TY - JOUR T1 - Perseverance is innovation: the journey to successful tobacco tax reform JF - Tobacco Control JO - Tob Control SP - 241 LP - 242 DO - 10.1136/tobaccocontrol-2021-057088 VL - 31 IS - 2 AU - Jeffrey Drope AU - Erika Siu AU - Frank J Chaloupka Y1 - 2022/03/01 UR - http://tobaccocontrol.bmj.com/content/31/2/241.abstract N2 - The tobacco control community consistently describes tobacco taxation in two ways: it is the most effective intervention and the least implemented.1 The scholarship on tax’s effectiveness for decreasing consumption and increasing tax revenues has depth and breadth.2 In contrast, implementation research—that is, how, when and why governments change their tax structures and/or rates— is poor. Even the most comprehensive resource on tobacco economics, the National Cancer Institute Monograph 21 (with WHO), does not dedicate a section or sub-section to implementation.2 In this issue, Scollo and Branston offer a creative and plausible pathway to push tobacco taxation in countries—almost always, high-income—already performing well on tax.3 In fact, the greatest challenges with tax implementation are in low-tax countries, almost always low-income or middle-income countries (LMICs), which are also the ones with the most potential public health gain because that is where most smokers live. Moreover, LMICs are likely to benefit most from new tax revenues that can help to pay for the increasing burdens on health systems exacerbated by the COVID-19 pandemic and post-pandemic recovery efforts.The second edition of the Tobacconomics Cigarette Tax Scorecard reports that globally, most countries are doing poorly on the key facets of implementation: optimising tax structure; raising prices; increasing the tax share of price and decreasing affordability.4 As figure 1 suggests, the global average overall and component scores are low and increased only incrementally from 2014 to 2020 (see online supplemental appendix for scoring rubrics). In other words, prices and tax shares of price are too low, affordability is not changing in enough countries and tax structures are still suboptimal in most countries. The main plausible explanation is undoubtedly the tobacco industry’s success at thwarting tobacco tax reforms. The industry correctly … ER -