# The health, financial and distributional consequences of increases in the tobacco excise tax among smokers in Lebanon

 Title: The health, financial and distributional consequences of increases in the tobacco excise tax among smokers in Lebanon Author: Salti, Nisreen; Brouwer, Elizabeth; Verguet, Stéphane Note: Order does not necessarily reflect citation order of authors. Citation: Salti, Nisreen, Elizabeth Brouwer, and Stéphane Verguet. 2016. “The health, financial and distributional consequences of increases in the tobacco excise tax among smokers in Lebanon.” Social Science & Medicine (1982) 170 (1): 161-169. doi:10.1016/j.socscimed.2016.10.020. http://dx.doi.org/10.1016/j.socscimed.2016.10.020. Full Text & Related Files: 5115647.pdf (349.0Kb; PDF) Abstract: Tobacco use is a significant risk factor for the leading causes of death worldwide, including cancer, heart disease and stroke. Most of these deaths occur in low- and middle-income countries, where tobacco-related deaths are also rising rapidly. Taxation is one of the most effective tobacco control measures, yet evidence on the distributional impact of tobacco taxation in low- and middle-income countries remains scant. This paper considers the financial and health effects, by socio-economic class, of increasing tobacco taxes in Lebanon, a middle-income country. An Almost Ideal Demand System is used to estimate price elasticities of demand for tobacco products. Extended cost-effectiveness analysis (ECEA) methods are applied to quantify, across quintiles of socio-economic status, the health benefits gained, the additional tax revenues raised, and the net financial consequences for households from a 50% increase in the price of tobacco through excise taxes. We find that demand for tobacco is price inelastic with elasticities ranging from −0.32 for the poorest quintile to −0.22 for the richest quintile. The increase in tobacco tax is estimated to result in 65,000 (95% CI: 37,000–93,000) premature deaths averted, 25% of them in the poorest quintile, $300M ($256–340M) of additional tax revenues, 12% borne by the poorest quintile, $23M ($13–33M) of out-of-pocket spending on healthcare averted, 36% of which accrue to the poorest quintile, 9% to the richest. These savings would be associated with 23,000 (13,000–33,000) poverty cases averted (63% in the poorest quintile). Increasing tobacco taxes would lead to large financial and health benefits, and would be pro-poor in health gains, savings on healthcare, and poverty reduction. Published Version: doi:10.1016/j.socscimed.2016.10.020 Other Sources: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5115647/pdf/ Terms of Use: This article is made available under the terms and conditions applicable to Other Posted Material, as set forth at http://nrs.harvard.edu/urn-3:HUL.InstRepos:dash.current.terms-of-use#LAA Citable link to this page: http://nrs.harvard.edu/urn-3:HUL.InstRepos:29739134 Downloads of this work: