Simulated effect of tobacco tax variation on population health in California

Am J Public Health. 2001 Feb;91(2):239-44. doi: 10.2105/ajph.91.2.239.


Objectives: This study simulated the effects of tobacco excise tax increases on population health.

Methods: Five simulations were used to estimate health outcomes associated with tobacco tax policies: (1) the effects of price on smoking prevalence; (2) the effects of tobacco use on years of potential life lost; (3) the effect of tobacco use on quality of life (morbidity); (4) the integration of prevalence, mortality, and morbidity into a model of quality adjusted life years (QALYs); and (5) the development of confidence intervals around these estimates. Effects were estimated for 1 year after the tax's initiation and 75 years into the future.

Results: In California, a $0.50 tax increase and price elasticity of -0.40 would result in about 8389 QALYs (95% confidence interval [CI] = 4629, 12,113) saved the first year. Greater benefits would accrue each year until a steady state was reached after 75 years, when 52,136 QALYs (95% CI = 38,297, 66,262) would accrue each year. Higher taxes would produce even greater health benefits.

Conclusions: A tobacco excise tax may be among a few policy options that will enhance a population's health status while making revenues available to government.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • California / epidemiology
  • Community Health Planning / economics
  • Community Health Planning / methods*
  • Confidence Intervals
  • Female
  • Forecasting
  • Health Policy
  • Health Promotion / economics
  • Health Promotion / methods*
  • Health Status*
  • Humans
  • Life Expectancy
  • Male
  • Models, Econometric*
  • Morbidity
  • Outcome Assessment, Health Care
  • Population Surveillance
  • Prevalence
  • Program Evaluation
  • Quality-Adjusted Life Years*
  • Sex Distribution
  • Smoking / economics
  • Smoking / epidemiology*
  • Smoking / psychology
  • Smoking Prevention*
  • Taxes / economics*
  • Value of Life