Taxation is one of the most effective tobacco control measures, yet evidence on the distributional impact of tobacco taxation in low- and middle-income countries remains scant. This paper considers the financial and health effects, by socio-economic class, of increasing tobacco taxes in Lebanon, a middle-income country, and finds increasing tobacco taxes would lead to large financial and health benefits, and would be pro-poor in health gains, savings on healthcare, and poverty reduction.
Extended cost-effectiveness analysis methods are applied to quantify, across quintiles of socio-economic status, the health benefits gained, the additional tax revenues raised, and the net financial consequences for households from a 50% increase in the price of tobacco through excise taxes. The increase in tobacco tax is estimated to result in 65,000 (95% CI: 37,000–93,000) premature deaths averted, 25% of them in the poorest quintile, $300M ($256–340M) of additional tax revenues, 12% borne by the poorest quintile, $23M ($13–33M) of out-of-pocket spending on healthcare averted, 36% of which accrue to the poorest quintile, 9% to the richest. These savings would be associated with 23,000 (13,000–33,000) poverty cases averted (63% in the poorest quintile).
Salti N, Brouwer E, Verguet S. The Health, Financial and Distributional Consequences of Increases in the Tobacco Excise Tax Among Smokers in Lebanon. Social Science & Medicine 2016; 170: 161-169. http://dcp-3.org/resources/health-financial-and-distributional-consequences-increases-tobacco-excise-tax-among