Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.
Increasing the price of tobacco products through tobacco taxation is one of the most effective tobacco control interventions.1 An additional benefit is that a “dedicated tobacco tax” (where some or all of the revenue raised is earmarked for specific spending or programmes) can generate revenue for funding other tobacco control and health programmes.2 3 Should dedicated tobacco taxes be introduced, it will be useful for decision makers to know whether there is support from all sociodemographic categories of smokers. Accordingly, we aimed to examine smoker support for tobacco taxes by an individual level measure of deprivation.
As part of the New Zealand arm of an international study (the International Tobacco Control (ITC) project),4 5 we surveyed a national sample of 1376 New Zealand adult (18+ years) smokers (between March 2007 and February 2008). We asked the question: (ii) “Would you support an increase in the tax on tobacco if all the extra money was used to promote healthy lifestyles, including helping smokers wanting to quit?” (with “yes” and “no” response options). Responses to this question were considered in relation to an individualised deprivation score “NZiDep” that has been developed for the New Zealand setting (and is based on eight questions).6 Further detail on the survey methods is available elsewhere.7
We found majority support for increased tobacco tax (if dedicated) among smokers in all five groupings of NZiDep (table 1), with confidence intervals excluding 50% in three out of the five groupings. There was no apparent trend towards decreasing or increasing support with increasing individual deprivation (p for trend = 0.98).
These results suggest that there is majority support for increased (dedicated) tobacco taxes by smokers across all levels of individual deprivation in New Zealand. Although the most deprived smokers who continue to smoke after a tax increase will be likely to experience more financial hardship, it is possible that this concern is being balanced by other factors. That is, most deprived smokers may believe that a tobacco tax rise would be more likely to assist them quit, or would provide the revenue for smoking cessation services to help them quit. Indeed, the international evidence increasingly favours tobacco tax being a pro-equity strategy, given the findings of a systematic review.8 Subsequent published work to this review also suggests that higher tobacco prices are “egalitarian” in their impact in the US9 and reduce social disparities in Australia.10
Nevertheless, actions are needed to maximise any pro-equity effect of tobacco tax increases and to allay as far as possible legitimate social justice concerns. Governments should ensure that where substantial tobacco tax increases are introduced, they are accompanied by measures to ensure that high quality smoking cessation services and support are available to poorer smokers. For such activities to be well funded, the revenue should ideally come from dedicated tobacco taxes, as has been used successfully in a number of settings.2 3 Reassuringly for policymakers, our work suggests that dedicated taxes are supported by smokers across the socioeconomic spectrum.
What this paper adds
Increasing the price of tobacco products through tobacco taxation is one of the most effective tobacco control interventions. But smoker support for “dedicated tobacco tax” increases is not well studied.
In this nationally representative survey we found majority support for increased (dedicated) tobacco taxes by smokers across all levels of individual-level deprivation in New Zealand.
Such findings, together with existing international evidence that favours tobacco tax being a pro-equity strategy, may facilitate policymaker support for introducing dedicated tobacco taxes.
The ITC Project (NZ) team thank the interviewees who kindly contributed their time, our other project partners (http://www.wnmeds.ac.nz/itcproject.html) and particularly our colleague George Thomson for comments on the draft.
Funding The Health Research Council of New Zealand provided funding.
Competing interests None.
Provenance and peer review Not commissioned; externally peer reviewed.
Ethics approval Ethics approval was granted by the Multi-Region Ethics Committee (New Zealand).