Authors
- Verica Kralj — Croatian Institute of Public Health, Zagreb, Croatia — ORCID: 0000-0002-4623-828X
- Petra Čukelj — Croatian Institute of Public Health, Zagreb, Croatia — ORCID: 0000-0002-2292-2167
- Ivana Brkić Biloš — Croatian Institute of Public Health, Zagreb, Croatia — ORCID: 0000-0001-9088-8960
- Krunoslav Capak — Croatian Institute of Public Health, Zagreb, Croatia
Keywords
tax, tobacco, alcohol, prevention, chronic noncommunicable diseases
DOI
https://doi.org/10.15836/ccar2018.427Full Text
Tobacco use and alcohol consumption are two leading risk factors for development of chronic noncommunicable diseases, including cardiovascular diseases, cancer, lung diseases and liver cirrhosis. Aside from direct healthcare costs for treating these conditions, they can also cause premature mortality of working-age population and related additional financial costs. World Health Organization has identified an evidence-based list of interventions that are highly cost-effective and feasible to implement, so called „best buys“. ( 1 - 3 ) The most notable ones on population level are tax increase on tobacco products and alcohol. Taxation is an effective, low cost intervention, which can significantly reduce the risk of chronic noncommunicable diseases. Ten percent price increase reduces tobacco consumption for 4 to 5%, and alcohol consumption for 6,5%. Therefore, in their strategic documents WHO proposes measures of fiscal and marketing policies to reduce availability, but also consumption, of tobacco products, alcohol, and food products that are high in saturated fat, trans fat, sugar and salt. Taxation is recognized as an efficient legislative tool to reduce tobacco and alcohol consumption, and therefore not only current, but also future healthcare costs. Meanwhile, although the consumption is reduced, the rate of this reduction is not the same as the rate of price increase, and governments still gain additional tax revenue. Tax increase is especially useful as a tool for reduction of tobacco and alcohol consumption in young people, as the increase in price makes these products less available. Besides the reduction in consumption, this also leads to a decrease in the number of young people that develop tobacco and alcohol habit. Research has also shown that majority of non-smokers, but also a significant number of smokers, supports higher tobacco taxes, especially if additional revenue will be used for prevention programs and improvement of the health system. In order to successfully implement excise taxes, it is necessary to have intersectoral collaboration, especially collaboration of the financial and health sector, but also to deal with lobbying and interfering from the tobacco and alcohol industries.