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Stacey N, Summan A, Tugendhaft A, et al. Simulating the impact of excise taxation for disease prevention in low-income and middle-income countries: an application to South Africa. BMJ Glob Health. 2018;3(1):e000568doi: 10.1136/bmjgh-2017-000568.
Stacey, N., Summan, A., Tugendhaft, A., Laxminarayan, R., & Hofman, K. (2018). Simulating the impact of excise taxation for disease prevention in low-income and middle-income countries: an application to South Africa. BMJ global health, 3(1), e000568. https://doi.org/10.1136/bmjgh-2017-000568
Stacey, Nicholas, et al. "Simulating the impact of excise taxation for disease prevention in low-income and middle-income countries: an application to South Africa." BMJ global health vol. 3,1 (2018): e000568. doi: https://doi.org/10.1136/bmjgh-2017-000568
Stacey N, Summan A, Tugendhaft A, Laxminarayan R, Hofman K. Simulating the impact of excise taxation for disease prevention in low-income and middle-income countries: an application to South Africa. BMJ Glob Health. 2018 Jan 05;3(1):e000568. doi: 10.1136/bmjgh-2017-000568. eCollection 2018. PMID: 29515917; PMCID: PMC5838397.
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BMJ Glob Health. 2018 Jan 05;3(1):e000568. doi: 10.1136/bmjgh-2017-000568. eCollection 2018.

Simulating the impact of excise taxation for disease prevention in low-income and middle-income countries: an application to South Africa.

BMJ global health

Nicholas Stacey, Amit Summan, Aviva Tugendhaft, Ramanan Laxminarayan, Karen Hofman

Affiliations

  1. Priority Cost Effective Lessons for Systems Strengthening, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
  2. Center for Disease Dynamics Economics and Policy, Washington, District of Columbia, USA.

PMID: 29515917 PMCID: PMC5838397 DOI: 10.1136/bmjgh-2017-000568

Abstract

INTRODUCTION: Excise taxes are policy tools that have been applied internationally with some success to reduce consumption of products adversely impacting population health including tobacco, alcohol and increasingly junk foods and sugary beverages. As in other low-income and middle-income countries, South Africa faces a growing burden of lifestyle diseases; accordingly we simulate the impact of multiple excise tax interventions in this setting.

METHODS: We construct a mathematical model to simulate the health and revenue effects of increased excise taxes, which is adaptable to a variety of settings given its limited data requirements. Applying the model to South Africa, we simulate the impact of increased tax rates on tobacco and beer and of the introduction of a tax on sugar-sweetened beverages (SSB). Drawing on surveys of product usage and risk factor prevalence, the model uses a potential impact fraction to simulate the health effects of tax interventions.

RESULTS: Adopting an excise rate of 60% on tobacco would result in a gain of 858 923 life-years (95% uncertainty interval (UI) 480 188 to 1 310 329), while adopting an excise rate of 25% on beer would result in a gain of 568 063 life-years (95% UI 412 110 to 775 560) and the adoption of a 20% tax on SSBs would result in a gain of 688 719 life-years (95% UI 321 788 to 1 079 653).

CONCLUSION: More aggressive excise tax policies on tobacco, beer and SSBs in South Africa could result in meaningful improvements in population health and raised revenue.

Keywords: health policy; prevention strategies; public health

Conflict of interest statement

Competing interests: None declared.

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