In countries around the world, tobacco use, excessive alcohol consumption, and consumption of sugar-sweetened beverages (SSBs) are significant contributors to the global epidemic of noncommunicable diseases. As a consequence, they contribute, as well, to excess health care costs and productivity losses. A large and growing body of research documents that taxes specific to such products, known as excise taxes, reduce consumption of these products and thereby diminish their adverse health consequences. Although such taxation has historically been motivated primarily by revenue generation, governments are increasingly using these taxes to discourage unhealthy consumption. We review the global evidence on the impact of taxes and prices on the consumption of these products and the health and social consequences. We then evaluate arguments commonly raised against these taxes, identify best practices in excise tax policy, and conclude with a summary of the current status of tobacco, alcohol, and SSB excise taxes globally.


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Literature Cited

  1. 1. 
    Andreyeva T, Long MW, Brownell KD 2010. The impact of food prices on consumption: a systematic review of research on the price elasticity of demand for food. Am. J. Public Health 100:2216–22
    [Google Scholar]
  2. 2. 
    Basu S, Vellakkal S, Agrawal S, Stuckler D, Popkin B, Ebrahim S 2014. Averting obesity and type 2 diabetes in India through sugar-sweetened beverage taxation: an economic-epidemiologic modeling study. PLOS Med 11:1e1001582
    [Google Scholar]
  3. 3. 
    Blecher E 2015. Taxes on tobacco, alcohol and sugar sweetened beverages: linkages and lessons learned. Soc. Sci. Med. 136–137:175–79
    [Google Scholar]
  4. 4. 
    Blecher EH, van Walbeek CP 2009. Cigarette affordability trends: an update and some methodological comments. Tob. Control 18:3167–75
    [Google Scholar]
  5. 5. 
    Bowser D, Canning D, Okunogbe A 2016. The impact of tobacco taxes on mortality in the USA, 1970–2005. Tob. Control 25:52–59
    [Google Scholar]
  6. 6. 
    Chaloupka FJ, Sweanor D, Warner KE 2015. Differential taxes for differential risks—toward reduced harm from nicotine-yielding products. N. Engl. J. Med. 373:7594–97
    [Google Scholar]
  7. 7. 
    Chriqui JF, Chaloupka FJ, Powell LM, Eidson SS 2013. A typology of beverage taxation: multiple approaches for obesity prevention and obesity prevention-related revenue generation. J. Public Health Policy 34:3403–23
    [Google Scholar]
  8. 8. 
    Colchero MA, Guerrero-López CM, Molina M, Rivera JA 2016. Beverage sales in Mexico before and after implementation of a sugar sweetened beverage tax. PLOS ONE 11:9e0163463
    [Google Scholar]
  9. 9. 
    Colchero MA, Molina M, Guerrero-López CM 2017. After Mexico implemented a tax, purchases of sugar-sweetened beverages decreased and water increased: difference by place of residence, household composition, and income level. J. Nutr. 147:81552–57
    [Google Scholar]
  10. 10. 
    Colchero MA, Popkin BM, Rivera JA, Ng SW 2016. Beverage purchases from stores in Mexico under the excise tax on sugar sweetened beverages: observational study. BMJ 352:h6704
    [Google Scholar]
  11. 11. 
    Colchero MA, Rivera-Dommarco J, Popkin BM, Ng SW 2017. In Mexico, evidence of sustained consumer response two years after implementing a sugar-sweetened beverage tax. Health Aff 36:3564–71
    [Google Scholar]
  12. 12. 
    Colchero MA, Salgado JC, Unar-Munguía M, Hernández-Ávila M, Rivera-Donmarco JA 2015. Price elasticity of the demand for sugar sweetened beverages and soft drinks in Mexico. Econ. Hum. Biol. 19:129–37
    [Google Scholar]
  13. 13. 
    Colchero MA, Salgado JC, Unar-Munguía M, Molina M, Ng S, Rivera-Donmarco JA 2015. Changes in prices after an excise tax to sweetened sugar beverages was implemented in Mexico: evidence from urban areas. PLOS ONE 10:12e0144408
    [Google Scholar]
  14. 14. 
    Dobbs R, Sawers C, Thompson F, Manyika J, Woetzel JR et al. 2014. Overcoming obesity: an initial economic analysis Disc. Pap. McKinsey Glob. Inst. New York: https://www.mckinsey.com/∼/media/McKinsey/Business%20Functions/Economic%20Studies%20TEMP/Our%20Insights/How%20the%20world%20could%20better%20fight%20obesity/MGI_Overcoming_obesity_Full_report.ashx
  15. 15. 
    Elder RW, Lawrence B, Ferguson A, Naimi TS, Brewer RD et al. 2010. The effectiveness of tax policy interventions for reducing excessive alcohol consumption and related harms. Am. J Prev. Med. 38:2217–29
    [Google Scholar]
  16. 16. 
    Escobar MAC, Veerman JL, Tollman SM, Bertram MY, Hofman KJ 2013. Evidence that a tax on sugar sweetened beverages reduces the obesity rate: a meta-analysis. BMC Public Health 13:11072
    [Google Scholar]
  17. 17. 
    Evans WN, Ringel JS 1999. Can higher cigarette taxes improve birth outcomes?. J. Public Econ. 72:1135–54
    [Google Scholar]
  18. 18. 
    Finkelstein EA, Zhen C, Bilger M, Nonnemaker JM, Farooqui AM, Todd JE 2013. Implications of a sugar-sweetened beverage (SSB) tax when substitutions to non-beverage items are considered. J. Health Econ. 32:1219–39
    [Google Scholar]
  19. 19. 
    Finkelstein EA, Zhen C, Nonnemaker JM, Todd JE 2010. Impact of targeted beverage taxes on higher- and lower-income households. Arch. Intern. Med. 170:222028–34
    [Google Scholar]
  20. 20. 
    Fletcher JM, Frisvold DE, Tefft N 2010. The effect of soft drink taxes on child and adolescent consumption and weight outcomes. J. Public Econ. 94:11–12967–74
    [Google Scholar]
  21. 21. 
    Fuchs A, Meneses FJ 2017. Are tobacco taxes really regressive? Evidence from Chile World Bank Policy Res Work. Pap. 7988, World Bank Washington, DC: http://documents.worldbank.org/curated/en/389891484567069411/pdf/112072-REVISED-PUBLIC-R2-TTEC-20170213-forweb.pdf
  22. 22. 
    Fuchs A, Meneses F 2018. Tobacco price elasticity and tax progressivity in Moldova Rep., World Bank Washington, DC: https://openknowledge.worldbank.org/bitstream/handle/10986/29329/123122-WP-PUBLIC-WBGMoldovaTobaccoTaxationweb.pdf?sequence=1&isAllowed=y
  23. 23. 
    Goodchild M, Nargis N, Tursan d'Espaignet E 2017. Global economic cost of smoking-attributable diseases. Tob. Control 27:58–64
    [Google Scholar]
  24. 24. 
    Guerrero-López CM, Molina M, Colchero MA 2017. Employment changes associated with the introduction of taxes on sugar-sweetened beverages and nonessential energy-dense food in Mexico. Prev. Med. 105:S43–49
    [Google Scholar]
  25. 25. 
    Guerrero-López CM, Unar-Munguía M, Colchero MA 2017. Price elasticity of the demand for soft drinks, other sugar-sweetened beverages, and energy dense food in Chile. BMC Public Health 17:1180
    [Google Scholar]
  26. 26. 
    Hatoun J, Davis-Plourde K, Penti B, Cabral H, Kazis L 2018. Tobacco control laws and pediatric asthma. Pediatrics 141:S130–135
    [Google Scholar]
  27. 27. 
    Ho V, Ross JS, Steiner CA, Mandawat A, Short M et al. 2017. A nationwide assessment of the association of smoking bans and cigarette taxes with hospitalizations for acute myocardial infarction, heart failure, and pneumonia. Med. Care Res. Rev. 74:6687–704
    [Google Scholar]
  28. 28. 
    IARC (Int. Agency Res. Cancer). 2011. Effectiveness of Tax and Price Policies for Tobacco Control IARC Handb. Cancer Prev. Tob. Control , Vol. 14 Lyon, Fr.: IARC Publ http://publications.iarc.fr/Book-And-Report-Series/Iarc-Handbooks-Of-Cancer-Prevention/Effectiveness-Of-Tax-And-Price-Policies-For-Tobacco-Control-2011
  29. 29. 
    IDF (Int. Diabetes Fed.). 2017. IDF Diabetes Atlas Brussels: IDF, 8th ed.. http://diabetesatlas.org/resources/2017-atlas.html
  30. 30. 
    Jawad M, Leet JT, Glantz S, Millett C 2018. Price elasticity of demand of non-cigarette tobacco products: a systematic review and meta-analysis. Tob. Control. https://doi.org/10.1136/tobaccocontrol-2017-054056
  31. 31. 
    John RM, Rao RK, Rao MG, Moore J, Deshpande RS et al. 2010. The economics of tobacco and tobacco taxation in India Rep., Int. Union Against Tuberc. Lung Dis. Paris: https://www.tobaccofreekids.org/assets/global/pdfs/en/India_Tobacco_Economics_full_en.pdf
  32. 32. 
    Joossens L, Merriman D, Ross H, Raw M 2009. How eliminating the global illicit cigarette trade would increase tax revenues and save lives Rep., Int. Union Against Tuberc. Lung Dis. Paris: https://www.tobaccofreekids.org/assets/global/pdfs/en/ILL_global_cig_trade_full_en.pdf
  33. 33. 
    Long MW, Gortmaker SL, Ward ZJ, Resch SC, Moodie ML et al. 2015. Cost-effectiveness of a sugar-sweetened beverage excise tax in the U.S. Am. J. Prev. Med. 49:1112–23
    [Google Scholar]
  34. 34. 
    López-Olmedo N, Popkin BM, Taillie LS 2018. The socioeconomic disparities in intakes and purchases of less-healthy foods and beverages have changed over time in urban Mexico. J. Nutr. 148:1109–16
    [Google Scholar]
  35. 35. 
    Manyema M, Veerman LJ, Chola L, Tugendhaft A, Sartorius B et al. 2014. The potential impact of a 20% tax on sugar-sweetened beverages on obesity in South African adults: a mathematical model. PLOS ONE https://doi.org/10.1371/journal.pone.0105287
  36. 36. 
    Markowitz S 2008. The effectiveness of cigarette regulations in reducing cases of sudden infant death syndrome. J. Health Econ. 27:106–33
    [Google Scholar]
  37. 37. 
    Marquez PV, Moreno-Dodson B 2017. Tobacco tax reform at the crossroads of health and development: a multisectoral perspective. Rep., World Bank Washington, DC: https://openknowledge.worldbank.org/handle/10986/28494
  38. 38. 
    Meng Y, Brennan A, Purshouse R, Hill-McManus D, Angus C et al. 2014. Estimation of own and cross price elasticities of alcohol demand in the UK: a pseudo-panel approach using the Living Costs and Food Survey 2001–2009. J. Health Econ. 34:96–103
    [Google Scholar]
  39. 39. 
    Nargis N, Thompson ME, Fong GT, Driezen P, Ghulam Hussain AKM et al. 2015. Prevalence and patterns of tobacco use in Bangladesh from 2009 to 2012: evidence from International Tobacco Control (ITC) Study. PLOS ONE 10:110141135
    [Google Scholar]
  40. 40. 
    NCI (Natl. Cancer Inst.), WHO (World Health Organ.). 2016. The economics of tobacco and tobacco control NCI Tob. Control Monogr. Ser. 21, NCI/WHO, Bethesda MD/Geneva: https://cancercontrol.cancer.gov/brp/tcrb/monographs/21/docs/m21_complete.pdf
  41. 41. 
    Paraje G 2016. The effect of prices and socio-economic level on the consumption of sugar-sweetened beverages (SSBs): the case of Ecuador. PLOS ONE 11:3e0152260
    [Google Scholar]
  42. 42. 
    Patrick SW, Warner KE, Pordes E, Davis MM 2016. Cigarette tax increases and infant mortality. Pediatrics 137:1e20152901
    [Google Scholar]
  43. 43. 
    Powell LM, Chriqui JF, Khan T, Wada R, Chaloupka FJ 2013. Assessing the potential effectiveness of food and beverage taxes and subsidies for improving public health: a systematic review of prices, demand, and body weight outcomes. Obes. Rev. 14:2110–28
    [Google Scholar]
  44. 44. 
    Powell LM, Wada R, Persky JJ, Chaloupka FJ 2014. Employment impact of sugar-sweetened beverage taxes. Am. J. Public Health 104:4672–77
    [Google Scholar]
  45. 45. 
    Rehm J, Mathers C, Popova S, Thavorncharoensap M, Teerawattananon Y, Patra J 2009. Global burden of disease and injury and economic cost attributable to alcohol use and alcohol use disorders. Lancet 373:2223–33
    [Google Scholar]
  46. 46. 
    Ringel JS, Evans WN 2001. Cigarette taxes and smoking during pregnancy. Am. J. Public Health 91:1851–56
    [Google Scholar]
  47. 47. 
    Sánchez-Romero LM, Penko J, Coxson PG, Fernández A, Mason A et al. 2016. Projected impact of Mexico's sugar-sweetened beverage tax policy on diabetes and cardiovascular disease: a modeling study. PLOS Med 13:11e1002158
    [Google Scholar]
  48. 48. 
    Silver LD, Ng SW, Ryan-Ibarra S, Taillie LS, Induni M et al. 2017. Changes in prices, sales, consumer spending, and beverage consumption one year after a tax on sugar-sweetened beverages in Berkeley, California, US: a before-and-after study. PLOS Med 14:4e1002283
    [Google Scholar]
  49. 49. 
    Smith A 1975 (1776). An Inquiry into the Nature and Causes of the Wealth of Nations E Cannan London: Methuen
  50. 50. 
    Smith TA, Lin BH, Lee JY 2010. Taxing caloric sweetened beverages: potential effects on beverage consumption, calorie intake, and obesity Econ. Res. Serv. Rep. Summ., US Dep. Agric. Washington, DC: https://www.ers.usda.gov/webdocs/publications/44732/8310_err100_reportsummary_1_.pdf?v=41056
  51. 51. 
    Sornpaisarn B, Shield K, Cohen J, Schwartz R, Rehm J 2013. Elasticity of alcohol consumption, alcohol-related harms, and drinking initiation in low- and middle-income countries: a systematic review and meta-analysis. Int. J. Drug Alcohol Res. 2:45–58
    [Google Scholar]
  52. 52. 
    Sornpaisarn B, Shield KD, Österberg E, Rehm J, eds. 2017. Resource tool on alcohol taxation and pricing policies Rep., World Health Organ. Geneva: http://www.who.int/substance_abuse/publications/tax_book/en/
  53. 53. 
    Srivastava P, McLaren KR, Wohlgenant M, Zhao X 2014. Econometric modelling of price response by alcohol types to inform alcohol tax policies Work. Pap. 05/14, Dep. Econ. Bus. Stat. Monash Univ., Melbourne Aust.:
  54. 54. 
    Wada R, Chaloupka FJ, Powell LM, Jernigan DH 2017. Employment impacts of alcohol taxes. Prev. Med. 105:S50–55
    [Google Scholar]
  55. 55. 
    Wada R, Han E, Powell LM 2015. Associations between soda prices and intake: evidence from 24-h dietary recall data. Food Policy 55:54–60
    [Google Scholar]
  56. 56. 
    Wagenaar AC, Salois MJ, Komro KA 2009. Effects of beverage alcohol price and tax levels on drinking: a meta-analysis of 1003 estimates from 112 studies. Addiction 104:179–90
    [Google Scholar]
  57. 57. 
    Wagenaar AC, Tobler AL, Komro KA 2010. Effects of alcohol tax and price policies on morbidity and mortality: a systematic review. Am. J. Public Health 100:112270–78
    [Google Scholar]
  58. 58. 
    WHO (World Health Organ.). 2010. WHO technical manual on tobacco tax administration Rep., WHO Geneva: http://www.who.int/tobacco/publications/tax_administration/en/
  59. 59. 
    WHO (World Health Organ.). 2015. WHO report on the global tobacco epidemic, 2015: raising taxes on tobacco products Rep., WHO Geneva: https://www.who.int/tobacco/global_report/2015/en/
  60. 60. 
    WHO (World Health Organ.). 2016. Fiscal policies for diet and the prevention of noncommunicable diseases Rep., WHO Geneva: http://www.who.int/dietphysicalactivity/publications/fiscal-policies-diet-prevention/en/
  61. 61. 
    WHO (World Health Organ.). 2017. Appendix IX: WHO report on the global tobacco epidemic, 2017 Rep., WHO Geneva: http://www.who.int/tobacco/global_report/2017/appendix-ix/en/
  62. 62. 
    WHO (World Health Organ.). 2018. Global Information System on Alcohol and Health (GISAH). Global Health Observatory (GHO) Data http://www.who.int/gho/alcohol/en/
  63. 63. 
    Yürekli A, Önder Z, Elibol M, Erk N, Cabuk A et al. 2010. The economics of tobacco and tobacco taxation in Turkey Rep., Int. Union Against Tuberc. Lung Dis. Paris: http://www.who.int/tobacco/en_tfi_turkey_report_feb2011.pdf
  64. 64. 
    Zhen C, Finkelstein EA, Nonnemaker JM, Karns SA, Todd JE 2014. Predicting the effects of sugar-sweetened beverage taxes on food and beverage demand in large demand systems. Am. J. Agric. Econ. 96:11–25
    [Google Scholar]

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