Modelling the implications of reducing smoking prevalence: the benefits of increasing the UK tobacco duty escalator to public health and economic outcomes

TY - JOUR

T1 - Modelling the implications of reducing smoking prevalence

T2 - the benefits of increasing the UK tobacco duty escalator to public health and economic outcomes

AU - Knuchel-Takano, Andre

AU - Hunt, Daniel

AU - Jaccard, Abbygail

AU - Bhimjiyani, Arti

AU - Brown, Martin

AU - Retat, Lise

AU - Brown, Katrina

AU - Hinde, Sebastian

AU - Selvarajah, Chit

AU - Bauld, Linda

AU - Webber, Laura

N1 - This is an author-produced version of the published paper. Uploaded in accordance with the publisher’s self-archiving policy. Further copying may not be permitted; contact the publisher for details

PY - 2018/10/6

Y1 - 2018/10/6

N2 - INTRODUCTION: Taxing tobacco is one of the most effective ways to reduce smoking prevalence, mitigate its devastating consequential health harms and progress towards a tobacco-free society. This study modelled the health and economic impacts of increasing the existing cigarette tobacco duty escalator (TDE) in the UK from the current 2% above consumer price inflation to 5%.METHODS: A two-stage modelling process was used. First, a non-linear multivariate regression model was fitted to cross-sectional smoking data, creating longitudinal projections from 2015 to 2035. Second, these projections were used to predict the future incidence, prevalence and cost of 17 smoking-related diseases using a Monte Carlo microsimulation approach. A sustained increase in the duty escalator was evaluated against a baseline of continuing historical smoking trends and the existing duty escalator.RESULTS: A sustained increase in the TDE is projected to reduce adult smoking prevalence to 6% in 2035, from 10% in a baseline scenario. After increasing the TDE, only 65% of female and 60% of male would-be smokers would actually be smoking in 2035. The intervention is projected to avoid around 75 200 new cases of smoking-related diseases between 2015 and 2035. In 2035 alone, £49 m in National Health Service and social care costs and £192 m in societal premature mortality and morbidity costs are projected to be avoided.CONCLUSION: Increasing the UK TDE to 5% above inflation could effectively reduce smoking prevalence, prevent diseases and avoid healthcare costs. It would deliver substantial progress towards a tobacco-free society and should be implemented by the UK Government with urgency.

AB - INTRODUCTION: Taxing tobacco is one of the most effective ways to reduce smoking prevalence, mitigate its devastating consequential health harms and progress towards a tobacco-free society. This study modelled the health and economic impacts of increasing the existing cigarette tobacco duty escalator (TDE) in the UK from the current 2% above consumer price inflation to 5%.METHODS: A two-stage modelling process was used. First, a non-linear multivariate regression model was fitted to cross-sectional smoking data, creating longitudinal projections from 2015 to 2035. Second, these projections were used to predict the future incidence, prevalence and cost of 17 smoking-related diseases using a Monte Carlo microsimulation approach. A sustained increase in the duty escalator was evaluated against a baseline of continuing historical smoking trends and the existing duty escalator.RESULTS: A sustained increase in the TDE is projected to reduce adult smoking prevalence to 6% in 2035, from 10% in a baseline scenario. After increasing the TDE, only 65% of female and 60% of male would-be smokers would actually be smoking in 2035. The intervention is projected to avoid around 75 200 new cases of smoking-related diseases between 2015 and 2035. In 2035 alone, £49 m in National Health Service and social care costs and £192 m in societal premature mortality and morbidity costs are projected to be avoided.CONCLUSION: Increasing the UK TDE to 5% above inflation could effectively reduce smoking prevalence, prevent diseases and avoid healthcare costs. It would deliver substantial progress towards a tobacco-free society and should be implemented by the UK Government with urgency.

KW - Journal Article

KW - economics

KW - cessation

KW - end game

KW - taxation

KW - prevention

KW - Prevalence

KW - Taxes/economics

KW - Humans

KW - Male

KW - Models, Economic

KW - United Kingdom/epidemiology

KW - Incidence

KW - Health Care Costs

KW - Public Health/economics

KW - Smoking/economics

KW - Adult

KW - Female

UR - http://www.scopus.com/inward/record.url?scp=85049166526&partnerID=8YFLogxK

U2 - 10.1136/tobaccocontrol-2017-053860

DO - 10.1136/tobaccocontrol-2017-053860

M3 - Article

C2 - 29212863

VL - 27

SP - e124-e129

JO - Tobacco Control

JF - Tobacco Control

SN - 1468-3318

IS - e2

ER -