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Tobacco pricing & packaging in middle-income countries

Examining the impact of tobacco pricing and packaging strategies on tobacco use and equity in middle-income countries

The ETCP in collaboration with research units in Canada, Chile, Colombia, Ecuador, and Vietnam has been awarded a competitive 5-year research grant from the Global Alliance for Chronic Diseases. The Canadian Institute of Health Research, the International Development Research Centre (IDRC) in Canada and the Medical Research Councils of South Africa contributed to the funding.

Tobacco use causes more than 6 million premature deaths per year worldwide, a number that is expected to rise to more than 8 million by 2030, and most of which (about 70%) are expected to be occurring in low- and middle-income countries. There is overwhelming evidence that higher cigarette prices reduce tobacco use with greater reductions among young people and those from more socioeconomically disadvantaged group, but the tobacco industry asserts that higher tobacco taxes harm vulnerable populations, lead to increased consumption of illicit cigarettes, and that packaging policies are ineffective.

This project will study the impact of tobacco prices on smoking onset, smoking cessation, and tobacco consumption in South Africa focusing on the vulnerable communities. To supplement the existing data, the ETCP will conduct two waves of a targeted survey in five townships across South Africa to better understand the distributional effects of potential tax changes on this population. We will collect detailed information on socioeconomic characteristics, tobacco use, purchasing behaviour, price and expenditure from each individual. These surveys will allow us to investigate tax avoidance behaviour, the importance of illicit cigarette trade and any changes in these factors across time.

The effects of both tax and retail price will be analysed according to their effect by socioeconomic status, sex, and age with simulations to determine the ultimate impacts on tax revenue, tobacco use, and health outcomes. Additionally, the ETCP will study the impact of proposed changes in cigarette packaging, including an introduction of plain packaging on smokers' behavior.

Evidence generated by this research will be used to address the industry's claims about the regressivity of tobacco taxes with the aim of influencing tax policy and tobacco product labelling practices in South African specifically, and in low- and middle-income countries more generally, with the goal of ultimately preventing ill health and deaths caused by tobacco consumption.

The project provides funds for one Post-Doc Research Fellow (Alfred Kechia Mukong and partially cover salaries for another three ETCP's researcher (Hana Ross, Corné van Walbeek and Nicole Vellios). It will also facilitate the ETCP's engagement with South African policy makers and other international researchers with similar research interest.