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Comment & Response
November 25, 2019

Could Tobacco Control Policies Be a Smokescreen?

Author Affiliations
  • 1University Hospital, Amiens, France
JAMA Pediatr. 2020;174(1):102. doi:10.1001/jamapediatrics.2019.4506

Lord, protect me from my friends; I can take care of my enemies.

Voltaire

To the Editor The conclusion that “large cigarette tax increases may be a strategy that can be used to help reduce smoking among youths”1 by Guindon et al deserved comment. First, the goals of tax increases are to increase benefits, the reduction of smoking prevalence being only an ancillary result. In Australia, a most proactive country against tobacco (2016 smoking prevalence: 15%), revenue from taxes increased from A$8.0 million in 2001 to A$10.4 million in 2016 ($5.45 million to $7.09 million US dollars).2 In France, governments shared profits with the industry: since 2005, there have been no relevant increase in taxes (always less than 6%, a level inadequate to decrease sales in high-income countries) and small increases in industrial price until March 2017 (15% increase in price targeting roll-your-own tobacco plus a ban on low-price packs, which represented 40% of sales). This did not preclude the agency Public Health France from overlooking this measure and claiming that “increased reimbursement for nicotine substitutes, plain packaging, month without tobacco caused a decrease in smoking prevalence (from 38.8% in 2016 to 34.0% in 2017 for the lowest income and 49.7% to 43.5% for the unemployed).”3 Coincidentally, experts have been enduringly calling to raise prices to €20 in 2020 ($22.16), but the new government only promised €10 ($11.08). The Chilean case seems between France and Australia.1

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