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June 10, 2019

Challenges and Opportunities for Tobacco Control Policies in the 21st Century

Author Affiliations
  • 1Dartmouth-Hitchcock Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
  • 2The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
  • 3University of Hawaii Cancer Center, Honolulu
JAMA Pediatr. 2019;173(8):723-725. doi:10.1001/jamapediatrics.2019.1482

Taxation is one of the most effective means of tobacco control, but tobacco companies often argue that imposing or raising taxes on cigarettes will be counterproductive. Guindon and colleagues1 analyzed the case of British American Tobacco (BAT) in Chile and concluded that increased cigarette prices and nonprice tobacco control policies were associated with a reduction in cigarette smoking initiation. Their analyses suggest that higher cigarette prices—in this case, the result of BAT’s own pricing policy—were associated with reduced hazards of smoking initiation among youths and counter the notion commonly advanced by the tobacco industry that taxation increases black market sales. These data from a unique natural experiment contribute to a substantial body of evidence on the effectiveness of tax and price policies together with advertising and marketing restrictions for reducing tobacco use, an important public health goal of our time.2,3 In addition, the study highlights several important challenges facing 21st-century tobacco control efforts.

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