释放烟草税收的力量,减轻墨西哥吸烟的社会成本:微观模拟模型。

IF 2.9 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Belen Saenz-de-Miera, Luz Myriam Reynales-Shigematsu, Alfredo Palacios, Ariel Bardach, Agustin Casarini, Natalia Espinola, Federico Rodriguez Cairoli, Andrea Alcaraz, Federico Augustovski, Andres Pichon-Riviere
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引用次数: 0

摘要

尽管烟草税是最具成本效益的烟草控制政策,但在世界卫生组织的 MPOWER 一揽子减少吸烟政策中,烟草税却是实施最少的。在墨西哥,十多年来吸烟率和税收都保持稳定。本研究旨在提供证据,说明征税对减轻墨西哥烟草相关疾病负担和主要可归因社会成本(包括经常被忽视的非正规(无偿)护理成本)的潜在影响。我们采用了一阶蒙特卡洛微观模拟模型,该模型考虑到了不良健康事件和死亡的风险,跟踪假定的人口队列。首先,我们估算烟草导致的发病率和死亡率、直接医疗成本和间接成本,如劳动生产率损失和非正规护理成本。然后,我们评估了通过征税使香烟价格上涨 50%以及 25% 和 75% 两种替代方案的潜在影响。数据来源包括全国性调查和生命统计数据。在墨西哥,每年有 63,000 人过早死亡,427,000 人患病,烟草造成的社会成本高达 1,946 亿墨西哥元(8.5 美元),其中直接医疗成本为 1,162 墨西哥元(5.1 美元),间接成本为 785 墨西哥元(3.4 美元),占国内生产总值的 0.8%。目前的烟草税收仅够支付这些成本的 23.3%。通过征税将香烟价格提高 50%,可在未来十年内减少 49,000 人过早死亡,而避免的直接和间接成本将分别达到 879 亿美元(3.8)和 676 亿美元(2.9)。即使在非法贸易增加的悲观情况下,收益也将远远超过任何可能的损失。烟草使用给墨西哥人口带来了高昂的社会成本,但烟草税是一项双赢政策,既能提高人口健康水平,又能降低烟草的社会成本。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Unlocking the power of tobacco taxation to mitigate the social costs of smoking in Mexico: a microsimulation model.

Despite being the most cost-effective tobacco control policy, tobacco taxation is the least implemented component of the World Health Organization MPOWER package to reduce smoking worldwide. In Mexico, both smoking prevalence and taxation have remained stable for more than a decade. This study aims to provide evidence about the potential effects of taxation to reduce the burden of tobacco-related diseases and the main attributable social costs in Mexico, including informal (unpaid) care costs, which are frequently ignored. We employ a first-order Monte Carlo microsimulation model that follows hypothetical population cohorts considering the risks of an adverse health event and death. First, we estimate tobacco-attributable morbidity and mortality, direct medical costs and indirect costs, such as labour productivity losses and informal care costs. Then, we assess the potential effects of a 50% cigarette price increase through taxation and two alternative scenarios of 25% and 75%. The inputs come from several sources, including national surveys and vital statistics. Each year, 63 000 premature deaths and 427 000 disease events are attributable to tobacco in Mexico, while social costs amount to MX$194.6 billion (US$8.5)-MX$116.2 (US$5.1) direct medical costs and MX$78.5 (US$3.4) indirect costs-representing 0.8% of gross domestic product. Current tobacco tax revenue barely covers 23.3% of these costs. Increasing cigarette prices through taxation by 50% could reduce premature deaths by 49 000 over the next decade, while direct and indirect costs averted would amount to MX$87.9 billion (US$3.8) and MX$67.6 billion (US$2.9), respectively. The benefits would far outweigh any potential loss even in a pessimistic scenario of increased illicit trade. Tobacco use imposes high social costs on the Mexican population, but tobacco taxation is a win-win policy for both gaining population health and reducing tobacco societal costs.

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来源期刊
Health policy and planning
Health policy and planning 医学-卫生保健
CiteScore
6.00
自引率
3.10%
发文量
98
审稿时长
6 months
期刊介绍: Health Policy and Planning publishes health policy and systems research focusing on low- and middle-income countries. Our journal provides an international forum for publishing original and high-quality research that addresses questions pertinent to policy-makers, public health researchers and practitioners. Health Policy and Planning is published 10 times a year.
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