title: The association between economic recession and public support for increased tobacco taxation in 27 European countries.
abstract: BACKGROUND
  Increased taxation on tobacco products is an effective method of reducing tobacco use. This study assessed population support among respondents aged ≥15 years, from 27 European Union (EU) countries for increased taxation and other tobacco control measures during the 2009-2012 period.
  
  
  METHODS
  Nationally representative data were obtained from the 2009 (n=26,788) and 2012 (n=26,751) cross-sectional Eurobarometer surveys. Estimates were compared using chi-square statistics. The effect of the relative change in gross domestic product (GDP) on the change in support for increased taxation during 2009-2012 was calculated using the Pearson correlation coefficient and linear regression models.
  
  
  RESULTS
  Between 2009 and 2012, population support for increased taxes on tobacco products declined (56.1% to 53.2%; p<0.001). However, support for other tobacco control measures increased significantly. After adjusting for baseline GDP per capita (2009), a 10% increase in GDP per capita was associated with 4.5% increase in support of tax increases. When Latvia and Lithuania were excluded from the analyses (because of their marked deviation from the general trend), there was a strong correlation between the change in GDP and support for increased taxes (ρ=0.64; p<0.001). Also, after adjusting for baseline GDP, support for higher taxes on tobacco increased by 7.0% for every 10% increase in GDP between 2009 and 2012.
  
  
  CONCLUSIONS
  Population support for tax increases declined in the EU between 2009 and 2012, especially in countries with declines in GDP nonetheless, public support for other tobacco control measures remains high, thus indicating a viable environment for more comprehensive tobacco control.
authors: Department of Primary Care and Public Health, School of Public Health, Imperial College London, UK f.filippidis@imperial.ac.uk.
authors: Filippos T
authors: FT
authors: Filippidis
authors: Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, USA.
authors: Israel T
authors: IT
authors: Agaku
authors: Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, USA Clinic of Social and Family Medicine, University of Crete, Greece.
authors: Constantine I
authors: CI
authors: Vardavas
authors: Department of Primary Care and Public Health, School of Public Health, Imperial College London, UK.
authors: Azeem
authors: A
authors: Majeed
mesh_terms: D000293:Adolescent; D000328:Adult; D057172:Economic Recession / Q000706:statistics & numerical data*; D005060:Europe; D006801:Humans; D011639:Public Opinion; D013660:Taxes; D062789:Tobacco Products / Q000191:economics*
keywords: Europe; Tobacco; economic recession; population support; taxation