Tobacco price increases in Korea and their impact on socioeconomic inequalities in smoking and subsequent socioeconomic inequalities in mortality: a modelling study

Abstract

ObjectiveThrough a modelling study, we assessed the impact of tobacco price increases on smoking and smoking inequalities by income, and then quantified the subsequent effects on mortality and inequalities in mortality in Korea.MethodsEleven-year pooled data from the Korea National Health and Nutrition Examination Survey (KNHANES) (n=65 197) were used to estimate the income group-specific price elasticity. The price elasticity was then used to calculate changes in current smoking prevalence and per capita cigarette consumption resulting from a spectrum of hypothetical tobacco price increases. The mortality risk function from the 10-year mortality follow-up data of the National Health Insurance Service-National Sample Cohort (n=293 858, numbers of deaths=14 953) and the current distributions of smoking-related variables from the KNHANES 2015–2017 were employed to estimate the effect of tobacco price increases on inequality in mortality.ResultsLow-income Korean smokers were more responsive to changes in tobacco price. Increasing the tobacco price by 100% would achieve the overall reduction of 2.0% for 10-year mortality. For mortality inequalities by income, the relative index of inequality (slope index of inequality) would be reduced by 3.8% (4.8%) for 10-year mortality.ConclusionsThis modelling study showed that tobacco price increases in Korea can reduce current smoking prevalence and per capita cigarette consumption in the whole population, and especially among the poor, which in turn would reduce the gap in mortality between income groups.