1.  2007 Johns Hopkins Bloomberg School of Public Health Tobacco Taxation Frank J. Chaloupka, PhD University of Illinois at Chicago International Tobacco Evidence Network

2.  2007 Johns Hopkins Bloomberg School of Public Health 2 Overview Why tax tobacco? Types of tobacco taxes Impact of tobacco taxes on tobacco product prices Effects of taxes and prices on cigarette smoking and other tobacco use Impact of tobacco taxes on tobacco tax revenues Conclusions

3.  2007 Johns Hopkins Bloomberg School of Public Health 3 Why Tax Tobacco? Revenue Generation Efficient revenue generation  Primary motive historically and still true in many countries today  Very efficient source of revenue, given:  Low share of tax in price in most countries  Relatively inelastic demand for tobacco products  Few producers and few close substitutes

4.  2007 Johns Hopkins Bloomberg School of Public Health 4 Why Tax Tobacco? Revenue Generation “Sugar, rum, and tobacco are commodities which are no where necessaries of life, which are become objects of almost universal consumption, and which are therefore extremely proper subjects of taxation.” — Adam Smith, Wealth of Nations, 1776

5.  2007 Johns Hopkins Bloomberg School of Public Health 5 Why Tax Tobacco? Promote Public Health Promote public health  Increasingly important motive for higher tobacco taxes in many high-income countries  Emerging as important factor in some low- and middle- income countries  Based on substantial and growing evidence on the effects of tobacco taxes and the prices on tobacco use  Particularly among young, less-educated, and low-income populations

6.  2007 Johns Hopkins Bloomberg School of Public Health 6 Why Tax Tobacco? Promote Public Health “The Parties recognize that price and tax measures are an effective and important means of reducing tobacco consumption by various segments of the population, in particular young persons.” — Framework Convention on Tobacco Control, Article 6

7.  2007 Johns Hopkins Bloomberg School of Public Health 7 Why Tax Tobacco? External Costs Cover the external costs of tobacco  Less frequently used motive  Account for costs resulting from tobacco use imposed on nonusers  Can also include “internalities” that result from addiction and time-inconsistent preferences

8.  2007 Johns Hopkins Bloomberg School of Public Health 8 Source: Philip Morris. (1985). Smoking and Health Initiatives. Industry Perspective Industry understands the importance of tobacco taxes  "With regard to taxation, it is clear that in the U.S., and in most countries in which we operate, tax is becoming a major threat to our existence”  "Of all the concerns, there is one—taxation—that alarms us the most. While marketing restrictions and public and passive smoking (restrictions) do depress volume, in our experience taxation depresses it much more severely. Our concern for taxation is, therefore, central to our thinking..."

9.  2007 Johns Hopkins Bloomberg School of Public Health 9 Types of Tobacco Taxes Variety of tobacco taxes  Taxes on the value of the tobacco crop  Customs duties on tobacco leaf imports and/or exports  Customs duties on tobacco product imports and/or exports  Sales taxes  Value-added taxes  Implicit taxes  Tobacco excise taxes

10.  2007 Johns Hopkins Bloomberg School of Public Health 10 Two Types of Excises Specific taxes: excises based on quantity or weight (e.g., tax per pack of 20 cigarettes) Ad valorem taxes: excises based on value of tobacco products (e.g., a specific percentage of manufacturer’s prices for tobacco products) Some countries use a mix of specific and ad valorem tobacco excises Many countries apply different types of taxes and/or tax rates on different types of tobacco products  For example: manufactured cigarettes vs. bidis

11.  2007 Johns Hopkins Bloomberg School of Public Health 11 Specific vs. Ad Valorem Tobacco Excises Strengths/weaknesses depend on a variety of factors and goals of tax Specific taxes  Generally produce a more stable stream of revenue  Real value falls with inflation  Promote higher “quality” products

12.  2007 Johns Hopkins Bloomberg School of Public Health 12 Specific vs. Ad Valorem Tobacco Excises Ad valorem taxes  More unstable revenues given that revenues depend on industry pricing  Government effectively subsidizes industry price cuts  Rises with inflation If reducing tobacco use is a primary goal, a specific tax is generally preferred  Particularly when regularly adjusted for inflation

13.  2007 Johns Hopkins Bloomberg School of Public Health 13 Taxes and Tobacco Product Prices Impact of tobacco taxes on tobacco use and other outcomes depends on the impact of tax on prices of tobacco products  Impact on prices will vary based on several factors, including the following:  Structure of tobacco product market  Cost of tobacco product production  Industry price-related marketing efforts  Potential for individual tax avoidance and larger-scale, more organized tobacco product smuggling  Most evidence (largely from the United States) indicates that tobacco tax increases result in comparable tobacco product price increases  That is, tax increases are fully passed on to tobacco users

14.  2007 Johns Hopkins Bloomberg School of Public Health 14 Inflation-Adjusted Cigarette Prices, U.S., 1955–2006 Source: adapted by CTLT from Tax Burden on Tobacco. (2006); author’s calculations. -

15.  2007 Johns Hopkins Bloomberg School of Public Health 15 Inflation-Adjusted Cigarette Taxes and Prices: S. Africa Source: adapted by CTLT from Van Walbeek. (2003). -

16.  2007 Johns Hopkins Bloomberg School of Public Health 16 Source: adapted by CTLT from Chaloupka, et al. (2000). Tax Levels and Prices Vary Widely across Countries

17.  2007 Johns Hopkins Bloomberg School of Public Health 17 Increases in Tobacco Product Taxes and Prices Induce current users to try to quit  Many will be successful in long-term Keep former users from restarting Prevent potential users from starting  Particularly effective in preventing transition from experimentation to regular use

18.  2007 Johns Hopkins Bloomberg School of Public Health 18 Increases in Tobacco Product Taxes and Prices Reduce consumption among those who continue to use Lead to other changes in tobacco-use behavior, including:  Substitution to cheaper products or brands  Changes in buying behavior  Compensation

19.  2007 Johns Hopkins Bloomberg School of Public Health 19 Price and Tobacco Use in High-Income Countries Well over 100 studies from high-income countries consistently find that:  A 10% increase in price reduces overall consumption of tobacco products by 2.5–5%  Consensus estimate: 10% price increase reduces consumption by 4%  Estimated impact on sales higher in presence of significant tax avoidance and smuggling  Long-run impact larger as addicted users respond over time to permanent increases in taxes and prices

20.  2007 Johns Hopkins Bloomberg School of Public Health 20 Cigarette Prices and Consumption: U.K. Source: adapted by CTLT from Townsend. (1998).

21.  2007 Johns Hopkins Bloomberg School of Public Health 21 Cigarette Prices and Sales: U.S. Source: adapted by CTLT from Tax Burden on Tobacco. (2007); author’s calculations.

22.  2007 Johns Hopkins Bloomberg School of Public Health 22 Price and Tobacco Use: Low-/Middle-Income Countries Growing evidence from low- and middle-income countries suggests that the impact of tax and price increases is up to twice as large as in high-income countries  Consistent with predictions from economic theory that price sensitivity is greater among those on lower incomes

23.  2007 Johns Hopkins Bloomberg School of Public Health 23 Price and Tobacco Use: Low-/Middle-Income Countries Growing evidence from low- and middle-income countries suggests that the impact of tax and price increases is up to twice as large as in high-income countries  A few estimates  Southeast Asia: 10% price increase reduced overall consumption by 6–9%  China: 10% price increase reduces consumption by 6.5–13%  South Africa: 10% price increase reduces consumption by 6–7%  Morocco: 10% price increase reduces consumption by 5–15%

24.  2007 Johns Hopkins Bloomberg School of Public Health 24 Cigarette Prices* and Consumption: South Africa Source: adapted by CTLT from Van Walbeek. (2003).

25.  2007 Johns Hopkins Bloomberg School of Public Health 25 Cigarette Prices* and Consumption: Morocco Source: adapted by CTLT from Aloui. (2003).

26.  2007 Johns Hopkins Bloomberg School of Public Health 26 Price, Smoking Prevalence, and Cessation Estimates suggest that about half of the impact of price on overall tobacco use result from changes in prevalence  Implies that a 10% price increase reduces prevalence by:  1–2.5% in high-income countries  2.5–5% in low- middle-income countries  Changes in prevalence in response to price increase largely result from cessation among current users  U.S. estimates suggest 10% price increase increases number of smokers trying to quit by more than 10%, with about 2% successful in long-term

27.  2007 Johns Hopkins Bloomberg School of Public Health 27 Cigarette Prices and Adult Smoking Prevalence: U.S. Source: adapted by CTLT from Tax Burden on Tobacco. (2007); U.S. National Health Interview, various years; author’s calculations.

28.  2007 Johns Hopkins Bloomberg School of Public Health 28 Cigarette Prices and Quitting Smoking: U.S. Sources: adapted by CTLT from Tax Burden on Tobacco. (2006); U.S. Behavioral Risk Factor Surveillance System. (2005); author’s calculations.

29.  2007 Johns Hopkins Bloomberg School of Public Health 29 Price Sensitivity and Age Growing evidence that tobacco use among younger persons is two to three times more responsive to price than tobacco use among older persons  Largely based on studies from the United States, but there is growing evidence from other countries  Consistent with economic theory, given:  Lower incomes of youth  Greater importance of peer influences on youth  Influence of addiction  Greater preference for the present among youth

30.  2007 Johns Hopkins Bloomberg School of Public Health 30 Price Sensitivity and Age Growing evidence that tobacco use among younger persons is two to three times more responsive to price than tobacco use among older persons  Changes in youth prevalence largely result from reductions in initiation of tobacco use  Evidence suggests that higher taxes and prices are most effective in preventing youth from moving beyond experimentation and into regular tobacco use and addiction

31.  2007 Johns Hopkins Bloomberg School of Public Health 31 Youth Smoking Prevalence and Cigarette Price: U.S. Source: adapted by CTLT from Tax Burden on Tobacco. (2006); U.S. Monitoring the Future Surveys; author’s calculations.

32.  2007 Johns Hopkins Bloomberg School of Public Health 32 Price Sensitivity and Income/Education A growing number of studies find that tobacco use among less- educated and/or lower-income persons is more responsive to price  Economic theory implies that lower-income persons are generally more responsive to changes in prices for goods or services they consume than are higher-income persons  U.K.: lowest socioeconomic group is very responsive to price, while highest socioeconomic group virtually unresponsive to price* * Source: Townsend, J. (1994).

33.  2007 Johns Hopkins Bloomberg School of Public Health 33 Price Sensitivity and Income/Education A growing number of studies find that tobacco use among less- educated and/or lower-income persons is more responsive to price  U.S.: smoking in households below median income level are about four times more sensitive to price than smoking in households above median*  Similar evidence emerging from low- and middle-income countries * Source: Farrelly, M. (2001).

34.  2007 Johns Hopkins Bloomberg School of Public Health 34 Dedicated Tobacco Taxes A growing number of governments are using dedicated tobacco taxes (also called hypothecated or earmarked tobacco taxes) to support tobacco control activities  Include “health promotion foundations” and “comprehensive tobacco control programs” Research evidence, largely from high-income countries, shows that funding for tobacco control programs:  Reduces overall tobacco consumption  Increases adult cessation and prevents youth initiation  Reduces tobacco use in other high-risk populations

35.  2007 Johns Hopkins Bloomberg School of Public Health 35 Tobacco Taxes and Deaths Caused by Tobacco Given the evidence on the impact of tobacco taxes and prices on tobacco use, large increases in taxes globally would significantly reduce premature deaths caused by tobacco use  Short-run reductions in deaths result from increased cessation  Significant health benefits of cessation  Long-run reductions result from preventing initiation

36.  2007 Johns Hopkins Bloomberg School of Public Health 36 Source: adapted by CTLT from Jha, et al. (2006). Tobacco Deaths and Tobacco Control

37.  2007 Johns Hopkins Bloomberg School of Public Health 37 Tobacco Taxes and Revenues Increases in tobacco taxes lead to increases in tobacco tax revenues, despite reductions in tobacco use  Low share of tax in price in most countries  Implies large tax increase will raise price by smaller percentage  Less than proportionate fall in consumption in response to given percentage price increase in most countries  Revenues rise even in presence of tax avoidance and smuggling

38.  2007 Johns Hopkins Bloomberg School of Public Health 38 Federal Cigarette Tax and Tax Revenues, U.S. Source: adapted by CTLT from Tax Burden on Tobacco. (2006); author’s calculations.

39.  2007 Johns Hopkins Bloomberg School of Public Health 39 Cigarette Taxes* and Tax Revenues*: South Africa Source: adapted by CTLT from Van Walbeek. (2003).

40.  2007 Johns Hopkins Bloomberg School of Public Health 40 Cigarette Taxes* and Tax Revenues*: Indonesia Source: adapted by CTLT from Djutaharta, et al. (2005).

41.  2007 Johns Hopkins Bloomberg School of Public Health 41 What Is the “Right” Level of Tobacco Taxes? This is a complex question that depends on a variety of factors, including the following:  Motives for tobacco taxation  Improving public health vs. generating revenue? (taxes can accomplish both)  Tax rates in neighboring countries  Potential for tax avoidance and smuggling World Bank suggests that a useful yardstick is two-thirds to four- fifths of the price accounted for by tax in countries that have taken a comprehensive approach to reducing tobacco use

42.  2007 Johns Hopkins Bloomberg School of Public Health 42 Summary Higher tobacco taxes will lead to higher tobacco product prices Increases in tobacco taxes and prices will reduce tobacco use and the disease and death it causes  Increase cessation among current users  Prevent relapse among former users  Prevent initiation of regular tobacco use  Reduce consumption among those who continue to use Higher tobacco taxes raise revenues  New revenues can be used to support comprehensive tobacco- control efforts that would further reduce tobacco use

43.  2007 Johns Hopkins Bloomberg School of Public Health 43 Additional Resources International Tobacco Evidence Network  www.tobaccoevidence.net World Bank tobacco page  www.worldbank.org/tobacco World Health Organization’s Tobacco-Free Initiative  www.who.int/tobacco/en/ Research for International Tobacco Control  www.idrc.ca/en/ev-83280-201-1-DO_TOPIC.html

44.  2007 Johns Hopkins Bloomberg School of Public Health 44 Additional Resources Jha, P., Chaloupka, F.J. (1999). Curbing the Epidemic: Governments and the Economics of Tobacco Control. Washington D.C.: World Bank. Jha, P., Chaloupka, F.J., eds. (2000). Tobacco Control in Developing Countries. Oxford: Oxford University Press. Chaloupka, F.J., Warner, K.E. (2000). “The Economics of Smoking.” In Handbook of Health Economics. New York: North Holland.

45.  2007 Johns Hopkins Bloomberg School of Public Health 45 Additional Resources Ross, H., Chaloupka, F.J. (2006). Economic Policies for Tobacco Control in Developing Countries. Revista de Salud Pública de México, 48(S1):S113-120. Jha, P., Chaloupka, F.J., et al. (2006). “Tobacco Addiction.” In Disease Control Priorities in Developing Countries, 2nd Edition. Washington D.C.: Oxford University Press and the World Bank.