Simulated effect of tobacco tax variation on population health in California.
OBJECTIVE
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.
Kaplan
R M
RM
Department of Family and Preventive Medicine, 0628, University of California, San Diego, La Jolla, CA 92093-0628, USA.
Ake
C F
CF
Emery
S L
SL
Navarro
A M
AM
D000293:Adolescent; D000328:Adult; D002140:California / Q000453:epidemiology; D018672:Community Health Planning / Q000191:economics / Q000379:methods*; D016001:Confidence Intervals; D005260:Female; D005544:Forecasting; D006291:Health Policy; D006293:Health Promotion / Q000191:economics / Q000379:methods*; D006304:Health Status; D006801:Humans; D008017:Life Expectancy; D008297:Male; D017059:Models, Econometric; D009017:Morbidity; D017063:Outcome Assessment, Health Care; D011159:Population Surveillance; D015995:Prevalence; D015397:Program Evaluation; D019057:Quality-Adjusted Life Years; D017678:Sex Distribution; D012907:Smoking / Q000191:economics / Q000453:epidemiology* / Q000523:psychology; D000074606:Smoking Prevention; D013660:Taxes / Q000191:economics*; D026712:Value of Life