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Tobacco price increases in Korea and their impact on socioeconomic inequalities in smoking and subsequent socioeconomic inequalities in mortality: a modelling study
  1. Hwa-Kyung Lim1,
  2. Young-Ho Khang1,2
  1. 1Institute of Health Policy and Management, Seoul National University Medical Research Center, Seoul, Korea (the Republic of)
  2. 2Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
  1. Correspondence to Professor Young-Ho Khang, Institute of Health Policy and Management, Seoul National University Medical Research Center, Seoul 03080, Korea (the Republic of); yhkhang{at}


Objective Through a modelling study, we assessed the impact of tobacco price increases on smoking and smoking inequalities by income, and then quantified the subsequent effects on mortality and inequalities in mortality in Korea.

Methods Eleven-year pooled data from the Korea National Health and Nutrition Examination Survey (KNHANES) (n=65 197) were used to estimate the income group-specific price elasticity. The price elasticity was then used to calculate changes in current smoking prevalence and per capita cigarette consumption resulting from a spectrum of hypothetical tobacco price increases. The mortality risk function from the 10-year mortality follow-up data of the National Health Insurance Service-National Sample Cohort (n=293 858, numbers of deaths=14 953) and the current distributions of smoking-related variables from the KNHANES 2015–2017 were employed to estimate the effect of tobacco price increases on inequality in mortality.

Results Low-income Korean smokers were more responsive to changes in tobacco price. Increasing the tobacco price by 100% would achieve the overall reduction of 2.0% for 10-year mortality. For mortality inequalities by income, the relative index of inequality (slope index of inequality) would be reduced by 3.8% (4.8%) for 10-year mortality.

Conclusions This modelling study showed that tobacco price increases in Korea can reduce current smoking prevalence and per capita cigarette consumption in the whole population, and especially among the poor, which in turn would reduce the gap in mortality between income groups.

  • disparities
  • price
  • public policy
  • socioeconomic status
  • taxation
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  • Contributors Y-HK conceived and supervised the study. H-KL conducted the data analysis and wrote the first draft of the manuscript. Both authors contributed to drafting and critical revision of the manuscript and have approved the final article.

  • Funding This article has been adapted and developed from a research report, titled 'A Modelling Study on the Effects of Change in Smoking Inequality according to Tobacco Control', which was supported by the Korea Health Promotion Institute. This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI18C0446).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval This study was approved by the Seoul National University Hospital Institutional Review Board (IRB No. E-1806-144-953).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available on reasonable request. The Korea National Health and Nutrition Examination Survey data are publicly available. The National Health Insurance Service (NHIS)-National Sample Cohort data might be available to Korean researchers upon request to the Big Data Steering Department of the NHIS.

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