Study finds association between cigarette tax and reduced child mortality

Higher tobacco taxes are associated with reduced neonatal and child mortality, according to an analysis of 159 countries published this week in the open-access journal PLOS Global Public Health by Anthony Laverty of Imperial College London, UK, and colleagues.

The exposure of pregnant women and babies to tobacco and second-hand smoke is known to increase the risks of neonatal and infant mortality. Increasing tobacco taxes has proven to be the most effective measure to reduce tobacco consumption and associated health risks, especially among low-income populations. A tobacco tax rate of 75% or more is recommended by the World Health Organization (WHO).

In the new study, researchers used data from 2008 to 2018 from 159 countries on neonatal and child mortality, tobacco taxation and other related variables, including gross domestic product, fertility rate, education and access to drinking water.

On average across all the countries studied, the neonatal mortality rate was 14.4 and the infant mortality rate was 24.9 per 1,000 live births. Worldwide, between 2008 and 2018, the average neonatal and infant mortality rates were 14.4 and 24.9 deaths per 1,000 live births, respectively. These rates were higher in the LRICs than in the PREs – with 33 children under the age of one, including 19 newborns, per 1,000 dying each year in the LRICs, compared to 4 newborns and 6 children under one year out of 1,000 in the PRE. The average total tax on cigarettes relative to the retail price was 49.1%, with only 11.2% of low- and middle-income countries and 42.1% of high-income countries reaching the recommended taxation of 75%. The team found that a ten percentage point increase in total cigarette tax was associated with a 2.6% decrease in neonatal mortality (95% CI 1.9-3.2) and a 1.9% decrease in infant mortality (95% CI 1.3-2.6). Based on the results, it is estimated that 231,220 (95% CI: 152,658-307,655) infant deaths, including 181,970 (95% CI: 135,679-226,377) neonatal deaths, could have been prevented by 2018 if all countries had applied a cigarette tax of at least 75%. rate.

The study was unable to control for all potential confounders, but the authors suggest that the health effects of taxation are likely related to decreased prenatal and postnatal exposure to second-hand smoke and reducing smoking during pregnancy.

The authors add, “We know that smoking continues to kill more than 8 million people a year, and that raising tobacco taxes is an effective way to bring that number down. This study underlines that if everywhere taxed tobacco at the levels recommended by the WHO, we would considerably reduce neonatal and infant mortality.”

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