How much downside? Quantifying the relative harm from tobacco taxation

Area of Science:

• Public Health
• Health Economics
• Epidemiology

Background:

• Tobacco taxation is a key public health strategy to reduce smoking prevalence and related harms.
• Concerns exist regarding potential negative impacts of tobacco taxes, such as financial hardship and subsequent effects on life expectancy, particularly in socioeconomically deprived groups.

Purpose of the Study:

• To quantify the estimated loss of life expectancy attributable to tobacco taxation in New Zealand.
• To assess the impact of financial hardship and flow-on health effects resulting from tobacco tax policies.

Main Methods:

• Utilized data on life expectancy and smoking gradients by neighborhood socioeconomic deprivation.
• Incorporated survey data on tobacco expenditure.
• Modeled the percentage of the association between neighborhood deprivation and life expectancy mediated by financial hardship (100%, 50%, 25%).

Main Results:

• Estimated loss of life expectancy from tobacco tax was minimal for the total population (0.005-0.027 years).
• For the most deprived populations, the loss ranged from 0.009 to 0.044 years (3-16 days).
• Loss of life expectancy from tobacco tax was orders of magnitude smaller than that attributable to deprivation or smoking.

Conclusions:

• The estimated harm to life expectancy from tobacco taxation is substantially smaller than the harm from smoking.
• Despite simplifying assumptions, the conclusion that tobacco taxation yields far more benefit than harm is robust.
• Policy makers can be reassured regarding the net positive impact of tobacco taxation on public health, including for deprived populations.