Cigarette taxation and socioeconomic inequalities in under-5 mortality across 94 low-income and middle-income countries

Bibliographic Details
Main Author: Bannon, Olivia S.
Publication Date: 2025
Other Authors: Been, Jasper V., Harper, Sam, Laverty, Anthony A., Millett, Christopher, van Lenthe, Frank J., Filippidis, Filippos T., Radó, Márta K.
Format: Article
Language: eng
Source: Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
Download full: http://hdl.handle.net/10362/183373
Summary: Funding Information: MKR is supported by the Swedish Research Council for Health, Working Life, and Welfare (grant number 2023\u201300678) and Stiftelsen Riksbankens Jubileumsfond (grant number P23\u20130640). OSB was supported by the European Union's Horizon 2020 Research and Innovation programme under the Marie Sk\u0142odowska-Curie grant (agreement number 101008139). CM is supported by the UK National Institute for Health and Care Research (grant number NIHR133252) using UK aid from the UK Government to support global health research. Publisher Copyright: © 2025 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
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spelling Cigarette taxation and socioeconomic inequalities in under-5 mortality across 94 low-income and middle-income countriesa longitudinal ecological studyPublic Health, Environmental and Occupational HealthSDG 3 - Good Health and Well-beingFunding Information: MKR is supported by the Swedish Research Council for Health, Working Life, and Welfare (grant number 2023\u201300678) and Stiftelsen Riksbankens Jubileumsfond (grant number P23\u20130640). OSB was supported by the European Union's Horizon 2020 Research and Innovation programme under the Marie Sk\u0142odowska-Curie grant (agreement number 101008139). CM is supported by the UK National Institute for Health and Care Research (grant number NIHR133252) using UK aid from the UK Government to support global health research. Publisher Copyright: © 2025 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Although increasing cigarette taxes is known to improve child survival, there are few data on their effect on socioeconomic inequalities in child mortality. We investigated the association between cigarette taxation and socioeconomic inequalities in mortality in children younger than 5 years (hereafter referred to as under-5 mortality) in low-income and middle-income countries (LMICs). Methods: This was a longitudinal ecological study. We linked country-level annual data on 94 LMICs, as defined by the World Bank, and annual data on under-5 mortality by wealth quintile from the UN Inter-agency Group for Child Mortality Estimation from 2008 to 2020. We used fixed-effect panel regression models to assess the association of cigarette taxes with absolute and relative inequalities in under-5 mortality by wealth quintile. Findings: Increasing total cigarette tax by 10-percentage-points was associated with reduced under-5 mortality rates in all wealth quintiles. Raising total cigarette tax from 0·0–24·9% to 25·0–74·9% and 75·0% or more of their total retail value was associated with 3·8% (95% CI 0·2 to 7·3) and 7·6% (1·4 to 13·4) decreases in absolute inequality in under-5 mortality, respectively. This finding was mainly attributable to specific tax, which was associated with a 1·4% (0·3 to 2·6) reduction in absolute inequality for each 10-percentage-point increase. We estimated that raising total cigarette taxes to 75·0% or more in all 94 LMICs could have averted 281 017 (196 916 to 362 301) under-5 deaths in 2021. Interpretation: High cigarette taxes are associated with a large decrease in absolute inequality in child mortality in LMICs. These findings support raising cigarette taxes to the WHO-recommended 75% or more of the retail value to protect the poorest children. Funding: Swedish Research Council for Health, Working Life, and Welfare; Stiftelsen Riksbankens Jubileumsfond; European Union's Horizon 2020 Research and Innovation; and UK National Institute for Health and Care Research.Centro de Investigação em Saúde Pública (CISP/PHRC)Comprehensive Health Research Centre (CHRC) - Pólo ENSPEscola Nacional de Saúde Pública (ENSP)RUNBannon, Olivia S.Been, Jasper V.Harper, SamLaverty, Anthony A.Millett, Christophervan Lenthe, Frank J.Filippidis, Filippos T.Radó, Márta K.2025-05-23T21:15:30Z2025-052025-05-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10362/183373eng2468-2667PURE: 116655066https://doi.org/10.1016/S2468-2667(25)00065-9info:eu-repo/semantics/openAccessreponame:Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)instname:FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiainstacron:RCAAP2025-05-26T01:43:14Zoai:run.unl.pt:10362/183373Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireinfo@rcaap.ptopendoar:https://opendoar.ac.uk/repository/71602025-05-29T07:36:43.263909Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) - FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiafalse
dc.title.none.fl_str_mv Cigarette taxation and socioeconomic inequalities in under-5 mortality across 94 low-income and middle-income countries
a longitudinal ecological study
title Cigarette taxation and socioeconomic inequalities in under-5 mortality across 94 low-income and middle-income countries
spellingShingle Cigarette taxation and socioeconomic inequalities in under-5 mortality across 94 low-income and middle-income countries
Bannon, Olivia S.
Public Health, Environmental and Occupational Health
SDG 3 - Good Health and Well-being
title_short Cigarette taxation and socioeconomic inequalities in under-5 mortality across 94 low-income and middle-income countries
title_full Cigarette taxation and socioeconomic inequalities in under-5 mortality across 94 low-income and middle-income countries
title_fullStr Cigarette taxation and socioeconomic inequalities in under-5 mortality across 94 low-income and middle-income countries
title_full_unstemmed Cigarette taxation and socioeconomic inequalities in under-5 mortality across 94 low-income and middle-income countries
title_sort Cigarette taxation and socioeconomic inequalities in under-5 mortality across 94 low-income and middle-income countries
author Bannon, Olivia S.
author_facet Bannon, Olivia S.
Been, Jasper V.
Harper, Sam
Laverty, Anthony A.
Millett, Christopher
van Lenthe, Frank J.
Filippidis, Filippos T.
Radó, Márta K.
author_role author
author2 Been, Jasper V.
Harper, Sam
Laverty, Anthony A.
Millett, Christopher
van Lenthe, Frank J.
Filippidis, Filippos T.
Radó, Márta K.
author2_role author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Centro de Investigação em Saúde Pública (CISP/PHRC)
Comprehensive Health Research Centre (CHRC) - Pólo ENSP
Escola Nacional de Saúde Pública (ENSP)
RUN
dc.contributor.author.fl_str_mv Bannon, Olivia S.
Been, Jasper V.
Harper, Sam
Laverty, Anthony A.
Millett, Christopher
van Lenthe, Frank J.
Filippidis, Filippos T.
Radó, Márta K.
dc.subject.por.fl_str_mv Public Health, Environmental and Occupational Health
SDG 3 - Good Health and Well-being
topic Public Health, Environmental and Occupational Health
SDG 3 - Good Health and Well-being
description Funding Information: MKR is supported by the Swedish Research Council for Health, Working Life, and Welfare (grant number 2023\u201300678) and Stiftelsen Riksbankens Jubileumsfond (grant number P23\u20130640). OSB was supported by the European Union's Horizon 2020 Research and Innovation programme under the Marie Sk\u0142odowska-Curie grant (agreement number 101008139). CM is supported by the UK National Institute for Health and Care Research (grant number NIHR133252) using UK aid from the UK Government to support global health research. Publisher Copyright: © 2025 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
publishDate 2025
dc.date.none.fl_str_mv 2025-05-23T21:15:30Z
2025-05
2025-05-01T00:00:00Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10362/183373
url http://hdl.handle.net/10362/183373
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 2468-2667
PURE: 116655066
https://doi.org/10.1016/S2468-2667(25)00065-9
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
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instname_str FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologia
instacron_str RCAAP
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