Pradesh
Before the price increase, an estimated total of about 10.7 million males older than 15 years smoked cigarettes across all of the four states studied ( Table 2 ). Men in the bottom income group (poorest 20% of the population) accounted for 21%, while men in the top income group (richest 20% of the population) accounted for 15% of the total number of male smokers.
Variables by income groups | Karnataka | Assam | Uttar Pradesh | Maharashtra | Four states total |
---|---|---|---|---|---|
First (bottom 20%) | 364.1 | 119.8 | 1,492.2 | 270.4 | 2,246.5 |
Second | 361.8 | 193.2 | 2,727.5 | 114.0 | 3,396.5 |
Third | 373.3 | 273.1 | 1,041.3 | 250.1 | 1,937.7 |
Fourth | 219.9 | 286.3 | 816.3 | 255.1 | 1,577.7 |
Fifth (top 20%) | 385.0 | 314.8 | 422.9 | 465.6 | 1,588.4 |
Total | 1,704.2 | 1,187.1 | 6,500.2 | 1,355.3 | 10,746.8 |
First: fifth ratio | 0.9 | 0.4 | 3.5 | 0.6 | 1.4 |
First (bottom 20%) | 75.7 | 31.9 | 322.7 | 55.4 | 485.7 |
Second | 60.0 | 41.0 | 470.0 | 18.6 | 589.6 |
Third | 46.1 | 43.1 | 133.7 | 30.4 | 253.4 |
Fourth | 17.9 | 29.8 | 69.0 | 20.4 | 137.0 |
Fifth (top 20%) | 15.0 | 15.7 | 17.2 | 17.9 | 65.8 |
Total | 214.7 | 161.4 | 1,012.6 | 142.8 | 1,531.5 |
First: fifth ratio | 5.0 | 2.0 | 18.8 | 3.1 | 7.4 |
First (bottom 20%) | 32.3 | 14.5 | 139.8 | 23.6 | 210.3 |
Second | 25.6 | 18.6 | 203.7 | 7.9 | 255.8 |
Third | 19.7 | 19.6 | 57.9 | 13.0 | 110.2 |
Fourth | 7.6 | 13.5 | 29.9 | 8.7 | 59.7 |
Fifth (top 20%) | 6.4 | 7.1 | 7.4 | 7.6 | 28.6 |
Total | 91.7 | 73.3 | 438.7 | 60.9 | 664.7 |
First: fifth ratio | 5.0 | 2.0 | 18.8 | 3.1 | 7.4 |
First (bottom 20%) | 574.7 | 265.5 | 2,489.9 | 421.8 | 3,751.9 |
Second | 455.1 | 341.3 | 3,626.6 | 141.7 | 4,564.7 |
Third | 349.8 | 359.5 | 1,031.6 | 231.7 | 1,972.6 |
Fourth | 135.6 | 248.0 | 532.0 | 155.5 | 1,071.1 |
Fifth (top 20%) | 113.9 | 130.9 | 132.3 | 136.2 | 513.3 |
Total | 1,629.1 | 1,345.1 | 7,812.5 | 1,086.9 | 11,873.7 |
First: fifth ratio | 5.0 | 2.0 | 18.8 | 3.1 | 7.3 |
First (bottom 20%) | 84.4 (46.6) | 36.6 (20.2) | 289.0 (159.6) | 57.4 (31.7) | 467.4 |
Second | 103.0 (56.9) | 43.7 (24.1) | 593.0 (327.5) | 22.9 (12.6) | 762.6 |
Third | 50.3 (27.8) | 50.1 (27.7) | 148.0 (81.7) | 33.2 (18.3) | 281.6 |
Fourth | 38.8 (21.4) | 28.3 (15.6) | 63.4 (35.0) | 23.6 (13.0) | 154.1 |
Fifth (top 20%) | 17.7 (9.8) | 13.3 (7.3) | 18.8 (10.4) | 13.7 (7.6) | 63.5 |
Total | 294.2 (162.5) | 172.0 (95.0) | 1,112.2 (614.3) | 150.8 (83.3) | 1,729.2 |
First: fifth ratio | 4.8 | 2.8 | 15.4 | 4.2 | 7.4 |
First (bottom 20%) | 22.6 | 9.8 | 77.7 | 15.4 | 125.6 |
Second | 27.2 | 11.7 | 159.3 | 6.1 | 204.4 |
Third | 10.6 | 13.4 | 39.7 | 7.4 | 71.2 |
Fourth | 8.1 | 7.6 | 17.0 | 5.0 | 37.7 |
Fifth (top 20%) | 3.4 | 3.6 | 5.0 | 2.8 | 14.7 |
Total | 71.9 | 46.2 | 298.8 | 36.7 | 453.6 |
First: fifth ratio | 6.7 | 2.8 | 15.4 | 5.6 | 8.5 |
First (bottom 20%) | 0.0 | 1.6 | 40.1 | 0.0 | 41.8 |
Second | 0.0 | 1.1 | 25.1 | 0.0 | 26.2 |
Third | 0.0 | 0.0 | 6.2 | 0.0 | 6.3 |
Fourth | 0.0 | 0.0 | 0.9 | 0.0 | 0.9 |
Fifth (top 20%) | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 |
Total | 0.0 | 2.6 | 72.3 | 0.0 | 75.1 |
First: fifth ratio | - | - | >100 | - | >100 |
Total | 0.1 (0.0) | 54.7 (30.2) | 617.7 (341.2) | 0.1 (0.0) | 672.5 |
First (bottom 20%) | 227.9 (125.9) | 35.8 (19.8) | 96.5 (53.3) | 99.6 (55.0) | 459.9 (254.0) |
Second | 122.0 (67.4) | 61.9 (34.2) | 231.5 (127.9) | 33.4 (18.4) | 448.8 (247.9) |
Third | 349.5 (193.1) | 87.6 (48.4) | 239.0 (132.0) | 179.2 (99.0) | 855.3 (472.4) |
Fourth | 336.2 (185.7) | 212.8 (117.5) | 415.0 (229.2) | 216.8 (119.8) | 1,180.7 (652.2) |
Fifth (top 20%) | 397.5 (219.5) | 240.2 (132.7) | 483.4 (267.0) | 319.3 (176.3) | 1,440.3 (795.5) |
Total | 1,433.1 (791.5) | 638.2 (352.5) | 1,465.4 (809.4) | 848.2 (468.5) | 4,385.0 (2,422.0) |
First: fifth ratio | 0.6 | 0.1 | 0.2 | 0.3 | 0.3 |
In 2018-19, the average market price of filtered cigarettes for a pack of 20 is about INR 224.49. With a tax increase to INR 10 plus 10% ad valorem , the price would increase to INR 344.04. This represents a 53.25% price increase. This increase in cigarette price would lead to about 1.5 million men quitting smoking across the four states, with the bottom income group having 7.4 times as many quitters as the top income group (485,725 vs 65,762). An estimated total of 665 thousand deaths due to COPD, stroke, heart disease, and cancer would be averted among current smokers due to quitting. The number of averted deaths in the bottom income group would be 7.4 times that in the top income group (210,289 vs 28,610). The deaths averted due to quitting would yield an estimated 11.9 million life-years, with the bottom income group gaining 7.3 times more life-years than those in the top income group (3,751,930 vs 513,319).
The cost averted for treating the four major tobacco-attributable diseases would amount to more than INR 1,729 crore ($Int 955 million). The treatment cost averted in the bottom income group would be 7.4 times higher than in the top income group (INR 467 crore vs 64 crore, or $Int 258 million vs 35 million). As a result of the total treatment cost averted, about 454 thousand men would avoid catastrophic health expenditures and about 75 thousand men would avoid falling into extreme poverty. The treatment cost and impoverishment averted would save about INR 672 crore ($Int 371 million) in AB-PMJAY. The increase in excise tax would generate an additional tax revenue of about INR 4,385 crore ($Int 2,422 million). In contrast to the distribution of health benefits, the extra revenue generated from men in the top income group would be about 3.1 times that from the bottom income group (INR 1,440 crore vs 460 crore, or $Int 759 million vs 254 million).
In Karnataka, there are about 1.7 million male cigarette smokers aged 15 and above in 2016–17. Men in the bottom and the top income groups each account for about 21% of the total number of smokers. Smoking prevalence declined modestly with age in those aged 15–29 to 60–69 but increased in those aged 70 and above.
With a 53.25% increase in cigarette price through the excise tax increase, about 215 thousand men would quit smoking, with the bottom income group having five times as many quitters as the top income group (75,743 vs 15,017). Quitting as a result of the price increase would avert about 92 thousand deaths due to COPD, stroke, heart disease, and cancer among male smokers. The number of deaths averted in the bottom income group would be five times that in the top income group (32,353 vs 6,414). As a result of the deaths averted, Karnataka would gain about 1.6 million life-years and avert about INR 294 crore ($Int 162 million) in treatment cost for treating the four tobacco-attributable diseases. The averted treatment cost in the bottom income group would be 4.8 times that in the top income group (INR 84 crore vs 18 crore, $Int 47 million vs 10 million). About 72 thousand men would avoid catastrophic health expenditures, with the bottom income group avoiding 6.7 times that of the top income group (22,618 vs 3,355). The tax increase would generate about INR 1,433 crore ($Int 792 million), of which the top income group would contribute 1.7 times that from bottom income group (INR 297 crore vs 228 crore, $Int 220 million vs 126 million).
Of the four states studied, Assam has the highest male cigarette smoking prevalence of 9.7% or about 1.2 million male cigarette smokers. Cigarette smoking prevalence vary considerably across age groups, with the highest prevalence among males aged 15–29 and lowest among males aged 60–69. The prevalence increases with income.
With a 53.25% increase in cigarette price, about 161 thousand men would quit smoking, with the bottom income group having twice as many quitters as the top income group (31,866 vs 15,706). Quitting as a result of the price increase would avert about 73 thousand deaths due to COPD, stroke, heart disease, and cancer among male smokes. The number of deaths averted in the bottom income group would be twice that in the top income group (14,467 vs 7,131). As a result of the deaths averted, Assam would gain about 1.3 million life-years and avert about INR 172 crore ($Int 95 million) in treatment cost for treating the four tobacco-attributable diseases. The averted treatment cost in the bottom income group would be 2.8 times that in the top income group (INR 37 crore vs 13 crore, $Int 20 million vs 7 million). As a result of the treatment cost averted, about 46 thousand men would avoid catastrophic health expenditures, and about 2,635 men would avoid falling into extreme poverty. The treatment cost and impoverishment averted would save about INR 55 crore ($Int 30 million) in AB-PMJAY. The tax increase would generate more than INR 638 crore ($Int 352 million), of which the top income group would contribute 6.7 times that from bottom income group (INR 240 crores vs 36 crore, $Int 132 million vs 20 million).
Uttar Pradesh has an overall male cigarette smoking prevalence of 8.6%, but has the highest number of male cigarette smokers among the four study states of about 6.5 million. The prevalence is highest among men aged 30–44 and declines with age to 4.3% among those aged 70 and above. In contrast to Assam, smoking prevalence decreases with income.
With a 53.25% increase in cigarette price, more than 1 million men would quit smoking, with the bottom income group having 18.8 times as many quitters as the top income group (322,707 vs 17,150). Quitting as a result of the price increase would avert about 439 thousand deaths due to COPD, stroke, heart disease, and cancer among male smokers. The number of deaths averted in the bottom income group would be 18.8 times that in the top income group (139,821 vs 7,431). As a result of the deaths averted, Uttar Pradesh would gain about 7.8 million life-years and avert about INR 1,112 crore ($Int 614 million) in treatment cost for treating the four tobacco-attributable diseases. The averted treatment cost in the bottom income group would be 15.4 times that in the top income group (INR 289 crore vs 19 crore, $Int 159 million vs 10 million). Due to the treatment cost averted, about 299 thousand men would avoid catastrophic health expenditure, 72 thousand men would avoid falling into extreme poverty, and about INR 618 crore ($Int 341 million) would be saved in AM-PMJAY. The tax increase would generate about INR 1,465 crore ($Int 809 million), of which the top income group would contribute 5 times that from bottom income group (INR 483 crore vs 96 crore, $Int 267 million vs 53 million).
Among the four study states, Maharashtra has the lowest male cigarette smoking prevalence of 2.7%. Smoking prevalence varies across age groups with the highest prevalence among men 30–44 years (3.4%) and lowest among men aged 70 and above (0.47%). Similar to Assam and in contrast to Uttar Pradesh, the prevalence increases with income.
With a 53.25% increase in cigarette price, about 143 thousand men would quit smoking, with the bottom income group having more than three times as many quitters as the top income group (55,410 vs 17,889). Quitting as a result of the price increase would avert about 61 thousand deaths due to COPD, stroke, heart disease, and cancer among male smokers. The number of deaths averted in the bottom income group would be 3.1 times that in the top income group (23,647 vs 7,635). As a result of the deaths averted, Maharashtra would gain about 1 million life-years and avert about INR 151 crore ($Int 83 million) in treatment cost for treating the four tobacco-attributable diseases. The averted treatment cost in the bottom income group would be about 4.2 times that in the top income group (INR 57 crore vs 14 crore, $Int 32 million vs 8 million). About 37 thousand men would avoid catastrophic health expenditures, with the bottom income group avoiding more than five times that of the top income group (15,409 vs 2,775). The tax increase would generate about INR 848 crore ($Int 468 million), of which the top income group would contribute 3.2 times that from bottom income group (INR 319 crore vs 100 crore, $Int 176 million vs 55 million).
Our sensitivity analysis yielded similar results. Across all three scenarios (25% price increase, 100% price increase, and price increase to INR 10 plus 10% ad valorem with a price elasticity of -0.34), the ratio of the additional life-years gained, treatment cost averted, and number of men avoiding catastrophic health expenditure between the bottom and the top income groups is similar to that in the baseline scenario ( Figure 1a–c ). Compared to the baseline scenario, with a 25% cigarette price increase, the ratio of the additional tax revenue collected from the top income group to the bottom income group increases in all four states, while with a 100% price increase, the bottom income group would accrue tax savings as a result of quitting and reduced consumption ( Figure 1d ). The cost savings to AB-PMJAY, in Assam and Uttar Pradesh, from a 25% price increase would be less than half that from the baseline scenario (INR 26 crore 55 crore in Assam, and INR 290 crore vs 618 crore in Uttar Pradesh), while that from a 100% price increase would be almost double (INR 103 crore in Assam and INR 1,160 crore in Uttar Pradesh) ( Figure 1e ). The findings using the Indian price elasticity of -0.34 are similar to that of the baseline scenario.
This study confirms that significant tax increases on filtered tobacco would be associated with pro-poor health outcomes as well as significant reductions in poverty and levels of catastrophic health expenditure in the Indian population. Increasing the market price of filtered tobacco is estimated to have a higher impact on the smoking rates of lower income Indian households, and as a result, poorer households bare a lower share of the overall net increased market cost. This study reaffirms that tobacco taxation is an important public policy approach that is associated with a pro-poor impact in India, as also found in other LMICs 10 – 15 .
The findings from this subnational analysis of four states are broadly consistent with the trends seen in the national results 12 . However, the magnitude of effects differs across states. For example, the ratio between the outcomes between the first and fifth income groups is largest in Uttar Pradesh due to a wide gap in the rates of cigarette smoking between the first and fifth income groups (11.4 vs 6.3%). In this state, the poor would benefit the most from large tax increases and this benefit is significantly higher than the national estimate. The subnational results provide an important economic platform to engage with state-level decision makers and other stakeholders to demonstrate the differential impact that higher cigarette taxes can achieve within their jurisdictions. These results should be used to stimulate action from the local level and foster a groundswell of political buy-in to advance the national agenda to adopt higher tobacco taxes. Leveraging sub-national data to develop an economic case for stronger tobacco taxation policies is a strategy that is currently being pursued in several other settings including Mexico and Colombia 30 .
The number of men avoiding impoverishment is minimal in Karnataka and Maharashtra, which is likely because of a higher income level overall in these two states. Similarly, cost-savings to AB-PMJAY is also small in these states as fewer people are eligible to AB-PMJAY. While the potential to alleviate poverty was minimal, the higher taxes would be associated with an avoidance of a significant amount of treatment costs and reductions in catastrophic health expenditures in both states and the highest share of these reductions would be among the poorest groups. By applying the ECEA method, we have demonstrated the impact that higher cigarette taxes will have on the two key indicators that are used to assess progress towards achieving financial risk protection and universal health coverage, namely avoidance of illness-related poverty and catastrophic health expenditures 31 . This work highlights the criticality of this fiscal policy measure for achieving universal health coverage and the Sustainable Development Goals (SDGs).
There is now robust evidence generated from several LMICs that support the role of tobacco taxation policies in achieving significant health outcomes, particularly among the poor, as well as an overall reduction in poverty 10 – 15 . By curbing rates of tobacco-related non-communicable diseases in LMICs, tobacco taxation is also a means to advance economic development in these settings. Yet, the momentum for implementing and sustaining this fiscal policy approach has yet to be achieved in India and other settings. Advancing more aggressive taxation of tobacco across India and other LMICs is urgently needed to align with the recommendations of the FCTC. Recent reports suggest that for most countries, the increases that have been made to date are still far too small to significantly alter smoking rates 32 .
This study has limitations. First, we used education as the proxy for income. This may underestimate the true socioeconomic status of households. Second, a subset of subnational inputs was not available and so national inputs were used. In some cases this could under or overestimate the effects, though we anticipate the impact would be minimal as national data were substituted for less than 20% of overall inputs. Third, AB-PMJAY has expanded to beyond covering only those living below the poverty line 33 . Hence, savings to AB-PMJAY due to averted treatment costs is likely much higher than estimated. Fourth, we have not accounted for the potential substitution to other tobacco products.
Tobacco taxation remains the single most effective public policy approach for curbing smoking rates. In this study, we confirm that the poorest will benefit the most from an increase in cigarette taxes, with more life-years gained, more premature deaths and treatment costs averted, and more cases of poverty and catastrophic health expenditures avoided compared to the richest income groups. By applying the ECEA method at the subnational level, we provide first-ever estimates of the differential impact of cigarette taxes within the Indian population. The estimates generated for each of the four states provide a powerful economic input that will equip state-level decision-makers to make a strong case for higher taxes within national debates. From this work, state-level decision makers can also make the important link between cigarette taxes and the SDGs (e.g. SDG 1: End poverty in all its forms everywhere), given the substantial impact that higher taxes will also have on alleviating poverty within the population.
[version 1; peer review: 1 approved, 2 approved with reservations]
This work was supported by the Bill and Melinda Gates Foundation [OPP51447] This work was also supported by the International Development Research Centre, Cancer Research UK [108819]
The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Corné van walbeek.
1 Research Unit on the Economics of Excisable Products, School of Economics, Faculty of Commerce, University of Cape Town, Cape Town, South Africa
This is an interesting paper that considers the impact of a sizable increase in the excise tax in four Indian states. By international standards, smoking prevalence in India (and in these states) is not high. The authors show that an increase in the excise tax to 10 INR (presumably per stick, although this was not clear) plus an additional 10% tax would result in positive public health and fiscal results in all four states.
The rationale for the choice of these four states is not clear, but one gets the impression from the Discussion that this research was done with the aim to advocate for higher taxes in these four states. That is a worthy cause, although, given the size of India, a tax at the national level would have a multiplied effect, compared to a tax increase in just four states.
The significant contribution of this study is that it indicates that an excise tax increase is strongly progressive/pro-poor, in that the poor benefit much more than the rich.
While the results are generally believable at the intuitive level, the authors do not provide sufficient information to allow others to replicate the study. The DOI link to the data did not work when I tested it.
The finding that the excise tax increase will result in many thousands of men escaping extreme poverty, requires further explanation and justification. The authors indicate (quite correctly) that the poor's demand for tobacco is more price elastic than the non-poor. Thus a greater percentage of the poor will quit when faced with a higher price of cigarettes (or tobacco more generally). But what about those smokers who do not quit smoking when they are faced with a higher price? Some may cut back on their consumption (there is evidence of that in the literature), but even for them, their total expenditure on cigarettes/tobacco may increase. For some poor smokers who are unable/unwilling to reduce their consumption, a sizable increase in the price of cigarettes will have a significant effect on their total expenditure. In some cases this will push some smokers into extreme poverty (for those who are on the verge of extreme poverty before the tax increase), or push them further into extreme poverty. The paper says nothing about this
The authors show that of the 2.247 million poor (lowest 20%) smokers, about 486 thousand will quit. That means that more than 1.6 million smokers do not quit and will probably increase their expenditure on cigarettes. I do not think that this is considered, and it should be.
The authors state up front, and again in the limitations, that they use education as a proxy for income. I don't know India well, and I can accept that education and income are highly correlated, but why don't the authors simply call it what it is, namely differences in education?
Also, the authors acknowledge that their analysis does not account for product substitution. Whether that is a big potential issue, I cannot judge. However, the authors say nothing about cross-state shopping. Is it a big potential problem?
I appreciate that this paper was written primarily for an Indian audience, and I suspect that the target market would be policy makers in these four states, but the paper does not indicate whether sub-national taxes are common in India, whether other states have already implemented such tobacco taxes, and whether the constitution/government allows states to implement them.
As a technical document the paper is adequate and useful, but there are a number of issues that are hanging in the air, and that should, ideally, have more discussion and analysis.
Is the work clearly and accurately presented and does it cite the current literature?
If applicable, is the statistical analysis and its interpretation appropriate?
Are all the source data underlying the results available to ensure full reproducibility?
Is the study design appropriate and is the work technically sound?
Are the conclusions drawn adequately supported by the results?
Are sufficient details of methods and analysis provided to allow replication by others?
Reviewer Expertise:
I have worked on the economics of tobacco control for more than 20 years, focusing on taxation, tax modelling, tobacco pricing and illicit trade, primarily in South Africa, but also in other LMICs.
I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above.
1 Centre for Public Policy Research (CPPR), Kochi, Kerala, India
General comments:
This study examines the implication of an arbitrary cigarette tax increase on select outcomes such as life years gained, tax revenue generated, amount of catastrophic health expenditures averted and savings on a national health care scheme. It focuses its analysis on 4 select Indian states—Karnataka, Assam, Uttar Pradesh, and Maharashtra—chosen rather arbitrarily. This is one of the few recent studies to have examined the impact of tax increase at the subnational level and the kind of outcome variables the study focuses are quite relevant from a public health policy point of view. The study and its conclusions are quite useful for tobacco control policy in India, and taxation in particular. An important policy relevant conclusion from the study is that cigarette tax increases are disproportionately beneficial for India’s poor. This counters the age-old tobacco industry argument that tobacco taxes are regressive. This study establishes it is not.
Although the study provides insightful analysis of the impact of a proposed tax increase, it comes with certain limitation most of which may be addressed rather quickly. Below are my specific comments on the same, not necessarily in the order of its importance.
Specific comments:
I have been working on economics of tobacco control with particular interest in India for more than 15 years. I have worked extensively around issues of tobacco taxation in India and have published several peer reviewed research papers on this issue.
1 Takshashila Institution, Bengaluru, Karnataka, India
Comments on the Study, “Impact of cigarette tax increase on health and financing outcomes in four Indian states”:
This is an important study analysing welfare implications of increases in tax on cigarettes in four Indian States namely, Karnataka, Assam, Uttar Pradesh, and Maharashtra. The authors use an extended cost-effectiveness analysis (ECEA) model developed in an earlier Disease Control Priorities Project to estimate the impact of cigarette price increases caused by tax increase in 2018-19 across five income groups in four states in India. The welfare implications are analysed in terms of smoking reduction, deaths averted due to major tobacco-attributable diseases (chronic obstructive respiratory disease (COPD), stroke, heart disease and cancer), life-years gained, treatment cost averted, number of men avoiding catastrophic health expenditures and extreme poverty, additional tax revenues raised from the tax increase, and cost savings to the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY).
The study estimates that, in 2018-19, an increase in the price of cigarettes by 53.25% due to increase in the tax for a pack of 20 would have led to about 1.5 million men quitting smoking across the four states, with the bottom income group having 7.4 times as many quitters as the top income group. It would also have averted 665 thousand deaths due to COPD, stroke, heart disease, and cancer among current smokers due to quitting. The deaths averted due to quitting would had added an estimated 11.9 million life-years, with the bottom income group gaining 7.3 times more life-years than those in the top income group. The cost saving on hospitalisation for avoiding treatment of major tobacco-attributable diseases is estimated at Rs. 1,729 crore ($Int 955 million and the saving is estimated at 7.4 times higher for the bottom income group. This would have helped almost 75 thousand people to falling into extreme poverty. The saving on treatment cost and impoverishment is estimated at Rs. 672 crore ($Int 371 million) in AB-PMJAY and additional tax revenue generated is estimated at Rs. 4,385 crore ($Int 2,422 million).
Thus, the study confirms that significant tax increases on filtered tobacco could improve pro-poor health outcomes and appreciable reductions in poverty. This study reaffirms that tobacco taxation is an important pro-poor public policy. This is a competent piece of work with significant public policy implications. I recommend the article for indexing.
Public Finance
I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard.
IMAGES
COMMENTS
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This thesis investigates the relationship between tobacco taxes and the consumption of cigarettes in France. The goal of this thesis is to determine the impact of the recent successive increases in tobacco taxes on the demand for cigarettes. The basic model of "rational addiction" of Becker et al (1994) is used and modified to construct and
Data on taxes and prices per 20-cigarette pack of the most popular brand of cigarette in each study country in 2014 were sourced from WHO's Report on the global tobacco epidemic. 10 In this data set, the amount of excise and other taxes on cigarettes is calculated on the basis of each country's actual tax system. Excise is a tax imposed on ...
Moreover, higher tobacco taxes are effective in reducing tobacco consumption and thereby improving public health. The ability to increase revenues and improve public health has made tobacco tax increases a popular policy lever to pull in recent decades. However, a longstanding debate exists in Europe regarding the harmonization of cigarette ...
Placement of the thesis statement. Step 1: Start with a question. Step 2: Write your initial answer. Step 3: Develop your answer. Step 4: Refine your thesis statement. Types of thesis statements. Other interesting articles. Frequently asked questions about thesis statements.
This thesis investigates the relationship between tobacco taxes and the consumption of cigarettes in France. The goal of this thesis is to determine the impact of the recent successive increases in tobacco taxes on the demand for cigarettes. The basic model of "rational addiction" of Becker et al (1994) is used and modified to construct and ...
Understanding what makes a good thesis statement is one of the major keys to writing a great research paper or argumentative essay. The thesis statement is where you make a claim that will guide you through your entire paper. ... Cigarette Tax Heavily taxing and increasing the price of cigarettes is essentially a tax on the poorest Americans ...
1. Introduction. Tobacco is perhaps the most heavily taxed and regulated product in the United States. As of January 2020, the average state plus federal excise tax on a pack of cigarettes was $2.82, which represents almost 40 percent of the tax-inclusive retail price. 1 Per-pack excise taxes range considerably across states, from a low of $0.17 in Missouri to a high of $4.50 in Washington, DC.
In 2010, the state's cigarette excise tax further increased to $4.35 per pack of 20 cigarettes or little cigars. There is an additional local tax imposed at $1.50 per pack, bringing the combined state and local tax to $5.85, the highest in the nation.
Banning of cigarette smoking will be beneficial to all smokers regardless of their age (Society, 2010). Many cigarette smokers are at higher risk of being infected with different types of cancer. These include: "Lung, Larynx, Oral cavity, Esophagus, Kidney, Cervix, Bladder, stomach among other cancers" (Society, 2010, p. 1).
Statement by Minister Chambers on Budget 2025. ... I am introducing a domestic tax on e-cigarettes on public health grounds as there has been a significant rise in their use. The tax will apply to all e-liquids at a rate of 50c per ml of e-liquid. A typical disposable vape contains 2ml of e-liquid, and costs in the region of €8.
The most effective intervention to reduce tobacco use is a large increase in the federal excise tax on cigarettes that enables minimal downward substitutions to shorter, cheaper cigarettes 1, 7- 9. Evidence from several low- and middle-income countries (LMICs) has shown that the impact of tobacco taxation would disproportionately favour ...