, No. 1, University Rd., East Rd., Tainan, 701, Taiwan
| | - Yueh-Chen Li
- Department of Public Health, College of Medicine, National Cheng Kung University, No. 1, University Rd., East Rd., Tainan, 701, Taiwan
| | - Ya-Hui Chang
- Department of Public Health, College of Medicine, National Cheng Kung University, No. 1, University Rd., East Rd., Tainan, 701, Taiwan
| | - Yuu-Hueih Hsu
- Department of Public Health, College of Medicine, National Cheng Kung University, No. 1, University Rd., East Rd., Tainan, 701, Taiwan
| | - Yi-Chin Huang
- Department of Public Health, College of Medicine, National Cheng Kung University, No. 1, University Rd., East Rd., Tainan, 701, Taiwan
| | - Chin-Li Lu
- Graduate Institute of Food Safety, National Chung Hsing University, No. 250, Kuo Kuang Rd., Taichung, 402, Taiwan
| | - Chung-Yi Li
- Department of Public Health, College of Medicine, National Cheng Kung University, No. 1, University Rd., East Rd., Tainan, 701, Taiwan
- Department of Public Health, College of Public Health, China Medical University, No. 100, Section 1, Jingmao Rd., Taichung, 406, Taiwan
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, No.500, Lioufeng Rd., Taichung, 413, Taiwan
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Hall MG, Ruggles PR, McNeel K, Prestemon CE, Lee CJY, Lowery CM, Campos AD, Taillie LS. Understanding Whether Price Tag Messaging Can Amplify the Benefits of Taxes: An Online Experiment. Am J Prev Med 2024; 66:609-618. [PMID: 38189693 PMCID: PMC10957315 DOI: 10.1016/j.amepre.2023.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 11/20/2023] [Accepted: 11/20/2023] [Indexed: 01/09/2024]
Abstract
INTRODUCTION Excise taxes on unhealthy products like sugary drinks and tobacco can reduce purchases of these products. However, little research has investigated whether messages at the point of purchase, such as enhanced price tags, can increase the effects of taxes by heightening psychological reactions. This study aimed to examine whether including messages about taxes on price tags could amplify the benefits of excise taxes on unhealthy products. METHODS In 2022, an online study recruited 1,013 U.S. parents to view seven price tag messages (e.g., "includes a 19% sugary drink tax") and a control (i.e., standard price tag with the tax included in the price) displayed in random order alongside sugary drinks. Participants were randomly assigned to view a caution-symbol icon or no icon on price tags. Analyses were conducted in 2023. RESULTS All seven messages discouraged parents from buying sugary drinks for their children compared to control (average differential effects [ADEs] ranged from 0.28 to 0.48, all p<0.001). All messages led to greater attention to the price tag (ADEs ranged from 0.24 to 0.41, all p<0.001) and greater consideration of the cost of sugary drinks (ADEs ranged from 0.31 to 0.50, all p<0.001). Icons elicited higher cost consideration than text-only price tags (ADE=0.15, p<0.010), but not discouragement (p=0.061) or attention (p=0.079). CONCLUSIONS Messaging on price tags could make excise taxes more effective. Policymakers should consider requiring messaging on price tags when implementing taxes.
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Affiliation(s)
- Marissa G Hall
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
| | - Phoebe R Ruggles
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Katherine McNeel
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland
| | - Carmen E Prestemon
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Cristina J Y Lee
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California
| | - Caitlin M Lowery
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Aline D'Angelo Campos
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Lindsey Smith Taillie
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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13
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Yu Y, Liu J, Wang Q. Has environmental protection tax reform promoted green transformation of enterprises? Evidence from China. Environ Sci Pollut Res Int 2024; 31:29472-29496. [PMID: 38578592 DOI: 10.1007/s11356-024-32844-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 03/06/2024] [Indexed: 04/06/2024]
Abstract
Facing the increasingly stringent constraints of resources and the environment, the green transformation of enterprises is imperative. This study selects A-share listed companies in Shanghai and Shenzhen from 2014 to 2021 as samples, using the difference-in-differences method to examine the impact of the environmental protection tax reform (EPTR) on the green transformation of enterprises. The results indicate that the EPTR can promote the green transformation of enterprises, achieving this through three channels: raising the cost of pollution, strengthening the rigidity of law enforcement, and breaking the collusion between the government and enterprises. Notably, this promotional effect is more significant in non-state-owned enterprises, companies in the eastern and western regions, firms with low financing constraints, and those with high media attention. Further analysis shows that the EPTR has a positive impact on the green total factor productivity (GTFP) of enterprises, which implies that enterprises are not only proactively pushing for a green transformation at the strategic level but also taking practical actions. This study responds to the problem of the greening of tax system to promote the green development of enterprises from two aspects of enterprise strategic implementation and productivity and explores the impact mechanism from the perspective of institutional logic. It enriches the research on the effectiveness of the EPTR at the micro-level and broadens the research perspective on the impact mechanisms of environmental regulation. The findings of this study provide references for further optimising relevant policies and regulations and also offer insights for other countries and regions seeking sustainable development.
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Affiliation(s)
- Yaxi Yu
- School of Economics and Management, Southwest Jiaotong University, Chengdu, 610031, Sichuan, China
| | - Junqi Liu
- School of Business, Southwest University of Political Science and Law, Chongqing, 401120, China
| | - Qi Wang
- School of Architecture and Civil Engineering, Xihua University, Chengdu, 610039, Sichuan, China.
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14
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News Brief: Taxing sugar-sweetened beverages is an effective strategy to decrease consumption. Am J Nurs 2024; 124:15. [PMID: 38511699 DOI: 10.1097/01.NAJ.0001010540.14623.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
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15
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Spence JC, Mangan A, Sivak A. Effectiveness of the Children's Fitness Tax Credit: A scoping review. Can J Public Health 2024; 115:356-366. [PMID: 38472639 PMCID: PMC11027750 DOI: 10.17269/s41997-024-00861-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 01/23/2024] [Indexed: 03/14/2024]
Abstract
OBJECTIVES A scoping review was conducted to synthesize the literature examining impact of the Children's Fitness Tax Credit (CFTC) on the physical activity (PA) of Canadian children. Specifically, we posed two research questions seeking evidence for: (1) equitable take-up (e.g., claiming, use) of the CFTC by Canadian families; and (2) effectiveness of the CFTC in promoting or facilitating PA or sport participation among Canadian children and adolescents. METHODS A search was conducted in May 2023 of five databases (e.g., Medline, Scopus) and hand searching using terms such as children, adolescents, physical activity, sport, tax credit or taxation. Documents were included if they were data-based studies, available in English or French, and related to the research questions. They were then coded for characteristics of the document, sample, data, behaviour, and findings. SYNTHESIS Of 318 possible documents, 7 documents revealing 26 findings were included after a full-article scan. Most of the documents were published and had a national scope. The most frequent source of data was from parental reports (62%), with the most common types of behaviour being tax claim take-up rates (31%) or PA (27%). For the two research questions, the available evidence suggests no support for equitable take-up of the CFTC or the amount claimed, and most of the findings indicated no (64%) or limited effectiveness of the tax credit (29%). CONCLUSION The CFTC had limited to no impact in promoting PA among Canadian children, particularly for those experiencing low income.
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Affiliation(s)
- John C Spence
- Faculty of Kinesiology, Sport, & Recreation, University of Alberta, Edmonton, AB, Canada.
| | - Amie Mangan
- Faculty of Kinesiology, Sport, & Recreation, University of Alberta, Edmonton, AB, Canada
| | - Allison Sivak
- Geoffrey and Robin Sperber Health Sciences Library, University of Alberta, Edmonton, AB, Canada
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16
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Liu D, Feng M, Liu Y, Wang L, Hu J, Wang G, Zhang J. A tripartite evolutionary game study of low-carbon innovation system from the perspective of dynamic subsidies and taxes. J Environ Manage 2024; 356:120651. [PMID: 38531135 DOI: 10.1016/j.jenvman.2024.120651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 02/12/2024] [Accepted: 03/10/2024] [Indexed: 03/28/2024]
Abstract
Traditional manufacturing industry is in the early stages of transition to low-carbon innovative production, and is in urgent need of a low-carbon innovation system to achieve the goal of carbon neutrality. In order to realize the effective supervision of enterprise carbon emissions, this paper constructs a tripartite evolutionary game model among the corporate, government and public from the perspective of dynamic subsidies and taxes. The main results are as follows. First, the increase in government subsidies to a certain extent will help encourage companies to choose low-carbon innovative production strategies, but more subsidies are not always better. Excessive subsidies will increase the cost of government regulation and reduce the probability of government regulation. Second, the tripartite evolutionary game system does not converge under the static subsidies and taxes mechanism. But the system could quickly converges to the stable condition under dynamic subsidies and taxes. The stable point is the situation of corporate low-carbon innovation, government regulation, and public supervision. Third, the public intervention and supervision can effectively prevent the phenomenon of government misconduct and enterprises over-emission production. And the influence of public reward and punishment is more effective for the government than for enterprises.
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Affiliation(s)
| | - Meili Feng
- Zhejiang Gongshang University, Hangzhou, China
| | - Yanni Liu
- Hangzhou Normal University, Hangzhou, China.
| | - Liming Wang
- Hangzhou Dianzi University Information Engineering College, Hangzhou, China
| | - Jinhao Hu
- Zhejiang Gongshang University, Hangzhou, China
| | - Gaojie Wang
- Zhejiang Gongshang University, Hangzhou, China
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17
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Sassano M, Castagna C, Villani L, Quaranta G, Pastorino R, Ricciardi W, Boccia S. National taxation on sugar-sweetened beverages and its association with overweight, obesity, and diabetes. Am J Clin Nutr 2024; 119:990-1006. [PMID: 38569789 DOI: 10.1016/j.ajcnut.2023.12.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 12/07/2023] [Accepted: 12/14/2023] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Consumption of sugar-sweetened beverages (SSBs) has been linked to several adverse health outcomes, thus many countries introduced taxation to reduce it. OBJECTIVES To summarize national SSB taxation laws and to assess their association with obesity, overweight and diabetes. METHODS We conducted a systematic scoping review up to January 2022 on PubMed, Web of Science, Embase, and Google Search to identify taxes on SSBs. An interrupted time series analysis (ITSA) was conducted on 17 countries with taxation implemented in 2013 or before to evaluate the level and slope modifications in the rate of change of standardized prevalence rates of overweight, obesity, and diabetes. Random-effects meta-regression was used to assess whether year of entry into force of the law, national income, and tax design affected observed results. RESULTS We included 76 tax laws issued between 1940 and 2020 by 43 countries, which were heterogeneous in terms of tax design, amount, and taxed products. Among children and adolescents, ITSA showed level or slope reduction for prevalence of overweight and obesity in 5 (Brazil, Samoa, Palau, Panama, Tonga) and 6 (El Salvador, Uruguay, Nauru, Norway, Palau, Tonga) countries out of 17, respectively. No clear pattern of modification of results according to investigated factors emerged from the meta-regression analysis. CONCLUSIONS Taxation is highly heterogeneous across countries in terms of products and design, which might influence its effectiveness. Our findings provide some evidence regarding a deceleration of the increasing prevalence rates of overweight and obesity among children occurring in some countries following introduction of taxation. PROSPERO registration number: CRD42021233309.
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Affiliation(s)
- Michele Sassano
- Section of Hygiene, Department of Health Science and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy; Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Carolina Castagna
- Section of Hygiene, Department of Health Science and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Leonardo Villani
- Section of Hygiene, Department of Health Science and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gianluigi Quaranta
- Section of Hygiene, Department of Health Science and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy; Department of Women, Children and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Roberta Pastorino
- Section of Hygiene, Department of Health Science and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy; Department of Women, Children and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
| | - Walter Ricciardi
- Section of Hygiene, Department of Health Science and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Stefania Boccia
- Section of Hygiene, Department of Health Science and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy; Department of Women, Children and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
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18
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Ferraiolo K. Popular Votes on Tobacco Tax Increases, 2012-2022. J Health Polit Policy Law 2024; 49:217-248. [PMID: 37801022 DOI: 10.1215/03616878-10989711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
CONTEXT Researchers have examined the campaign strategies, messaging, and outcomes of popular votes on tobacco tax increases from 1998 to 2008, but no study has investigated measures that have appeared since 2008. METHODS The author uses state newspaper archives, voter pamphlets, academic reports, advocacy websites, and personal interviews to obtain information about the 11 tobacco tax increase ballot measures that appeared from 2012 to 2022. FINDINGS The three measures that succeeded during 2012-2022 featured sufficient financial resources, collaboration with influential stakeholders, and early public support. Two of the three successful measures offered significant concessions to the tobacco industry, and both were designed as legislatively referred statutes. Elsewhere, proponents sought unsuccessfully to enact citizen-led initiatives that would allocate revenue to progressive policy priorities. In contrast to previous eras, tobacco industry arguments often centered around antitax and antigovernment rhetoric, which was viewed as especially compelling in conservative states. The industry's success rate was higher than in the past, and it continued to outspend its opponents, sometimes by staggering margins. CONCLUSIONS Campaign spending and early support remain critical to the success of tobacco tax ballot measures. Big Tobacco can extract significant concessions even in defeat, and direct democracy is an effective but imperfect ally to tobacco control advocates.
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Batis C. Taxes to sugar-sweetened beverages: are changes in obesity and diabetes observable? Am J Clin Nutr 2024; 119:874-875. [PMID: 38569784 DOI: 10.1016/j.ajcnut.2024.01.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 01/29/2024] [Accepted: 01/31/2024] [Indexed: 04/05/2024] Open
Affiliation(s)
- Carolina Batis
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca, Morelos, Mexico.
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20
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Esser MB, Sherk A, Liu Y, Henley SJ, Naimi TS. Reducing Alcohol Use to Prevent Cancer Deaths: Estimated Effects Among U.S. Adults. Am J Prev Med 2024; 66:725-729. [PMID: 38514233 PMCID: PMC10963036 DOI: 10.1016/j.amepre.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 12/03/2023] [Accepted: 12/03/2023] [Indexed: 03/23/2024]
Abstract
INTRODUCTION The Dietary Guidelines for Americans, 2020-2025 recommends non-drinking or no more than 2 drinks for men or 1 drink for women in a day. However, even at lower levels, alcohol use increases the risk for certain cancers. This study estimated mean annual alcohol-attributable cancer deaths and the number of cancer deaths that could potentially be prevented if all U.S. adults who drank in excess of the Dietary Guidelines had instead consumed alcohol to correspond with typical consumption of those who drink within the recommended limits. METHODS Among U.S. residents aged ≥20 years, mean annual alcohol-attributable cancer deaths during 2020-2021 that could have been prevented with hypothetical reductions in alcohol use were estimated. Mean daily alcohol consumption prevalence estimates from the 2020-2021 Behavioral Risk Factor Surveillance System, adjusted to per capita alcohol sales to address underreporting of drinking, were applied to relative risks to calculate population-attributable fractions for cancers that can occur from drinking alcohol. Analyses were conducted during February-April 2023. RESULTS In the U.S., an estimated 20,216 cancer deaths were alcohol-attributable/year during 2020-2021 (men: 14,562 [72.0%]; women: 5,654 [28.0%]). Approximately 16,800 deaths (83% of alcohol-attributable cancer deaths, 2.8% of all cancer deaths) could have been prevented/year if adults who drank alcohol in excess of the Dietary Guidelines had instead reduced their consumption to ≤2 drinks/day for men or ≤1 drink/day for women. Approximately 650 additional deaths could have been prevented annually if men consumed 1 drink/day, instead of 2. CONCLUSIONS Implementing evidence-based alcohol policies (e.g., increasing alcohol taxes, regulating alcohol outlet density) to decrease drinking could reduce alcohol-attributable cancers, complementing clinical interventions.
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Affiliation(s)
- Marissa B Esser
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Adam Sherk
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, British Columbia, Canada
| | - Yong Liu
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - S Jane Henley
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Timothy S Naimi
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, British Columbia, Canada
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21
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Brikci N. Innovative domestic financing mechanisms for health in Africa: An evidence review. J Health Serv Res Policy 2024; 29:132-140. [PMID: 37328259 PMCID: PMC10910821 DOI: 10.1177/13558196231181081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
OBJECTIVES This article synthesizes the evidence on what have been called innovative domestic financing mechanisms for health (i.e. any domestic revenue-raising mechanism allowing governments to diversify away from traditional approaches such as general taxation, value-added tax, user fees or any type of health insurance) aimed at increasing fiscal space for health in African countries. The article seeks to answer the following questions: What types of domestic innovative financial mechanisms have been used to finance health care across Africa? How much additional revenue have these innovative financing mechanisms raised? Has the revenue raised through these mechanisms been, or was it meant to be, earmarked for health? What is known about the policy process associated with their design and implementation? METHODS A systematic review of the published and grey literature was conducted. The review focused on identifying articles providing quantitative information about the additional financial resources generated through innovative domestic financing mechanisms for health care in Africa, and/or qualitative information about the policy process associated with the design or effective implementation of these financing mechanisms. RESULTS The search led to an initial list of 4035 articles. Ultimately, 15 studies were selected for narrative analysis. A wide range of study methods were identified, from literature reviews to qualitative and quantitative analysis and case studies. The financing mechanisms implemented or planned for were varied, the most common being taxes on mobile phones, alcohol and money transfers. Few articles documented the revenue that could be raised through these mechanisms. For those that did, the revenue projected to be raised was relatively low, ranging from 0.01% of GDP for alcohol tax alone to 0.49% of GDP if multiple levies were applied. In any case, virtually none of the mechanisms have apparently been implemented. The articles revealed that, prior to implementation, the political acceptability, the readiness of institutions to adapt to the proposed reform and the potential distortionary impact these reforms may have on the targeted industry all require careful consideration. From a design perspective, the fundamental question of earmarking proved complex both politically and administratively, with very few mechanisms actually earmarked, thus questioning whether they could effectively fill part of the health-financing gap. Finally, ensuring that these mechanisms supported the underlying equity objectives of universal health coverage was recognized as important. CONCLUSIONS Additional research is needed to understand better the potential of innovative domestic revenue generating mechanisms to fill the financing gap for health in Africa and diversify away from more traditional financing approaches. Whilst their revenue potential in absolute terms seems limited, they could represent an avenue for broader tax reforms in support of health. This will require sustained dialogue between Ministries of Health and Ministries of Finance.
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Affiliation(s)
- Nouria Brikci
- Research Fellow in health economics, Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
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22
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Zhong S, Zhou Z, Jin D. Impact of Environmental Protection Tax on carbon intensity in China. Environ Sci Pollut Res Int 2024; 31:29695-29718. [PMID: 38589588 DOI: 10.1007/s11356-024-33203-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 04/01/2024] [Indexed: 04/10/2024]
Abstract
In the context of increasingly severe global climate change, finding effective carbon emission reduction strategies has become key to mitigating climate change. Environmental Protection Tax (EPT), as a widely recognized method, effectively promotes climate change mitigation by encouraging emission reduction behaviors and promoting the application of clean technologies. Based on data from 282 cities in China, this paper takes the official implementation of the EPT in 2018 as the policy impact and the cities with increased tax rates for air taxable pollutants as the treatment group and uses DID model to systematically demonstrate the relationship between the implementation of the EPT and carbon intensity (CI) and further explores the possible pollutant emissions and green innovation mediating effects. The findings show that (1) the implementation of EPT can effectively reduce CI by about 4.75%, and this conclusion still holds after considering the robustness of variable selection bias, elimination of other normal effects, policy setting time bias, and self-selection bias. (2) The implementation of EPT can reduce CI by reducing pollutant emissions and improving the level of green innovation. (3) There is obvious regional heterogeneity in the carbon reduction effect of EPT, and the implementation of EPT has a more significant effect on CI in medium-tax areas, low environmental concern areas, general cities, and eastern regions. This paper not only provides a new analytical perspective for systematically understanding the carbon emission reduction effect of EPT but also provides policy insights for promoting regional green transformation and advancing carbon peak carbon neutralization.
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Affiliation(s)
- Shen Zhong
- School of Finance, Harbin University of Commerce, Harbin, 150028, China
| | - Zhicheng Zhou
- School of Finance, Harbin University of Commerce, Harbin, 150028, China
| | - Daizhi Jin
- School of Public Finance and Administration, Harbin University of Commerce, Harbin, 150028, China.
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23
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Retat L, Webber L, Jepsen P, Martin A, Cortez-Pinto H, Lazarus JV, Negro F, Mitchyn M, Guzek J, Card-Gowers J, Graff H, Nahon P, Sheron N, Sagi SZ, Buti M. Preventing liver disease with policy measures to tackle alcohol consumption and obesity: The HEPAHEALTH II study. J Hepatol 2024; 80:543-552. [PMID: 38092157 DOI: 10.1016/j.jhep.2023.11.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 11/06/2023] [Accepted: 11/16/2023] [Indexed: 02/03/2024]
Abstract
BACKGROUND & AIMS Chronic liver disease (CLD) causes 1.8% of all deaths in Europe, many of them from liver cancer. We estimated the impact of several policy interventions in France, the Netherlands, and Romania. METHODS We used a validated microsimulation model to assess seven different policy scenarios in 2022-2030: a minimum unit price (MUP) of alcohol of €0.70 or €1, a volumetric alcohol tax, a sugar-sweetened beverage (SSB) tax, food marketing restrictions, plus two different combinations of these policies compared against current policies (the 'inaction' scenario). RESULTS All policies reduced the burden of CLD and liver cancer. The largest impact was observed for a MUP of €1, which by 2030 would reduce the cumulative incidence of CLD by between 7.1% to 7.3% in France, the Netherlands, and Romania compared with inaction. For liver cancer, the corresponding reductions in cumulative incidence were between 4.8% to 5.8%. Implementing a package containing a MUP of €0.70, a volumetric alcohol tax, and an SSB tax would reduce the cumulative incidence of CLD by between 4.29% to 4.71% and of liver cancer by between 3.47% to 3.95% in France, the Netherlands, and Romania. The total predicted reduction in healthcare costs by 2030 was greatest with the €1 MUP scenario, with a reduction for liver cancer costs of €8.18M and €612.49M in the Netherlands and France, respectively. CONCLUSIONS Policy measures tackling primary risk factors for CLD and liver cancer, such as the implementation of a MUP of €1 and/or a MUP of €0.70 plus SSB tax could markedly reduce the number of Europeans with CLD or liver cancer. IMPACT AND IMPLICATIONS Policymakers must be aware that alcohol and obesity are the two leading risk factors for chronic liver disease and liver cancer in Europe and both are expected to increase in the future if no policy interventions are made. This study assessed the potential of different public health policy measures to mitigate the impact of alcohol consumption and obesity on the general population in three European countries: France, the Netherlands, and Romania. The findings support introducing a €1 minimum unit price for alcohol to reduce the burden of chronic liver disease. In addition, the study shows the importance of targeting multiple drivers of alcohol consumption and obesogenic products simultaneously via a harmonized fiscal policy framework, to complement efforts being made within health systems. These findings should encourage policymakers to introduce such policy measures across Europe to reduce the burden of liver disease. The modeling methods used in this study can assist in structuring similar modeling in other regions to expand on this study's findings.
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Affiliation(s)
| | | | - Peter Jepsen
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
| | | | - Helena Cortez-Pinto
- Clínica Universitária de Gastrenterologia, Centro de Nutrição e Metabolismo, Faculdade de Medicina, Universidade de Lisboa, Portugal
| | - Jeffrey V Lazarus
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain; CUNY Graduate School of Public Health and Health Policy (CUNY SPH), New York, NY, USA
| | - Francesco Negro
- Division of Gastroenterology and Hepatology, University Hospitals, Geneva, Switzerland
| | | | | | | | | | - Pierre Nahon
- AP-HP, Hôpitaux Universitaires Paris Seine Saint-Denis, Liver Unit, Bobigny; Université Sorbonne Paris Nord, Centre de recherche des Cordeliers, Université de Paris, Paris, France
| | - Nick Sheron
- The Foundation for Liver Research, The Institute of Hepatology, London111 Coldharbour Lane, London, SE5 9NT, UK
| | | | - Maria Buti
- Liver Unit, Hospital Universitario Vall d'Hebron, and CIBEREHD del Instituto de Salud Carlos III. Barcelona, Spain.
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Dhumal T, Rai P, Shah D, Murray PW, Kelly KM. Menstrual Products: Attitudes About Taxation and Safety. J Womens Health (Larchmt) 2024; 33:491-498. [PMID: 38407820 DOI: 10.1089/jwh.2023.0090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024] Open
Abstract
Background: This study explored factors associated with the differences between women and men in attitudes, norms, and the support of taxation of menstrual products (MPs) and menstrual-adjacent products. It also investigated the use of these products in women. Methods: Young adults from 18 to 30 years of age were recruited via social media, listserve emails, and flyers placed throughout a university campus. Following cognitive interviewing, a survey investigated attitudes, beliefs, and behaviors associated with MPs. Results: Individuals self-identified as men or women. Women (n = 154) had more positive general attitudes, less positive safety attitudes, and less support for taxation of MPs than men (n = 43). Regression analyses indicated that factors, such as race, age, attitudes, norms, and taxation, were associated with product use. Conclusions: Attitudes about safety and taxation differ for men and women. Tax policies and attitude-shifting interventions need to be tailored to their audience, and our study can inform that effort.
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Affiliation(s)
- Trupti Dhumal
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, West Virginia, USA
| | - Pragya Rai
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, West Virginia, USA
| | - Drishti Shah
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, West Virginia, USA
| | - Pamela W Murray
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Kimberly M Kelly
- Center for Innovation in Health Equity Research, Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA
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Wise J. One in two may be prepared to pay more for NHS through taxation, survey shows. BMJ 2024; 384:q754. [PMID: 38537945 DOI: 10.1136/bmj.q754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
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Théodore FL, González-Ángeles LR, Reynales-Shigematsu LM, Saenz-de-Miera B, Antonio-Ochoa E, Llorente B. The Challenges of Tobacco Fiscal Policy Implementation in Mexico From the Perspective of Key Actors. Nicotine Tob Res 2024; 26:444-451. [PMID: 37782763 DOI: 10.1093/ntr/ntad188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 09/10/2023] [Accepted: 09/17/2023] [Indexed: 10/04/2023]
Abstract
INTRODUCTION Raising tobacco taxes is considered the most effective strategy to avoid smoking initiation and discourage its use, especially among vulnerable groups. However, few low- and middle-income countries have adopted high tobacco taxes. Raising taxes is, therefore, an opportunity to strengthen and accelerate tobacco control. The objective of this study is to analyze the barriers and facilitators to the tobacco tax increase in Mexico. AIMS AND METHODS Based on the Governance Analytical Framework, data were generated through 17 in-depth interviews with key intersectoral actors for fiscal policy. The interviews were transcribed and coded according to Hufty's theory of governance. RESULTS Robust scientific evidence, intersectoral coordination, and the presence of "champions" boosted progress in tobacco control (facilitators). The main barriers were the incomplete implementation of the World Health Organization-Framework Convention on Tobacco Control (WHO-FCTC) and MPOWER package and lack of commitment ("political will") by government decision makers and legislators, misinformation about the effects of tobacco taxes, and strong tobacco industry interference. CONCLUSIONS Robust evidence is necessary but not sufficient to advance the implementation of the MPOWER (WHO-FCTC) actions. To achieve tobacco tax increases and public policies that protect people from unhealthy products in general, the implementation of policies or legal frameworks against industry interference in the development of public policies is imperative. IMPLICATIONS By analyzing the barriers and facilitators to increasing the tobacco tax in Mexico, this study identifies two key messages: (1) The need to sensitize legislators and the general population to the problem of smoking not only through epidemiological data but also through testimonies that highlight the life experiences and adversities faced by people who smoke. (2) The need for a regulatory framework to prevent industry interference in public affairs and conflicts of interest. The same framework could be very useful for public health policies to control the consumption of ultra-processed food products or alcohol.
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Affiliation(s)
- Florence L Théodore
- Centro de Investigación de Nutrición y Salud (CINyS), Instituto Nacional de salud Pública, Cuernavaca, Mexico
| | | | | | - Belen Saenz-de-Miera
- Departamento Académico de Economía, Universidad Autonoma de Baja California Sur, Baja California, Mexico
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Nguyen CV, Vellios N, Nguyen NH, Le TT. The impact of cigarette prices on smoking onset and cessation: evidence from Vietnam. Tob Control 2024; 33:e48-e53. [PMID: 36697222 DOI: 10.1136/tc-2022-057689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 01/12/2023] [Indexed: 01/26/2023]
Abstract
BACKGROUND Vietnam is a country with very high smoking rates among men. According to a Global Adult Tobacco Survey (GATS) conducted in 2015, the daily smoking prevalence among Vietnamese men was 39%. METHODS We used data from the 2010 and 2015 Vietnamese GATSs and cigarette price data from General Statistics Office of Vietnam. Since smoking prevalence is low among women, we only considered men. Using discrete-time hazard models, we estimated the effect of cigarette prices on smoking onset and cessation. Sensitivity analyses are conducted using different model specifications. RESULTS We find that higher cigarette prices reduce the probability of smoking onset. A 1% increase in the cigarette price reduces the hazard of smoking onset by 1.2% (95% CI -2.12% to -0.28%). This suggests that increases in tobacco taxation, which translate to price increases, can reduce smoking onset. We did not find evidence that cigarette prices impact smoking cessation among men in Vietnam. CONCLUSION Vietnam should continue to increase excise taxes on tobacco products to reduce smoking onset. Since smokers are resilient to excise tax increases, other tobacco control policies, such as smoke-free areas and tobacco advertisement bans, should be better enforced to encourage people to quit. Other policies not yet implemented, such as plain packaging of tobacco products, may also encourage smokers to quit.
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Affiliation(s)
- Cuong Viet Nguyen
- International School, Vietnam National University Hanoi, Hanoi, Vietnam
- Thang Long Institute of Mathematics and Applied Sciences (TIMAS), Thang Long University, Hanoi, Vietnam
| | - Nicole Vellios
- Research Unit on the Economics of Excisable Products, School of Economics, University of Cape Town, Cape Town, South Africa
| | | | - Thu Thi Le
- HealthBridge Foundation of Canada, Vietnam Office, Hanoi, Vietnam
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Ngo A, Drope J, Guerrero-López CM, Siu E, Chaloupka FJ. As countries improve their cigarette tax policy, cigarette consumption declines. Tob Control 2024; 33:e91-e96. [PMID: 36539293 PMCID: PMC10958272 DOI: 10.1136/tc-2022-057486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 11/29/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND This study examines the association between the Tobacconomics cigarette tax scores and cigarette consumption in 97 countries during the period of 2014-2020. METHODS Data on countries' retail cigarette sales and overall cigarette tax scores from 2014 to 2020 are drawn from the proprietary Euromonitor International database and the Tobacconomics Cigarette Tax Scorecard (second edition). Information on countries' tobacco control environments and demographic characteristics is from the relevant years' WHO Report on the Global Tobacco Epidemic, and the World Bank's World Development Indicators database. Ordinary least squares regressions are employed to examine the link between countries' overall cigarette tax scores and cigarette consumption. All regressions control for countries' tobacco control environments, countries' demographic characteristics, year indicators and country fixed effects. RESULTS Each unit increase in the overall cigarette tax scores is significantly associated with a reduction of 9% in countries' per-capita cigarette consumption during 2014-2020. The reduction is more pronounced in low and middle-income countries (9%) than in high-income countries (6%). The modest improvement in scores from 2014 to 2020 is associated with a reduction of 3.27% in consumption, while consumption could have been reduced by 20.74% had countries implemented optimal tax policies that would earn the highest score of 5. CONCLUSIONS Our results provide evidence on the association between higher cigarette tax scores and lower cigarette consumption. To reduce tobacco consumption, governments must strive to implement all four components in the Cigarette Tax Scorecard at the highest level.
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Affiliation(s)
- Anh Ngo
- Institute for Health Research and Policy, University of Illinois Chicago, Chicago, Illinois, USA
| | - Jeffrey Drope
- Health Policy and Administration, School of Public Health, University of Illinois Chicago, Chicago, IL, USA
| | | | - Erika Siu
- Institute for Health Research and Policy, University of Illinois Chicago, Chicago, Illinois, USA
| | - Frank J Chaloupka
- Institute for Health Research and Policy, University of Illinois Chicago, Chicago, Illinois, USA
- Health Policy and Administration, School of Public Health, University of Illinois Chicago, Chicago, IL, USA
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Jawad M, Awawda S, Abla R, Chalak A, Khader YS, Nakkash RT, Mostafa A, Salloum RG, Abu-Rmeileh NME. Impact of waterpipe tobacco taxation on consumption, government revenue and premature deaths averted in Jordan, Lebanon and Palestine: a simulation study. Tob Control 2024; 33:e85-e90. [PMID: 36601792 PMCID: PMC10958304 DOI: 10.1136/tc-2022-057284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 11/18/2022] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Despite the high prevalence of waterpipe tobacco smoking in the Eastern Mediterranean region, evidence supporting its fiscal measures is limited. We modelled the impact of waterpipe tobacco-specific excise taxes on consumption, government revenue and premature deaths averted in Jordan, Lebanon and Palestine. METHODS We developed a simulation model using country-specific and market share-specific price, consumption and price elasticity data from WHO, UN Comtrade and nationally representative surveys. We modelled increases to specific excise taxes to meet a 35.9% tax burden on 20 g of waterpipe tobacco in Lebanon and Jordan, in line with the global average, and to double government revenues from excise duties in Palestine, which has surpassed this average. RESULTS Specific excise tax was raised by $1.14 ($0.18-$1.32) in Jordan, $2.41 ($0.03-$2.44) in Lebanon (alongside removal of ad valorem taxes) and $2.39 ($1.72-$4.11) in Palestine per 20 g of waterpipe tobacco. Government revenue increased by $126.3 million in Jordan, $53.8 million in Lebanon and $162.4 million in Palestine while waterpipes smoked decreased by 32.4% in Jordan, 71.0% in Lebanon and 16.3% in Palestine. The corresponding numbers of premature deaths averted annually were approximately 162 000; 1 000 000; and 52 000. DISCUSSION Increases in waterpipe tobacco-specific excise taxes substantially reduce smoking and increase government revenue and averted premature deaths in Jordan, Lebanon and Palestine. This has positive implications for both public health and financing and should be considered a policy priority.
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Affiliation(s)
- Mohammed Jawad
- Public Health Policy Evaluation Unit, Imperial College London, London, UK
| | - Sameera Awawda
- Department of Economics and Institute of Community and Public Health, Birzeit University, Birzeit, Palestine
| | - Ruba Abla
- Department of Health Promotion and Community Health, American University of Beirut, Beirut, Lebanon
| | - Ali Chalak
- Department of Agriculture, American University of Beirut, Beirut, Lebanon
| | - Yousef S Khader
- Epidemiology and Biostatistics, Jordan University of Science and Technology, Irbid, Jordan
| | - Rima T Nakkash
- Health Behaviour and Education Department, American University of Beirut, Beirut, Lebanon
| | - Aya Mostafa
- Department of Community, Environmental, and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ramzi G Salloum
- Health Outcomes and Policy, University of Florida, Gainesville, Florida, USA
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Filby S. Cigarette prices and smoking among adults in eight sub-Saharan African countries: evidence from the Global Adult Tobacco Survey. Tob Control 2024; 33:e78-e84. [PMID: 36428094 PMCID: PMC10958268 DOI: 10.1136/tc-2022-057626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 11/15/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Despite growing concern over tobacco use in sub-Saharan Africa, evidence on the association between cigarette prices and adult smoking behaviour in the region is limited. OBJECTIVES To provide new evidence on the association between cigarette prices and adult smoking in eight sub-Saharan African countries. METHODS The analysis uses data from 51 270 individuals taken from the Global Adult Tobacco Survey, which was conducted in eight African countries during 2012-2018. The relationship between prices and smoking is estimated using probit models for smoking participation and generalised linear models for conditional cigarette demand. RESULTS Higher prices are significantly associated with lower cigarette demand across African countries. The estimated price elasticity of participation is -0.362 (95% CI -0.547 to -0.177). The price elasticity of conditional cigarette demand is -0.133 (95% CI -0.194 to -0.072) for people who have just started smoking. The estimated total price elasticity of cigarette demand by new adult smokers is -0.495. The absolute value of the conditional demand elasticity becomes smaller by 0.004 units for each additional year that a person smokes. For the average smoker in the sample, with a smoking duration of 18.07 years, the total elasticity estimate is -0.422. CONCLUSIONS Higher cigarette prices significantly decrease the likelihood of smoking and decrease the intensity of cigarette consumption among African adults. Increases in the excise tax that increase the retail price of cigarettes will play an important role in reducing adult tobacco use on the continent. Governments are encouraged to increase excise taxes to improve public health.
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Affiliation(s)
- Samantha Filby
- Research Unit on the Economics of Excisable Products, School of Economics, University of Cape Town, Rondebosch, Western Cape, South Africa
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Subbaraman MS, Schulte A, Berglas NF, Kerr WC, Thomas S, Treffers R, Liu G, Roberts SCM. Associations between alcohol taxes and varied health outcomes among women of reproductive age and infants. Alcohol Alcohol 2024; 59:agae015. [PMID: 38497162 PMCID: PMC10945295 DOI: 10.1093/alcalc/agae015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 02/20/2024] [Accepted: 02/23/2024] [Indexed: 03/19/2024] Open
Abstract
OBJECTIVE No studies have examined whether alcohol taxes may be relevant for reducing harms related to pregnant people's drinking. METHOD We examined how beverage-specific ad valorem, volume-based, and sales taxes are associated with outcomes across three data sets. Drinking outcomes came from women of reproductive age in the 1990-2020 US National Alcohol Surveys (N = 11 659 women $\le$ 44 years); treatment admissions data came from the 1992-2019 Treatment Episode Data Set: Admissions (N = 1331 state-years; 582 436 pregnant women admitted to treatment); and infant and maternal outcomes came from the 2005-19 Merative Marketscan® database (1 432 979 birthing person-infant dyads). Adjusted analyses for all data sets included year fixed effects, state-year unemployment and poverty, and accounted for clustering by state. RESULTS Models yield no robust significant associations between taxes and drinking. Increased spirits ad valorem taxes were robustly associated with lower rates of treatment admissions [adjusted IRR = 0.95, 95% CI: 0.91, 0.99]. Increased wine and spirits volume-based taxes were both robustly associated with lower odds of infant morbidities [wine aOR = 0.98, 95% CI: 0.96, 0.99; spirits aOR = 0.99, 95% CI: 0.98, 1.00] and lower odds of severe maternal morbidities [wine aOR = 0.91, 95% CI: 0.86, 0.97; spirits aOR = 0.95, 95% CI: 0.92, 0.97]. Having an off-premise spirits sales tax was also robustly related to lower odds of severe maternal morbidities [aOR = 0.78, 95% CI: 0.64, 0.96]. CONCLUSIONS Results show protective associations between increased wine and spirits volume-based and sales taxes with infant and maternal morbidities. Policies that index tax rates to inflation might yield more public health benefits, including for pregnant people and infants.
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Affiliation(s)
- Meenakshi S Subbaraman
- Behavioral Health and Recovery Studies, Public Health Institute, 555 12th St, Oakland, CA 94607, United States
| | - Alex Schulte
- Advancing New Standards in Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, S1330 Broadway, Suite 1100, Oakland, CA 94612, United States
| | - Nancy F Berglas
- Advancing New Standards in Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, S1330 Broadway, Suite 1100, Oakland, CA 94612, United States
| | - William C Kerr
- Alcohol Research Group, Public Health Institute, 6001 Shellmound Ave, Suite 450, Emeryville, CA 94608, United States
| | - Sue Thomas
- National Capital Region Center, Pacific Institute of Research and Evaluation, 4061 Powder Mill Road Suite 350, Beltsville, MD 20705-3113, United States
| | - Ryan Treffers
- National Capital Region Center, Pacific Institute of Research and Evaluation, 4061 Powder Mill Road Suite 350, Beltsville, MD 20705-3113, United States
| | - Guodong Liu
- Center for Applied Studies in Health Economics, Pennsylvania State College of Medicine, 90 Hope Drive, Suite 2200, Hershey, PA 17033, United States
| | - Sarah C M Roberts
- Advancing New Standards in Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, S1330 Broadway, Suite 1100, Oakland, CA 94612, United States
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Vellios N, van Walbeek C. Tax revenue lost due to illicit cigarettes in South Africa: 2002-2022. BMJ Open 2024; 14:e077855. [PMID: 38485481 PMCID: PMC10941134 DOI: 10.1136/bmjopen-2023-077855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 02/23/2024] [Indexed: 03/17/2024] Open
Abstract
OBJECTIVE To estimate lost excise and value-added tax (VAT) revenue as a result of illicit cigarette trade from 2002 to 2022. DESIGN Using gap analysis, we estimated the number of illicit cigarettes by calculating the difference between the number of self-reported cigarettes (derived from nationally representative surveys) and the number of legal (tax-paid) cigarettes (derived from government sources) from 2002 to 2022. We then calculated the excise and VAT revenue that the government lost through illicit trade, taking into account that some people would have quit or reduced their consumption if cigarette prices had been higher (ie, tax paid). SETTING South Africa. OUTCOME MEASURES Illicit trade estimates and lost revenue estimates. RESULTS The illicit cigarette market comprised 5% of the market in 2009, peaked at 60% in 2021, and decreased to 58% in 2022. Accounting for the fact that some people would have reduced their consumption if cigarette prices had been higher (had the illicit marke not existed), the government lost R15 billion in excise revenue and R3 billion in VAT revenue in 2022. From 2002 to 2022, the government lost R119 billion (2022 prices) in excise and VAT revenue. The majority of the lost revenue occurred in the period 2010 to 2022, where R110 billion (2022 prices) in excise and VAT revenue was lost. A comprehensive sensitivity analysis indicates that the estimated lost revenue of R119 billion from 2002 to 2022 falls within the range of R65 billion to R130 billion (all 2022 prices). CONCLUSIONS The South African government has been losing a significant amount of revenue by not receiving excise and VAT from all cigarettes consumed in South Africa. This trend is likely to continue if the government does not secure the supply chain from the point of production to the point of sale.
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Affiliation(s)
- Nicole Vellios
- Research Unit on the Economics of Excisable Products, School of Economics, University of Cape Town, Rondebosch, Western Cape, South Africa
| | - Corné van Walbeek
- Research Unit on the Economics of Excisable Products, School of Economics, University of Cape Town, Rondebosch, Western Cape, South Africa
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Varghese B, Panicker R, Mukhopadhyay D, Backholer K, Sethi V, de Wagt A, Murira Z, Bhatia N, Arora M. Estimating the potential impact of a health tax on the demand for unhealthy food and beverages and on tax revenue in India. Health Policy Plan 2024; 39:299-306. [PMID: 38102765 DOI: 10.1093/heapol/czad117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 11/01/2023] [Accepted: 12/11/2023] [Indexed: 12/17/2023] Open
Abstract
Foods high in fat, sugar or salt are important contributors to the rising burden of non-communicable diseases globally and in India. Health taxes (HTs) have been used by over 70 countries as an effective tool for reducing consumption of sugar sweetened beverages (SSBs). However, the potential impacts of HTs on consumption and on revenues have not been estimated in India. This paper aims to estimate the potential impact of health taxes on the demand for sugar, SSBs and foods high in fat, sugar or salt (HFSS) in India while exploring its impact on tax revenues. PE of sugar was estimated using Private Final Consumption Expenditure and Consumer Price Index data while price elasticities for SSBs and HFSS were obtained from literature. The reduction in demand was estimated for an additional 10-30% HT added to the current goods and services tax, for varying levels of price elasticities. The results show that for manufacturers of sweets and confectionaries who buy sugar in bulk and assuming a higher price elasticity of -0.70, 20% additional HT (total tax 48%) would result in 13-18% decrease in the demand for sugar used for confectionaries and sweets. For SSBs, HT of 10-30% would result in 7-30% decline in the demand of SSBs. For HFSS food products, 10-30% HT would result in 5-24% decline in the demand for HFSS products. These additional taxes would increase tax revenues for the government by 12-200% across different scenarios. Taxing unhealthy foods is likely to reduce demand, while increasing government revenues for reinvestment back into public health programmes and policies that may reduce obesity and the incidence of non-communicable diseases in India.
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Affiliation(s)
- Beena Varghese
- Indian Institute of Public Health, Public Health Foundation of India, Rajendra Nagar Mandal, Kismatpur, Hyderabad, Telangana 500030, India
| | - Rajashree Panicker
- Total Alliance Health Partners International, Dubai Healthcare City, Dubai 66566, UAE
| | - Dripto Mukhopadhyay
- Ascension Centre for Research and Analytics (ACRA), 5/1, Sector 5, Rajendra Nagar, Sahibabad, Ghaziabad, UP 201005, India
| | - Kathryn Backholer
- A/P Deakin University, Geelong, Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Burwood, Victoria 3125, Australia
| | - Vani Sethi
- UNICEF Regional Office for South Asia, Kathmandu 5815, Nepal
| | | | - Zivai Murira
- UNICEF Regional Office for South Asia, Kathmandu 5815, Nepal
| | - Neena Bhatia
- Ministry of Health and Family Welfare, Government of India, New Delhi 110011, India
| | - Monika Arora
- Public Health Foundation of India, Gurgaon, Haryana 122102, India
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Peñalvo JL. The impact of taxing sugar-sweetened beverages on diabetes: a critical review. Diabetologia 2024; 67:420-429. [PMID: 38177563 DOI: 10.1007/s00125-023-06064-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 10/18/2023] [Indexed: 01/06/2024]
Abstract
The global burden of type 2 diabetes is increasing at an alarming rate, fuelled by the obesity epidemic, with significant associated health and economic consequences and apparent inequalities. Sugar-sweetened beverages (SSBs) are a major source of added sugars in diets worldwide and have been linked to an increased risk of type 2 diabetes through a variety of mechanisms, including excess weight. Taxing SSBs has become a promising public health strategy to reduce consumption and mitigate the burden of type 2 diabetes. A substantial body of evidence suggests that SSB taxes lead to increased prices and subsequent reduced consumption, with a potentially greater effect among lower socioeconomic groups. This highlights the potential for tax policies to have an impact on type 2 diabetes and address health inequalities. Evidence from several ongoing SSB tax schemes, including sales and excise taxes, indicates positive effects on improving consumption patterns, and modelling studies point to health gains by averting type 2 diabetes and other cardiometabolic diseases. In contrast, evidence from empirical evaluation of the impact of SSB tax is scarce. Continued monitoring and the strengthening of evaluation research to develop context-tailored policies are required. In addition, there is a need to implement complementary efforts to amplify the impact of SSB taxation and effectively address the global burden of type 2 diabetes.
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Affiliation(s)
- José L Peñalvo
- Global Health Institute, University of Antwerp, Wilrijk, Belgium.
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Lee MM, Gibson LA, Hua SV, Lowery CM, Paul M, Roberto CA, Lawman HG, Bleich SN, Mitra N, Kenney EL. Advertising and Stocking at Small Retailers: A Sweetened Beverage Excise Tax in Philadelphia. Am J Prev Med 2024; 66:408-417. [PMID: 37774991 PMCID: PMC10922562 DOI: 10.1016/j.amepre.2023.09.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 09/21/2023] [Accepted: 09/22/2023] [Indexed: 10/01/2023]
Abstract
INTRODUCTION In 2017, Philadelphia enacted a $0.015 per ounce excise tax on SBs that covered both sugar-sweetened beverages and artificially-sweetened beverages, which reduced purchasing and consumption. This study assessed whether the tax also changed beverage advertising or stocking practices that could influence consumer behavior among stores in Philadelphia, Baltimore, and Philadelphia-adjacent counties not subject to the tax. METHODS Using a longitudinal difference-in-differences approach, beverage advertising and availability changes were evaluated from 4-month pretax to 6-, 12-, and 24-month post-implementation in small independent stores in Philadelphia (n=34) and Philadelphia-adjacent counties (n=38) versus Baltimore (n=43), a demographically similar city without a tax. Mixed effects models tested whether beverage advertising/availability increased in Philadelphia and surrounding counties after implementation versus Baltimore, included store-level random intercepts, and were stratified by beverage tax status, type, size, and store ZIP code income. Data were collected from 2016 to 2018, and analyses were performed in 2022-2023. RESULTS SB advertising increased post-tax in Philadelphia (6 months= +1.04 advertisements/store [95% CI=0.27, 1.80]; 12 months= +1.54 [95% CI=0.57, 2.52]; 24 months= +0.91 [95% CI=0.09, 1.72]) relative to Baltimore. This was driven by increased advertising of sweetened beverages in low-income ZIP codes. Marketing of SBs increased significantly in Philadelphia-adjacent counties relative to Baltimore. Although SB availability in Philadelphia did not change, it increased in surrounding county stores (6 months= +0.20 [95% CI=0.15, 0.25]; 12 months= +0.08 [95% CI=0.03, 0.12]) relative to Baltimore. CONCLUSIONS Marketing of SBs, especially in low-income neighborhoods and in surrounding counties, increased following Philadelphia's beverage tax among small, independent retailers. These increases in advertising might have dampened the tax's effect on purchasing behaviors, although estimated effects on sales remained large.
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Affiliation(s)
- Matthew M Lee
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
| | - Laura A Gibson
- Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Sophia V Hua
- Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Caitlin M Lowery
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Maiki Paul
- Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Christina A Roberto
- Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Hannah G Lawman
- Division of Chronic Disease and Injury Prevention, Philadelphia Department of Public Health, Philadelphia, Pennsylvania
| | - Sara N Bleich
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Nandita Mitra
- Division of Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Erica L Kenney
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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MUENNIG PETER, BELSKY DANIELW, MALINSKY DANIEL, NGUYEN KIEU, ROSEN ZOHN, ALLEN HEIDI. The Effect of the Earned Income Tax Credit on Physical and Mental health-Results from the Atlanta Paycheck Plus Experiment. Milbank Q 2024; 102:122-140. [PMID: 37788392 PMCID: PMC10938929 DOI: 10.1111/1468-0009.12675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 08/25/2023] [Accepted: 09/18/2023] [Indexed: 10/05/2023] Open
Abstract
Policy Points The Paycheck Plus randomized controlled trial tested a fourfold increase in the Earned Income Tax Credit (EITC) for single adults without dependent children over 3 years in New York and Atlanta. In New York, the intervention improved economic, mental, and physical health outcomes. In Atlanta, it had no economic benefit or impact on physical health and may have worsened mental health. In Atlanta, tax filing and bonus receipt were lower than in the New York arm of the trial, which may explain the lack of economic benefits. Lower mental health scores in the treatment group were driven by disadvantaged men, and the study sample was in good mental health. CONTEXT The Paycheck Plus experiment examined the effects of an enhanced Earned Income Tax Credit (EITC) for single adults on economic and health outcomes in Atlanta, GA and New York City (NYC). The NYC study was completed two years prior to the Atlanta study and found mental and physical benefits for the subgroups that responded best to the economic incentives provided. In this article, we present the findings from the Atlanta study, in which the uptake of the treatment (tax filings and EITC bonus) were lower and economic and health benefits were not observed. METHODS Paycheck Plus Atlanta was an unblinded randomized controlled trial that assigned n = 3,971 participants to either the standard federal EITC (control group) or an EITC supplement of up to $2,000 (treatment group) for three tax years (2017-2019). Administrative data on employment and earnings were obtained from the Georgia Department of Labor and survey data were used to examine validated measures of health and well-being. FINDINGS In Atlanta, the treatment group had significantly higher earnings in the first project year but did not have significantly higher cumulative earnings than the control group overall (mean difference = $1,812, 95% CI = -150, 3,774, p = 0.07). The treatment group also had significantly lower scores on two measures of mental health after the intervention was complete: the Patient Health Questionnaire 8 (mean difference = 0.19, 95% CI = 0.06, 0.32, p = 0.005) and the Kessler 6 (mean difference = 0.15, 95% CI = 0.03, 0.27, p = 0.012). Secondary analyses suggested these results were driven by disadvantaged men, but the study sample was in good mental health. CONCLUSIONS The EITC experiment in Atlanta was not associated with gains in earnings or improvements in physical or mental health.
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Affiliation(s)
| | - DANIEL W. BELSKY
- Mailman School of Public HealthColumbia University
- Butler Columbia Aging CenterColumbia University
| | | | | | - ZOHN ROSEN
- Mailman School of Public HealthColumbia University
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Mojtabai R, Susukida R, Nejat K, Amin-Esmaeili M. Association of cigarette excise taxes and clean indoor air laws with change in smoking behavior in the United States: a Markov modeling analysis. J Public Health Policy 2024; 45:100-113. [PMID: 38155242 DOI: 10.1057/s41271-023-00458-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2023] [Indexed: 12/30/2023]
Abstract
The rates of cigarette smoking in the United States have declined over the past few decades in parallel with increases in cigarette taxes and introduction of more stringent clean indoor air laws. Few longitudinal studies have examined association of taxes and clean indoor air policies with change in smoking nationally. This study examined the association of state and local cigarette taxes and clean indoor laws with change in smoking status of 18,499 adult participants of the longitudinal 2010-2011 Tobacco Use Supplement of the Current Population Survey over a period of 1 year. Every $1 increase in cigarette excise taxes was associated with 36% higher likelihood of stopping smoking among regular smokers. We found no association between clean indoor air laws and smoking cessation nor between taxes and clean indoor air laws with lower risk of smoking initiation. Cigarette taxes appear to be effective anti-smoking policies. Some state and local governments do not take full advantage of this effective policy measure.
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Affiliation(s)
- Ramin Mojtabai
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Hampton House, 624 North Broadway, Room 797, Baltimore, MD, 21205, USA
| | - Ryoko Susukida
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Hampton House, 624 North Broadway, Room 797, Baltimore, MD, 21205, USA
| | | | - Masoumeh Amin-Esmaeili
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Hampton House, 624 North Broadway, Room 797, Baltimore, MD, 21205, USA.
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Wang J, Ye Q. Evolutionary game analysis of multi-stakeholders in the WEEE recycling industry under propaganda subsidies and environmental damage taxes. Waste Manag 2024; 175:157-169. [PMID: 38199170 DOI: 10.1016/j.wasman.2023.12.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 10/26/2023] [Accepted: 12/31/2023] [Indexed: 01/12/2024]
Abstract
With an increase in the amount of waste electrical and electronic equipment (WEEE), the waste of resources and environmental hazards caused by WEEE cannot be ignored. Meanwhile, the lack of environmental awareness among consumers and the existence of informal recyclers pose a great challenge to the government in governing the WEEE recycling industry. This study constructs a tripartite evolutionary game model consisting of the government and formal and informal recyclers. Then, the payoff matrix, replicator dynamic equations and all the equilibrium points are obtained, and a stability analysis of the equilibrium points is performed to derive the evolutionary stability strategies (ESSs) and their formation conditions. Finally, the influence of important parameters on the WEEE recycling industry is examined through numerical analysis. The results suggest that the government cannot ignore the existence of informal recyclers but should take governance measures to intervene in informal recycling and guide such recyclers to upgrade their processing technology. Moreover, the willingness of informal recyclers to invest in processing technology increases with the increase in environmental damage taxes. Second, the government should provide formal recyclers with appropriate promotional subsidies. Third, the government should control its own cost of governance and reduce its financial burden. Fourth, with government subsidies, formal recyclers should decide whether to make promotional investments based on the investment cost and the sum of the benefits from the investment and government subsidy. Finally, under government tax pressure and the influence of formal recyclers' promotional investments, informal recyclers should actively invest in processing technology.
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Affiliation(s)
- Jian Wang
- School of Artificial Intelligence and Automation, Huazhong University of Science and Technology, Wuhan 430074, China; The MOE Engineering Research Center of Autonomous Intelligent Unmanned Systems, Wuhan, 430074, China.
| | - Qianyao Ye
- School of Artificial Intelligence and Automation, Huazhong University of Science and Technology, Wuhan 430074, China; Key Laboratory of Image Processing and Intelligent Control, Ministry of Education, Wuhan 430074, China
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Klimaviciute J. (No) time to be healthy: Optimal policy with time and monetary investments in health. Health Econ 2024; 33:410-431. [PMID: 37937730 DOI: 10.1002/hec.4765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 08/03/2023] [Accepted: 09/29/2023] [Indexed: 11/09/2023]
Abstract
Time is often an important ingredient of a healthy lifestyle. Starting from this observation, this paper studies optimal public policy concerned with promoting healthy choices taking into account both monetary and time investments in health. Individuals tend to underestimate the importance of their health while making decisions, which makes their investments too low compared to the first-best. While the decentralization of the first-best requires personalized subsidies on both time and monetary investments, this may be problematic due to informational issues. In a second-best world where individual productivities and time investments are publicly unobservable, whereas monetary investments are observable in an anonymous way, the paper considers a policy with a non-linear income tax and a linear subsidy on monetary health investments. If there are no incentive concerns, all other things equal, monetary investments complementary (substitutable) to time investments should be subsidized more (less) than those independent of time use. The addition of incentive concerns demonstrates that optimal subsidization of monetary health investments is less straightforward than one might think. Overall, the time ingredient in the production of health does play a role in the optimal policy design, affecting not only the subsidy on monetary health investments but also the income taxation.
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Affiliation(s)
- Justina Klimaviciute
- Faculty of Economics and Business Administration, Vilnius University, Vilnius, Lithuania
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Carriedo A, Ojeda E, Crosbie E, Mialon M. Public-Private Partnerships in Mexico: Implications of Engaging With the Food and Beverage Industry for Public Health Nutrition. Int J Health Policy Manag 2024; 13:8008. [PMID: 38618831 PMCID: PMC11016274 DOI: 10.34172/ijhpm.2024.8008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 01/28/2024] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND In the last few years, Mexico adopted public health policies to tackle non-communicable diseases (NCDs), such as front of package nutrition labelling, food marketing restrictions to children, and a soda tax. In parallel, transnational food and beverage industries (F&BIs), their allies, and the government have agreed on public-private partnerships (PPPs) to implement policies or deliver programs. However, research has questioned the benefits of PPPs and exposed its limitations as a suitable mechanism to improve public health. This study analyses how four PPPs between the Mexican government, the F&BI, and allies are working to achieve their goals. We critically assessed the objectives, scope, reported impacts, governance principles and perceived risks and benefits for the public health agenda of these PPPs. METHODS This qualitative study is based on 26 interviews with key actors, and 170 publicly available documents, including 22 obtained through freedom of information (FOI) requests related to four purposively selected PPPs aiming to improve health. RESULTS We found that the four PPPs studied had minimal public information available on their implementation and impact. The private partners tend to dictate the design, information management, and implementation of the programs, while promoting their brands. Few independent evaluations of the PPPs exist, and none reported on their effectiveness or public health benefits. Good governance principles, such as accountability, transparency, fairness, participation, integrity, and credibility, were barely followed in each of the cases studied. Public officials did not automatically question the conflict of interest (CoI) of such arrangements. When there were COI, the potential risks these posed did not always outweigh the financial benefits of working with the F&BI and its allies. CONCLUSION The four PPPs studied produced minimal gains for public health while boosting credibility for the participating transnational F&BIs. It shows the lack of awareness of how these PPPs might be hindering public health gains.
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Affiliation(s)
| | - Enaí Ojeda
- Instituto Nacional de Salud Pública, Morelos, Mexico
| | - Eric Crosbie
- School of Public Health, University of Nevada Reno, Reno, NV, USA
- Ozmen Institute for Global Studies, University of Nevada Reno, Reno, NV, USA
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Jindarattanaporn N, Phulkerd S, Chamratrithirong A, Soottipong Gray R, Pattaravanich U, Loyfah N, Thapsuwan S, Thongcharoenchupong N. How an agreement with restriction of unhealthy food marketing and sodium taxation influenced high fat, salt or sugar (HFSS) food consumption. BMC Public Health 2024; 24:586. [PMID: 38395859 PMCID: PMC10885404 DOI: 10.1186/s12889-024-18069-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 02/12/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Food taxation and food marketing policy are very cost-effectiveness to improve healthy diets among children. The objective of this study was to investigate the socio-demographic characteristics of Thais and attitude towards on policy unhealthy food marketing restriction and sodium taxation which influence high fat, sodium, and sugar (FHSS) food eating. METHODS The data were obtained from the 2021 Health Behavior of Population Survey, four-stage sampling method of the Thai people, aged 15 years and above, using a offline survey application-assisted face-to-face interview. Logistic Regression were used to analyze the explanatory variables on agreement and HFSS food intake. RESULTS Almost half (48.4%) of samples disagreed with sodium taxation, and 42.7% of the samples disagreed with food marketing restriction. Most (99.6%) of Thai respondents consumed HFSS food, including sugar sweetened beverages (SSB). Gender, age, education, income, BMI, and health status were associated with agreement with food marketing restriction policy and sodium taxation policy. There is no association between agreement with policy on sodium taxation and food marketing and HFSS food consumption. CONCLUSION Nearly half of Thais indicated that they disagreed with policy on food marketing restriction and sodium taxation. Therefore, understanding and awareness of the two policies among Thais should be further investigated in order to develop better policy communication for increased public understanding and engagement.
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Affiliation(s)
- Nongnuch Jindarattanaporn
- Institute for Population and Social Research, Mahidol University, Salaya Campus, 999 Phutthamonthon 4 Road, Phutthamonthon, 73170, Nakhon Pathom, Thailand
| | - Sirinya Phulkerd
- Institute for Population and Social Research, Mahidol University, Salaya Campus, 999 Phutthamonthon 4 Road, Phutthamonthon, 73170, Nakhon Pathom, Thailand.
| | - Aphichat Chamratrithirong
- Institute for Population and Social Research, Mahidol University, Salaya Campus, 999 Phutthamonthon 4 Road, Phutthamonthon, 73170, Nakhon Pathom, Thailand
| | - Rossarin Soottipong Gray
- Institute for Population and Social Research, Mahidol University, Salaya Campus, 999 Phutthamonthon 4 Road, Phutthamonthon, 73170, Nakhon Pathom, Thailand
| | - Umaporn Pattaravanich
- Institute for Population and Social Research, Mahidol University, Salaya Campus, 999 Phutthamonthon 4 Road, Phutthamonthon, 73170, Nakhon Pathom, Thailand
| | - Nutnicha Loyfah
- Institute for Population and Social Research, Mahidol University, Salaya Campus, 999 Phutthamonthon 4 Road, Phutthamonthon, 73170, Nakhon Pathom, Thailand
| | - Sasinee Thapsuwan
- Institute for Population and Social Research, Mahidol University, Salaya Campus, 999 Phutthamonthon 4 Road, Phutthamonthon, 73170, Nakhon Pathom, Thailand
| | - Natjera Thongcharoenchupong
- Institute for Population and Social Research, Mahidol University, Salaya Campus, 999 Phutthamonthon 4 Road, Phutthamonthon, 73170, Nakhon Pathom, Thailand
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Gendall P, Gendall K, Branston JR, Edwards R, Wilson N, Hoek J. Going 'Super Value' in New Zealand: cigarette pricing strategies during a period of sustained annual excise tax increases. Tob Control 2024; 33:240-246. [PMID: 36008127 DOI: 10.1136/tc-2021-057232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 08/09/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND Between 2010 and 2020, the New Zealand (NZ) Government increased tobacco excise tax by inflation plus 10% each year. We reviewed market structure changes and examined whether NZ tobacco companies shifted excise tax increases to maintain the affordability of lower priced cigarette brands. METHODS We cluster-analysed market data that tobacco companies supply to the NZ Ministry of Health, created four price partitions and examined the size and share of these over time. For each partition, we analysed cigarette brand numbers and market share, calculated the volume-weighted real stick price for each year and compared this price across different price partitions. We calculated the net real retail price (price before tax) for each price partition and compared these prices before and after plain packaging took effect. RESULTS The number and market share of Super Value and Budget brands increased, while those of Everyday and Premium brands decreased. Differences between the price of Premium and Super Value brands increased, as did the net retail price difference for these partitions. Following plain packaging's implementation, Super Value brand numbers more than doubled; contrary to industry predictions, the price difference between these and higher priced brands did not narrow. CONCLUSIONS Between 2010 and 2020, NZ tobacco companies introduced more Super Value cigarette brands and shifted excise tax increases to reduce the impact these had on low-priced brands. Setting a minimum retail price for cigarettes could curtail tobacco companies' ability to undermine tobacco taxation policies designed to reduce smoking.
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Affiliation(s)
- Philip Gendall
- Public Health, University of Otago Wellington, Wellington, New Zealand
| | | | | | - Richard Edwards
- Public Health, University of Otago Wellington, Wellington, New Zealand
| | - Nick Wilson
- Public Health, University of Otago Wellington, Wellington, New Zealand
| | - Janet Hoek
- Public Health, University of Otago Wellington, Wellington, New Zealand
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Filby S, Van Walbeek C, Pan L. Cigarette excise tax structure and cigarette prices in nine sub-Saharan African countries: evidence from the Global Adult Tobacco Survey. Tob Control 2024; 33:208-214. [PMID: 38378207 PMCID: PMC10882183 DOI: 10.1136/tc-2022-057414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 07/22/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Economic theory predicts that the excise tax structure influences the distribution of cigarette prices. Evidence shows that uniform specific excise tax structures exhibit the least price variability relative to other tax structures. The distribution of cigarette prices under different excise tax structures has never been examined for a group of African countries. OBJECTIVES To examine the distribution of cigarette prices under different tax structures in nine African countries and to critically evaluate the effectiveness of African regional tax directives in promoting public health. METHODS Data from the Global Adult Tobacco Survey, conducted in eight African countries during 2012-2018, and data from the 2017 Gambia Tobacco Survey were used to construct survey-derived cigarette prices. The coefficients of variation and skewness of the price distribution were compared in the context of each country's cigarette excise tax structure. RESULTS The least price variability is found in countries with a uniform specific tax, or a mixed system with a minimum specific floor. Cigarette price variability is largest in countries with uniform ad valorem tax structures. Three of the four countries with ad valorem tax structures are in regional blocs, where the tax directives specify that they should implement an ad valorem structure. CONCLUSIONS Regional tax directives that require the adoption of uniform specific excise taxes, or high minimum specific floors, could be an efficient way to get multiple African countries to adopt a tax structure that reduces substitution possibilities in response to excise tax increases.
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Affiliation(s)
- Samantha Filby
- Research Unit on the Economics of Excisable Products, School of Economics, University of Cape Town, Rondebosch, South Africa
| | - Corné Van Walbeek
- Research Unit on the Economics of Excisable Products, School of Economics, University of Cape Town, Rondebosch, South Africa
| | - Liping Pan
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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van der Zee K, van Walbeek C, Ross H. How much to pay for a track and trace system: a simulation model for South Africa. Tob Control 2024; 33:252-257. [PMID: 36104173 DOI: 10.1136/tc-2022-057550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 08/31/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND The illicit trade in tobacco reduces the effectiveness of tobacco-control policies. Independent track and trace (T&T) systems are considered one of the most effective measures available to reduce the illicit tobacco trade. South Africa, with an illicit trade estimated at over 35% of the total market, is yet to implement a T&T system. METHODS An Excel-based simulation model is used to determine the break-even T&T marker cost per pack. At the break-even cost per pack, the government would recover all costs associated with implementing T&T by collecting additional revenues. We conduct a scenario analysis to provide a range of break-even marker costs. FINDINGS A marker cost of between R2.68 (US$0.17) and R5.24 (US$0.34) per pack allows the South African government to collect enough additional revenue to recover all costs associated with T&T. Implementing such a system would reduce cigarette consumption by between 5% and 11.5%. Given that comparable systems cost significantly less than this range (roughly US$0.02 per pack), the government would in all likelihood be able to implement a system at a cost below the break-even rate, thus generating additional revenue. CONCLUSION The break-even simulation model provides a practical tool for the government to plan the implementation of T&T and to set up an evaluation criteria for the T&T tender process. The simulations illustrate that implementing T&T in South Africa would both reduce consumption (licit and illicit) and generate additional revenue. With some modifications, the model can be applied to other countries as well.
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Affiliation(s)
- Kirsten van der Zee
- Research Unit on the Economics of Excisable Products, School of Economics, University of Cape Town, Rondebosch, South Africa
| | - Corné van Walbeek
- Research Unit on the Economics of Excisable Products, School of Economics, University of Cape Town, Rondebosch, South Africa
| | - Hana Ross
- Research Unit on the Economics of Excisable Products, School of Economics, University of Cape Town, Rondebosch, South Africa
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Wilson N, Carter R, Heath D, Wei Z, Martinez E, Robertson L, Zhangmo P, Bloomfield S, Thomson GW, Hoek J, Edwards R. Assessing cigarette smuggling at a time of border closure to international tourists: survey of littered packs in New Zealand. Tob Control 2024; 33:273-274. [PMID: 36028304 DOI: 10.1136/tc-2022-057603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 08/19/2022] [Indexed: 11/03/2022]
Affiliation(s)
- Nick Wilson
- Public Health, University of Otago Wellington, Wellington, New Zealand
| | - Rachel Carter
- Public Health, University of Otago Wellington, Wellington, New Zealand
| | | | - Zhang Wei
- Public Health, University of Otago Wellington, Wellington, New Zealand
| | | | - Lindsay Robertson
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | | | | | - George W Thomson
- Public Health, University of Otago Wellington, Wellington, New Zealand
| | - Janet Hoek
- Public Health, University of Otago Wellington, Wellington, New Zealand
| | - Richard Edwards
- Public Health, University of Otago Wellington, Wellington, New Zealand
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Hagenaars LL, Fazzino TL, Mackenbach JD. Giving fruits and vegetables a tax break: lessons from a Dutch attempt. Public Health Nutr 2024; 27:e70. [PMID: 38356382 DOI: 10.1017/s1368980024000442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
OBJECTIVE Food taxation can improve diets by making unhealthy foods more expensive and by making healthy foods cheaper. In the Netherlands, a political window of opportunity arose in December 2021 to reduce the value-added tax (VAT) on fruits and vegetables to zero percent. The policy is now facing institutional friction along several fronts, however, delaying and potentially averting its implementation. We analysed this institutional friction to inform future food tax policies. DESIGN We qualitatively analysed open-access fiscal and health experts' position papers about benefits and downsides of the zero-rate that were discussed with members of parliament in June 2023. SETTING The Netherlands. PARTICIPANTS Not applicable. RESULTS Health and fiscal experts expressed noticeably different viewpoints towards the utility of the zero-rate. One important argument fiscal experts based their negative advice upon pertained to the legal restrictions for distinguishing between healthier and unhealthier forms of fruits and vegetables (i.e. the principle of neutrality). A zero-rate VAT on unhealthier forms of fruits and vegetables, e.g. processed cucumber, mixed with salt and sugar, would be undesirable, but differentiating between raw and processed cucumber would offend the neutrality principle. CONCLUSIONS The Dutch attempt to give fruits and vegetables a tax break highlights the need for crystal-clear food classifications when designing food tax policies. Public health nutritionists should combine classifications based on caloric density, palatability, degree of processing and nutrient content to provide a database for evidence-informed tax differentiation according to food item healthfulness.
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Affiliation(s)
- Luc L Hagenaars
- Amsterdam UMC location University of Amsterdam, Department of Public and Occupational Health, P.O. Box 7057, Amsterdam1007 MB, The Netherlands
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA, USA
| | - Tera L Fazzino
- University of Kansas, Department of Psychology, Lawrence, KS, USA
- University of Kansas, Cofrin Logan Center for Addiction Research and Treatment, Lawrence, KS, USA
| | - Joreintje Dingena Mackenbach
- Amsterdam UMC location Vrije Universiteit Amsterdam, Epidemiology and Data Science, Boelelaan, Amsterdam, The Netherlands
- Upstream Team, Amsterdam, The Netherlands
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Mardones C. Contribution of the carbon tax, phase-out of thermoelectric power plants, and renewable energy subsidies for the decarbonization of Chile - A CGE model and microsimulations approach. J Environ Manage 2024; 352:120017. [PMID: 38198840 DOI: 10.1016/j.jenvman.2024.120017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 12/06/2023] [Accepted: 01/01/2024] [Indexed: 01/12/2024]
Abstract
There are various climate policies to decarbonize the energy matrix of a country. In the case of Chile, a carbon tax of 5 USD/tCO2 was initially implemented, and later, a schedule was established for the phase-out of coal-fired thermoelectric plants, all the above in the absence of subsidies for non-conventional renewable energy (NCRE). This study uses a computable general equilibrium (CGE) model and microsimulations to assess the contribution of current climate policies and other more demanding scenarios that accelerate the decarbonization of the Chilean energy matrix, considering economic, environmental, and distributional impacts. Specifically, carbon taxes are simulated with and without complementary climate policies (phase-out of coal-fired power plants and NCRE subsidies). The results show that the scenarios that combine the three climate policies generate a greater decrease in greenhouse gas emissions (40.4% ∼ 57.5%). Besides, the drop in GDP is more pronounced when coal-fired thermoelectric plants phase out (0.3% additional), and NCRE subsidies contribute to moderately reducing emissions. However, NCRE subsidies reduce the negative effect on households' expenditure and income, especially in the poorest quintile. Finally, microsimulations show marginal changes in income distribution and an increase of up to 0.4 percentage points in the poverty rate.
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Affiliation(s)
- Cristian Mardones
- Department of Industrial Engineering, University of Concepción, Edmundo Larenas 217, 4th Floor, Concepción, Chile.
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Gong Y, Li Y, Liu J, Sun Y. Overcoming public resistance to carbon taxes: A cost-efficient solution built on a pre-existing reward-based climate policy. J Environ Manage 2024; 352:120025. [PMID: 38219673 DOI: 10.1016/j.jenvman.2024.120025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 12/25/2023] [Accepted: 01/02/2024] [Indexed: 01/16/2024]
Abstract
A carbon tax is effective at curbing carbon emissions, but it is met with low public support due to its high personal cost. Investigations have been conducted to reform carbon tax design to ease the burden on individuals by providing economic compensation, but the cost for governments is high. We propose a new cost-efficient solution by introducing people to a pre-existing reward-based climate policy to create a sense of economic compensation. Across three experiments, we show that the presence of a pre-existing reward-based climate policy increases participants' support for a carbon tax, especially when the innate connection between the two policies is made salient and people regard the reward as compensation for the tax. In contrast, if people are distracted from sensing this interrelationship, support for the tax does not differ from when it is introduced alone. Applicability of this approach was tested under different conditions where the pressure to reduce carbon emission is either high or low.
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Affiliation(s)
- Yuanchao Gong
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Yang Li
- School of Business, Beijing Technology and Business University, Beijing, 100048, China
| | - Jiejiao Liu
- Business School, Jiangxi Institute of Fashion Technology, Nanchang, 330201, China
| | - Yan Sun
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100049, China.
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Horwitz JR. Threatening Nonprofit Hospital Tax Exemption: A Better Path Forward. JAMA 2024; 331:469-470. [PMID: 38236589 DOI: 10.1001/jama.2023.28289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
This Viewpoint discusses regulation of nonprofit hospitals in a way that will advance their charitable purposes without eliminating their tax exemption status.
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Affiliation(s)
- Jill R Horwitz
- Center for Philanthropy and Nonprofits, UCLA School of Law, Los Angeles, California
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Harris E. Tax on Sugar-Sweetened Drinks Tied to Higher Prices, Fewer Purchases. JAMA 2024; 331:466. [PMID: 38265826 DOI: 10.1001/jama.2023.27967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
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