Aim of the project
To provide evidence and tools to inform the potential scale of effects of taxation across tobacco and alcohol as an intervention to improve public health and reduce health inequalities in the UK
Why this is important
Alcohol consumption and tobacco smoking are major modifiable risk factors for non-communicable diseases and people who both drink and smoke are at a further increased health risk. Taxation is recognised worldwide as an effective way to reduce alcohol consumption and encourage smokers to quit. However, there is a need to improve the evidence base upon which the joint effects of change to tobacco and alcohol tax will be calculated, e.g. so that the relationships among alcohol and tobacco use and socioeconomic status can be considered.
This research developed new evidence on current and potential future tobacco and alcohol pricing and tax policy in England. There were three key tasks:
- Understand the joint patterns of purchasing and use of the products across population subgroups.
- Use a consistent methodology to estimate the effects of industry influence on tax pass-through for off-trade alcohol, on-trade alcohol and tobacco.
- Produce more detailed evidence on how tobacco and alcohol consumption responds to price rises (the price elasticities of demand) and an understanding of the uncertainty in these estimates. For example, we need to better understand the extent to which consumers might quit smoking vs. switch to cheaper products.
Finally, the research plan recognised the need for impact assessment models capable of assessing the joint effects of tobacco and alcohol tax changes. This involves modelling the potential impact of combined alcohol and tobacco tax policy options on outcomes including changes in participation in drinking or smoking (any use vs abstinence), consumption levels, consumer expenditures, tax revenues to Government and net revenues to retailers, risk of harm related to 85 different clinical conditions, healthcare (NHS) costs, quality adjusted life years and mortality.
For information about the previous research that this project builds on see Partos et al. (2020) for tobacco and Meier et al. (2016) for alcohol.
Objectives
The objectives were designed to produce the evidence required for joint policy analysis of alcohol and tobacco tax policy changes.
- Qualitative investigation to understand through published evidence and stakeholder interviews the options for tobacco and alcohol tax policy changes, which options UK experts view as achievable and why.
- Analysis of social patterns in alcohol and tobacco spending to quantify the patterns of purchasing and consumption of across product types and price points for socio-demographic groups defined by age, sex, and socioeconomic status and for different smoker and drinker groups.
- Analysis of industry and consumer responses to tax changes to estimate the likely responses to tax changes in terms of:
- Alcohol and tobacco industry pricing strategy via modifying the extent to which tax changes are ‘passed through’ to product retail prices.
- Consumer demand for alcohol and tobacco products by estimating new price elasticities of demand for 10 alcohol product categories and two tobacco products in an integrated way.
- Population modelling to appraise the health and economic outcomes of tax interventions – To develop a health and economic model of the combined effects of changes to tax on alcohol and tobacco products, and use this model to appraise scenarios for changes to tax that are designed to support decision-making on tax policy
Public involvement
The aim of the public involvement in the SYNTAX project was to provide a perspective from lived experience on the options for alcohol and tobacco tax policy changes, and how any changes might affect people differently according to their alcohol and tobacco consumption and socio-demographic characteristics. The idea was that the project team would then use their understanding of the public perspectives to guide the process of generating and interpreting the research findings.
Three public panels were involved:
- The Sheffield Addiction Recovery Research Panel (support by the Clinical Research Office of Sheffield Teaching Hospitals NHS Foundation Trust). The group comprised former and current service users for drug and alcohol treatment and family and carers of people who have had experience of drug and alcohol misuse.
- The Tobacco and Nicotine Discussion Group in Nottingham (funded as part of the UK Centre for Tobacco and Alcohol Studies (UKCTAS), and subsequently the SPECTRUM UK Prevention Research Partnership consortium. The Tobacco and Nicotine Discussion Group comprised current smokers or those trying to quit smoking who were experienced in discussing tobacco and new nicotine product use, tobacco control policy, approaches to smoking cessation and new developments in tobacco harm reduction.
- The Alcohol and Food Discussion Group (also funded through UKCTAS and subsequently SPECTRUM) comprised members of the public who were occasional or regular drinkers and experienced in discussing alcohol consumption, public health policy relating to alcohol and related research ideas and current projects.
Each panel was visited by SYNTAX researchers during the project where panel members were guided through a structured discussion of alcohol and tobacco consumption behaviours, how consumption depends on product prices and available income, and their views on tax policy changes and its potential effects. These discussions were influenced by briefing information given to panel members including on the current rates of and revenues from alcohol and tobacco tax in the UK.
Outputs
Details of the outputs of the SYNTAX project are available on the STAPM website.
Funding
NIHR Public Health Research Board – project number 16/105/26.
SYNTAX team
Project Co-ordinators
- Prof Alan Brennan
- Dr Duncan Gillespie
Stakeholder Interview Team
- Dr Jenny Hatchard
- Dr Penny Buykx
Others involved in the project
- Anna Gilmore, Professor of Public Health, Department for Health, University of Bath
- Petra Meier, Professor of Public Health, Sheffield Centre for Health and Related Research, University of Sheffield
- John Holmes, Reader in Alcohol Policy, Sheffield Centre for Health and Related Research, University of Sheffield
- Colin Angus, Senior Research Fellow, Sheffield Centre for Health and Related Research, University of Sheffield
- Rosemary Hiscock, Research Associate, Department for Health, University of Bath
- Robert Pryce, Research Associate, Sheffield Centre for Health and Related Research, University of Sheffield
- Luke Wilson, Research Associate, Sheffield Centre for Health and Related Research, University of Sheffield
- Damon Morris, Research Associate, Sheffield Centre for Health and Related Research, University of Sheffield
- Grace Leeming, Research Assistant, Sheffield Centre for Health and Related Research, University of Sheffield
- Ryan Kai Le Chen, Research Assistant, Sheffield Centre for Health and Related Research, University of Sheffield