Re-thinking taxes to enhance public health
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1
University of Bath, School of Management, United Kingdom
2
University of Bath, Department for Health, United Kingdom
Publication date: 2018-03-01
Tob. Induc. Dis. 2018;16(Suppl 1):A609
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ABSTRACT
Background:
Tobacco, like many
other harm inducing products such as alcohol and unhealthy/sugary food, is
mainly manufactured and supplied by profit seeking private enterprise. Such companies have a strong incentive to
expand existing markets to increase profits at the expense of public health. Traditionally the objective of market
interventions is to correct perceived market failures, such as the
externalities created like second-hand smoking, or informational gaps regarding
risk. Excise duty, the most effective intervention,
has been viewed as a way of both raising revenue and deterring consumption
through higher prices. Yet despite multiple market interventions global epidemics associated with smoking and other harm inducing
products continue to create high levels of mortality and morbidity, and their
associated costs.
Methods:
A narrative review of the impact of public health related market interventions
on both the demand and supply side of the markets for tobacco, alcohol, and
food. A set of criteria on the impacts
of taxation on markets is developed.
Results:
Existing interventions, including tobacco/alcohol duty, are identified
as primarily changing the demand side, while there are very few supply focussed
interventions. Complementary approaches
to supply side taxation are identified which address corporate profits and the
ability of shareholders to access that profitability, thereby changing the
incentives faced by profit seeking companies.
Conclusions:
A new systems approach is needed to re-examine
and understand the wider impact and potential of taxation. Adopting such a holistic approach would help
moves towards a tobacco endgame and moves to address other company related epidemics
such as obesity and growing levels of diabetes.
Companies could not only be directed towards healthier products (such as
e-cigarettes or reduced sugar cereals), but also made to pay a greater
contribution towards the costs to society they help to create.