| Summary: | 碩士 === 國立陽明大學 === 公共衛生研究所 === 99 === Background:Raising cigarette tax has been demonstrated to be one of the most effective tobacco control measures. While other taxes remained stable, ear-marked cigarette tax (the health and welfare surcharge) was first imposed in 2002, by NT$ 5 per pack (~16 US cents, corresponding to approximately 12% increase in average retail price), which was increased by another NT$ 5 in 2006. We used data from the Survey of Family Income and Expenditure (SFIE), conducted by Directorate-General of Budget, Accounting and Statistics, to (1) examine whether tax increase affected smoking prevalence or tobacco consumption; (2) characterize the tax burden in households of different socioeconomic status.
Methods:Data from 2000 to 2008 SFIE, each comprising about 13,600 households, was analyzedby piecewise linear regression model adjusting for income, age, education, and occupation of heads of households. The cigarette price was calculated based on the annual Consumer Product Index, while tobacco consumption (packs per year) was estimated by dividing household tobacco expenditure with average price of cigarettes.
Results:As a whole, there is a steady trend of reduction in both household smoking rate and tobacco consumption from 2000 to 2008. Before the tax was raised, the trends were descending in smoking prevalence (slope = - 0.013, p < 0.01) and cigarette consumption (slope = -2.52, p = 0.03). No significant change in household smoking prevalence or cigarette consumption was associated with the first tax increase. With the second tax increase, there was a significant further reduction in smoking prevalence (slope = -0.018, difference in slope p-value = 0.02) and cigarette consumption (slope = -11.06, difference in slope p-value < 0.001) of male-headed households, which was not observed among female-headed households. We then compared the burden in smoking households of different socioeconomic status, using the proportion of cigarette tax to household income. The tax was estimated by multiplying cigarette consumption by tax per pack. The lowest income group had the highest proportion (4.4% in 2008), and the highest income group had the lowest proportion in all the years analyzed. The ratio of the proportion varied between 4.53 ~ 5.52 comparing the highest vs. the lowest 10% of households ranked by income. The difference is considered an underestimation considering that richer household may consume cigarettes of higher unit prices. The tobacco tax burden among smoking households (tobacco tax as a percentage of all other tax) in the lowest 10% income group ranged from 42.6% in 2000 to 77.0% in 2006, indicating that cigarette tax is a significant tax form for low-income households.
Conclusions:Cigarette tax increase was associated temporally with reduction in smoking prevalence, and even more so in cigarette consumption. However, the burden on low-income households demands further attention on fairness.
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