Visualizing data: Trends in smoking tobacco prices and taxes in India.

Tobacco smoking remains a leading risk factor for disease burden globally. In India alone, about 1 million deaths are caused annually by smoking. Although increasing tobacco prices has consistently been found to be the most effective intervention to reduce tobacco use, the documentation of prices and taxes across time and space has not been an essential component of tobacco control surveillance in most jurisdictions. This study aimed to examine, using graphical methods, trends in smoking tobacco taxes and prices in India at national and state-level. We used retail prices, price indices, and unit values (household expenditures on a commodity divided by the quantity purchased) collected and reported by government agencies. For bidis and cigarettes, we examined current and real (inflation-adjusted) prices, affordability (cost in terms of income), and key tax changes at both national and state-level. We show that real prices of bidis and cigarettes were relatively flat (even decreasing in the case of bidis) between 2000 and 2007, and clearly increasing from 2010. When rising income is taken into account, however, both cigarettes and bidis have become more affordable since 2000. We found that some but not all tax changes were accompanied by price changes and in particular, that tax decreases did not result in price decreases. It is feasible to evaluate tax and price policies at national and regional level using routinely collected data.