Authors' objectives:

The fight against smoking has become a priority in the area of public health for most governments of developed countries. Although some actions may have proportionally very limited effects, any strategy that reduces tobacco consumption, however small it may be in relative terms, is very beneficial in absolute numbers in both aspects of disease prevented and costs averted for the health system.

The objective of this report is to review several types of implemented strategies in the fight against smoking.

Authors' results and conclusions: Three types of strategy have been implemented in the fight against smoking: 1.The regulation of the industry, with disincentives to tobacco cultivation and regulation of access to the products derived from this plant, both for young people and adults. These two strategies alone have very little effect on tobacco consumption. More important has been the attempt to regulate the advertising market where, up to now, it would seem that some advances have been done (although this is not the case for Spain). However, the industrys potential to seeking alternative advertising systems and its ability to create new spaces and new markets must not be underestimated. 2.The promotion of health through campaigns. On their own, their effectiveness is very slight and has limited duration, but in combination, and especially when used to back up the nowadays enforcement of the law, they have shown to be quite effective in the mid term. This would apply equally to adults, adolescents, and young people. 3. Tax policies on tobacco. Despite they can have adverse effects on the Retail Price Index (RPI) and on the tobacco industry sector, tax measures have clearly shown to be effective. Although it must be kept in mind that this effectiveness is small when mild tax increases are applied, they do have an effect. The effects of tobacco duties could be summed up as follows: - The price elasticity of demand for tobacco products is around -0.4, which means that increases in price is met by proportionally smaller reductions in consumption. - Low-income groups are much more sensitive to the change than the more affluent. It is, therefore, a regressive tax. - The demand for tobacco products among adolescents and young people is more sensitive to price increases. - The increase in the price of tobacco has negative effects on the RPI and, therefore, on inflation. However, the European Union (EU) recommends that tobacco be removed from the calculation of the RPI. - The recommendations of the EU and of the World Health Organisation (WHO) are to increase the price of tobacco periodically by at least the RPI figure. - The EU recommends that duties should represent at least 70% of the retail price of tobacco. - Increases in duties increases the risk of smuggling. - Under these price elasticity conditions, when tobacco duties are increased, despite the reduction in consumption, State income increases. - The population in general is favourable to increases in the price of tobacco. - Tobacco duties are better received and accepted if they are earmarked for health purposes. In addition, they are more effective when they are hypothecated to financing programmes to fight smoking.

Authors' recommendations: Although these strategies have shown their effectiveness in some areas, when they are implemented together on the society as a whole, they are not so effective. This is due to the interaction between different constraints, among which should be highlighted the social structure of the community, cultural habits and the acceptance of smoking as a normal thing, especially when combined with the activities of the industry, which usually manoeuvres to subvert restrictions and find new ways of promoting and selling its products.

Authors' methods: Review

Project Status: Completed

URL for project: http://www.gencat.net/salut/depsan/units/aatrm/html/en/dir393/doc7921.ht ml

Year Published: 2003

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Spain

Organisation Name: Agencia de Qualitat i Avaluacio Sanitries de Catalunya

Contact Address: Antoni Parada, CAHTA, Roc Boronat, 81-95 (2nd floor), 08005 Barcelona, Spain, Tel. +34 935 513 928, Fax: +34 935 517 510

Contact Name: direccio@aatrm.catsalut.net / aparada@aatrm.catsalut.net

Contact Email: direccio@aatrm.catsalut.net / aparada@aatrm.catsalut.net

Copyright: Catalan Agency for Health Technology Assessment and Research (CAHTA)