Beyond excise taxes: a systematic review of literature on non-tax policy approaches to raising tobacco product prices

OBJECTIVE: Raising the price of tobacco products is considered one of the most effective ways to reduce tobacco use. In addition to excise taxes, governments are exploring other policies to raise tobacco prices and minimise price dispersion, both within and across price tiers. We conducted a systematic review to determine how these policies are described, recommended and evaluated in the literature. DATA SOURCES: We systematically searched six databases and the California Tobacco Control library for English language studies or reports, indexed on or before 18 December 2013, that included a tobacco keyword (eg, cigarette), policy keyword (eg, legislation) and a price keyword (eg, promotion). We identified 3067 abstracts. STUDY SELECTION: Two coders independently reviewed all abstracts and identified 56 studies or reports that explicitly described a public policy likely to impact the retail price of tobacco products through non-tax means. DATA EXTRACTION: Two coders independently identified tobacco products targeted by policies described, recommendations for implementing policies and empirical assessments of policy impacts. DATA SYNTHESIS: The most prevalent non-tax price policies were price promotion restrictions and minimum price laws. Few studies measured the impact of non-tax policies on average prices, price dispersion or disparities in tobacco consumption, but the literature includes suggestions for crafting policies and preparing for legal challenges or tobacco industry opposition. CONCLUSIONS: Price-focused evaluations of well-implemented non-tax price policies are needed to determine whether they can deliver on their promise to raise prices, reduce price dispersion and serve as an important complement to excise taxes.