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Taxing unhealthy products may help tackle chronic diseases

Soft drinks, alcohol and tobacco taxes work, claim studies

Adrian O'Dowd

Thursday, 05 April 2018

Various international policies of taxing soft drinks, alcohol and tobacco appear to be effective in tackling non-communicable diseases (NCDs), suggest new studies12345 published today in The Lancet.

In what the journal called the most comprehensive global analysis to date of evidence on expenditure, behaviour and socio-economic status, the studies concluded that taxes on these unhealthy products were a powerful response to rising rates of chronic diseases.

NCDs such as stroke, heart disease, diabetes, chronic respiratory disease and cancer are responsible for 38 million deaths each year.

The Lancet taskforce on NCDs and economics, which collected the series of papers, said that by analysing consumption patterns, expenditure and responsiveness to price changes across different income groups, this provided a good analysis of existing data to help governments understand the potential impact of taxes.

The analysis was based on available data from 13 countries – Chile, Guatemala, Panama, Nicaragua, Albania, Poland, Turkey, Tajikistan, Tanzania, Niger, Nigeria, India and Timor-Leste.

The taskforce said the five papers presented strong evidence that taxes on unhealthy products had the potential to produce significant health gains among the poorest in society who were disproportionately affected by NCDs.

Firstly, evidence showed that high-income households generally consumed more, and spent more, on alcohol, soft drinks and snacks, compared to low-income households. Patterns for tobacco were less consistent.

The authors argued, therefore, that increased taxes on unhealthy products would affect a larger number of high-income households than low-income households, meaning that the revenues generated by taxes would come disproportionately from high-income households.

Tax policies could also be designed to influence this effect, they said, because high-income consumers were more likely to buy more expensive beverages, especially alcohol, so an alcohol policy based on unit price could be less of a burden on low-income households, compared to a policy based on volume.

Secondly, as a proportion of total household expenditure, low-income households tended to be more affected by price changes compared to high-income households, although the effect varied. The analysis also showed that low-income households responded to price changes more readily than higher-income households.

In the UK, the response to the possible introduction of a minimum price for alcohol was estimated to be 7.6 times larger in the poorest households, compared to the wealthiest.

The authors modelled the consequences of a 50% increase in the price of cigarettes in Lebanon and estimated that twice as many smokers in the poorest households would quit compared to the richest with around a third (31%) of the increased tax revenue borne by the richest group and 7% by the poorest.

Dr Rachel Nugent, chair of The Lancet taskforce, said: “Non-communicable diseases are a major cause and consequence of poverty worldwide.

“Responding to this challenge means big investments to improve health care systems worldwide, but there are immediate and effective tools at our disposal. Taxes on unhealthy products can produce major health gains, and the evidence shows these can be implemented fairly, without disproportionately harming the poorest in society.”

RCGP chair Professor Helen Stokes-Lampard said: “The college has long supported taxes on soft drinks, alcohol and tobacco to help offset the burden of chronic diseases on the UK population.

“Today’s findings from The Lancet provide helpful further evidence that taxes on these unhealthy products are an effective response to combatting higher rates of chronic diseases without disproportionately affecting people from lower socio-economic backgrounds so we need to ensure this new evidence is reflected in future health policies going forward.”

  1. Nugent, R et al. Investing in non-communicable disease prevention and management to advance the Sustainable Development Goals. DOI:10.1016/S0140-6736(18)30667-6.
  2. Niessen, L et al. Tackling socioeconomic inequalities and non-communicable diseases in low-income and middle-income countries under the Sustainable Development agenda. DOI:10.1016/S0140-6736(18)30482-3.
  3. Jan, S et al. Action to address the household economic burden of non-communicable diseases. DOI:10.1016/S0140-6736(18)30323-4.
  4. Sassi, F et al. Equity impacts of price policies to promote healthy behaviours. DOI:10.1016/S0140-6736(18)30531-2.
  5. Bertram, M et al. Investing in non-communicable diseases: an estimation of the return on investment for prevention and treatment services. DOI:10.1016/S0140-6736(18)30665-2.

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