Impact of tobacco price and taxation on affordability and consumption of tobacco products in the Southeast Asia Region : a systematic review

Introduction: The objective of the review was to study the impact of tobacco taxes or prices on affordability and/or consumption of tobacco products in WHO-South East Asia Region (SEAR) countries, overall, and by socioeconomic status; and change in consumption of one tobacco product for a given change in price/tax on other tobacco product. Methods: The searches were run on five databases (Medline, Embase, Cinahl, EconLit, Tobacconomics) using keywords such as ‘tobacco’, ‘tax’, ‘price’, ‘impact’ with their synonyms. Additionally, first 100 articles through google search and e-reports from targeted sources were also reviewed. Studies illustrating the impact of prices/taxes on consumption/affordability of tobacco products in SEAR, available in English language, with no limitation on time were included in the review. After two steps of screening, data from 28 studies were extracted using a structured, and pre-tested data extraction form. Results: Out of the total twenty-eight studies, twelve studies reported an inverse association between price and consumption/affordability while 11 studies reported no or positive association between price and consumption/affordability of tobacco products. Five studies had unclear interpretations. Majority of studies estimated that the less affluent group were more price responsive as compared to the more affluent group. Some studies indicated increased consumption of one product in response to price rise of other product, although, the findings were inconsistent. Conclusions: The findings of our review support the use of tobacco tax and price measures as effective tools to address the tobacco epidemic. Our findings however also emphasise the importance of increasing tobacco product taxes and prices sufficiently to outweigh the effects of income growth, in order for the measures to be effective in reducing the affordability and consumption of tobacco products