Political economy of tobacco tax in Bangladesh: understanding policy context and implementation challenges.

Abstract

Background: Tobacco taxes are an effective method of reducing consumption, but Bangladesh's tax policy is weak and needs improvement in many areas.

Objective: This study aimed to analyse the political economy of tobacco tax design and implementation in Bangladesh.

Methods: We reviewed 45 tobacco tax documents, conducted stakeholder mapping, 12 key informant interviews and stakeholder analysis. We used thematic and content analysis approaches.

Results: In Bangladesh, the tobacco tax structure is complex and difficult to implement and not designed to curb tobacco consumption. The dual role of the Bangladesh government as regulator of and shareholder in the largest tobacco company weakens the formulation and implementation of tobacco taxes as health policy instruments. Tobacco is one of Bangladesh's highest revenue sectors. As such, tobacco companies yield significant indirect influence on the government and media to shape the conversation around tobacco taxes and to weaken those taxes' design and implementation. Despite significant challenges, a strong antitobacco network (including academia, civil society organisations, non-government organisations, the WHO and media actors) continues to advocate for the use of tobacco taxes to reduce tobacco consumption.

Conclusion: Our findings illustrate a complex interplay of political economy factors that challenge the design and implementation of tobacco taxes in Bangladesh. Creating opportunities for consultation and collaboration between the Ministries of Finance and Health regarding the formulation of tobacco taxes will be very important. National action plans with multi-stakeholder involvement are essential to achieving tobacco control goals through actionable steps.