Raei Behzad, Emamgholipour Sara, Takian Amirhossein, Yaseri Mehdi, Abdoli Ghahreman, Alizadeh Ahad
Department of Health Management & Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Health Equity Research Centre (HERC), Tehran University of Medical Sciences, Tehran, Iran.
Health Econ Rev. 2021 Aug 13;11(1):30. doi: 10.1186/s13561-021-00328-w.
To assess the potential impact of a tax-induced cigarette price increase on financial and health outcomes by different socioeconomic groups.
In a modeled condition using pooled cross-section data from Household Income and Expenditure Survey (2002-2017) and Iran 2019 population data, a methodology of an extended cost effectiveness analysis (ECEA) was applied to model the impact on cigarette consumption of hypothetically increased cigarette tax. The methodology was employed to evaluate: [1] health benefits (premature deaths averted); [2] health expenditures regarding smoking-related disease treatment averted; [3] additional tax revenues raised; [4] change in household expenditures on cigarettes; and [5] financial risk protection among male Iranian smokers in a time span of 60 years following a one-time increase in cigarette price of 75%. The Stata version 15.1 (StataCorp., College Station, TX, USA) was used to perform the relevant analysis and estimate regression models.
A 75% increase in cigarettes price through taxation would reduce the number of smokers by more than half a million, 11% of them in the poorest quintile; save about 1.9 million years of life (11% of which would be gained in the lowest quintile compared to 20% in the highest one); eliminate a total of US$196.4 million of health expenditures (9% of which would benefit the bottom quintile). Such a policy could raise the additional annual tax revenues by roughly US$ 1 billion, where the top two quintiles bear around 46% of the total tax burden. We estimated that the tax increase would avert an estimated 56,287 cases of catastrophic expenditure that wholly concentrated among the bottom two expenditure quintiles.
Increasing cigarette tax can provide health and financial benefits, and would be pro-poor in terms of health gains, Out-of-Pocket (OOP) savings, and financial risk protection against smoking-related diseases.
评估税收导致的香烟价格上涨对不同社会经济群体的财务和健康状况的潜在影响。
在使用家庭收入与支出调查（2002 - 2017年）的汇总横截面数据和伊朗2019年人口数据的模拟条件下，应用扩展成本效益分析（ECEA）方法来模拟假设的香烟税增加对香烟消费的影响。该方法用于评估：[1]健康效益（避免的过早死亡）；[2]避免的与吸烟相关疾病治疗的健康支出；[3]增加的额外税收收入；[4]家庭香烟支出的变化；以及[5]在香烟价格一次性上涨75%后的60年时间跨度内，伊朗男性吸烟者的财务风险保护。使用Stata 15.1版本（美国德克萨斯州大学站市的StataCorp公司）进行相关分析并估计回归模型。
通过税收使香烟价格上涨75%将使吸烟者数量减少超过50万，其中11%来自最贫困的五分之一群体；挽救约190万年的生命（其中最低五分之一群体获得11%，而最高五分之一群体获得20%）；消除总计1.964亿美元的健康支出（其中9%将惠及最底层五分之一群体）。这样一项政策每年可增加约10亿美元的额外税收收入，其中最高的两个五分之一群体承担约46%的总税收负担。我们估计，税收增加将避免约56,287例灾难性支出，这些支出完全集中在最底层的两个支出五分之一群体中。
提高香烟税可带来健康和财务效益，并且在健康收益、自付费用节省以及针对与吸烟相关疾病的财务风险保护方面有利于穷人。
