Skip to main content
Journal of Epidemiology and Community Health logoLink to Journal of Epidemiology and Community Health
. 2004 Jun;58(6):451–454. doi: 10.1136/jech.2003.011528

How much downside? Quantifying the relative harm from tobacco taxation

N Wilson 1, G Thomson 1, M Tobias 1, T Blakely 1
PMCID: PMC1732801  PMID: 15143110

Abstract

Objective: To estimate the loss of life expectancy attributable to tobacco taxation (via financial hardship and flow-on health effect) in New Zealand.

Design: Data were used on the gradients in life expectancy and smoking by neighbourhood socioeconomic deprivation and survey data on tobacco expenditure. Three estimates were modelled of the percentage of the crude association of neighbourhood deprivation with life expectancy that might be mediated via financial hardship: 100%, 50%, and 25% (best estimate). From this information the impact of tobacco taxation on life expectancy was estimated.

Main results: For the total population, the estimated loss of life expectancy due to tobacco tax ranged from 0.005 years to 0.027 years. For people living in the most deprived 30% of neighbourhoods, the range was 0.009 to 0.044 years (that is, 3 to 16 days of lost life expectancy). For the total population the loss of life expectancy attributable to tobacco tax ranged from 119 to 460 times less than that attributable to deprivation. The loss of life expectancy attributable to tobacco tax was 42 to 257 times less than that attributable to smoking.

Conclusions: The estimated harm to life expectancy from tobacco taxation (via financial hardship) is orders of magnitude smaller than the harm from smoking. Although the analyses involve a number of simplistic assumptions, this conclusion is likely to be robust. Policy makers should be reassured that tobacco taxation is likely to be achieving far more benefit than harm in the general population and in socioeconomically deprived populations.

Full Text

The Full Text of this article is available as a PDF (133.2 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bains N., Pickett W., Hoey J. The use and impact of incentives in population-based smoking cessation programs: a review. Am J Health Promot. 1998 May-Jun;12(5):307–320. doi: 10.4278/0890-1171-12.5.307. [DOI] [PubMed] [Google Scholar]
  2. Blakely Tony. Commentary: estimating direct and indirect effects-fallible in theory, but in the real world? Int J Epidemiol. 2002 Feb;31(1):166–167. doi: 10.1093/ije/31.1.166. [DOI] [PubMed] [Google Scholar]
  3. Blakely Tony, Woodward Alistair, Pearce Neil, Salmond Clare, Kiro Cindy, Davis Peter. Socio-economic factors and mortality among 25-64 year olds followed from 1991 to 1994: the New Zealand Census-Mortality Study. N Z Med J. 2002 Mar 8;115(1149):93–97. [PubMed] [Google Scholar]
  4. Chaloupka F. J., Cummings K. M., Morley C. P., Horan J. K. Tax, price and cigarette smoking: evidence from the tobacco documents and implications for tobacco company marketing strategies. Tob Control. 2002 Mar;11 (Suppl 1):I62–I72. doi: 10.1136/tc.11.suppl_1.i62. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Cole Stephen R., Hernán Miguel A. Fallibility in estimating direct effects. Int J Epidemiol. 2002 Feb;31(1):163–165. doi: 10.1093/ije/31.1.163. [DOI] [PubMed] [Google Scholar]
  6. Eide G. E., Gefeller O. Re: "Attributable risk in practice". Am J Epidemiol. 2000 Jan 15;151(2):208–212. doi: 10.1093/oxfordjournals.aje.a010192. [DOI] [PubMed] [Google Scholar]
  7. Hamilton V. H., Levinton C., St-Pierre Y., Grimard F. The effect of tobacco tax cuts on cigarette smoking in Canada. CMAJ. 1997 Jan 15;156(2):187–191. [PMC free article] [PubMed] [Google Scholar]
  8. Hopkins D. P., Briss P. A., Ricard C. J., Husten C. G., Carande-Kulis V. G., Fielding J. E., Alao M. O., McKenna J. W., Sharp D. J., Harris J. R. Reviews of evidence regarding interventions to reduce tobacco use and exposure to environmental tobacco smoke. Am J Prev Med. 2001 Feb;20(2 Suppl):16–66. doi: 10.1016/s0749-3797(00)00297-x. [DOI] [PubMed] [Google Scholar]
  9. Jha P., Chaloupka F. J. The economics of global tobacco control. BMJ. 2000 Aug 5;321(7257):358–361. doi: 10.1136/bmj.321.7257.358. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Meier K. J., Licari M. J. The effect of cigarette taxes on cigarette consumption, 1955 through 1994. Am J Public Health. 1997 Jul;87(7):1126–1130. doi: 10.2105/ajph.87.7.1126. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Robins J. M., Greenland S. Identifiability and exchangeability for direct and indirect effects. Epidemiology. 1992 Mar;3(2):143–155. doi: 10.1097/00001648-199203000-00013. [DOI] [PubMed] [Google Scholar]
  12. Tobias M., Jackson G. Avoidable mortality in New Zealand, 1981-97. Aust N Z J Public Health. 2001;25(1):12–20. doi: 10.1111/j.1467-842x.2001.tb00543.x. [DOI] [PubMed] [Google Scholar]
  13. Townsend J., Roderick P., Cooper J. Cigarette smoking by socioeconomic group, sex, and age: effects of price, income, and health publicity. BMJ. 1994 Oct 8;309(6959):923–927. doi: 10.1136/bmj.309.6959.923. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Warner K. E. The economics of tobacco: myths and realities. Tob Control. 2000 Mar;9(1):78–89. doi: 10.1136/tc.9.1.78. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Journal of Epidemiology and Community Health are provided here courtesy of BMJ Publishing Group

RESOURCES