title: Simulated effect of tobacco tax variation on population health in California.
abstract: 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.
authors.affiliation: Department of Family and Preventive Medicine, 0628, University of California, San Diego, La Jolla, CA 92093-0628, USA.
authors.forename: R M
authors.initials: RM
authors.lastname: Kaplan
authors.forename: C F
authors.initials: CF
authors.lastname: Ake
authors.forename: S L
authors.initials: SL
authors.lastname: Emery
authors.forename: A M
authors.initials: AM
authors.lastname: Navarro
mesh_terms: 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