Tobacco Control Policy Analysis & Intervention Evaluation in China and Tanzania

描述（由申请人提供）：根据《世界卫生组织烟草控制框架公约》（FCTC），控制烟草使用有两种主要战略：价格控制（税收/价格）和非价格控制（无烟公共场所，健康警语等）。本提案的主要重点是应用经济分析来解决烟草税收问题，并为中国和坦桑尼亚的价格控制政策建立证据基础。第二个重点是对中国的非价格管制政策进行评估，中国于2011年5月颁布了室内公共场所无烟条例。我们的研究小组在目前的资助下，在中国对烟草制品的需求和供应进行经济分析，并就提高额外烟草税的理由提出建议，取得了进展。然而，对2009年实施的税收调整影响的分析表明，有效利用这一价格控制措施存在许多障碍。这个竞争性的续期拨款建议做后续的税收政策相关分析来解决这些障碍。还提议进行一项增加特定消费税的试点试验，以及研究与烟草有关的疾病对政府农村保健支出的影响。该提案还包括对一项非价格措施，即2011年关于室内公共场所无烟的条例进行评估，以评估社区对健康风险的了解程度以及对此类条例的支持程度。通过专业联系，坦桑尼亚达累斯萨拉姆大学找到了我们的研究团队，将我们的研究经验和能力建设从中国扩展到坦桑尼亚：烟草制品的需求和供应，为坦桑尼亚政府实施控烟提供依据。如果得到资助，我们在坦桑尼亚的研究小组的工作将具有开创性，并将为该国的烟草控制研究奠定基础。这一竞争更新的目标是：1)在四个方面继续中国控烟研究：监测和评估2009年烟草税调整；开展烟草税试点；研究吸烟对政府农村卫生保健支出的影响；并评估2011年5月公共场所无烟条例的影响。2)在三个方面开展坦桑尼亚控烟研究：吸烟的经济成本；对香烟进行需求分析，模拟税收对消费和政府收入的影响；并研究烟草种植的经济回报。3)加强中国和坦桑尼亚控烟研究人员的能力建设。4)通过政策工作组和会议让两国决策者参与进来。开展这些研究的机构联盟包括中国四川大学、国家税务总局、中国疾病预防控制中心和中国烟草控制协会，以及坦桑尼亚达累斯萨拉姆大学和坦桑尼亚烟草控制论坛。

DESCRIPTION (provided by applicant): Under the WHO Framework Convention on Tobacco Control (FCTC), there are two major strategies to control tobacco use: price control (taxes/prices) and non-price control (smoke-free public places, health warnings etc.). The primary focus of this proposal is to apply economic analysis to address tobacco taxation issues and build the evidence base for price control policies in China and Tanzania. A secondary focus is to conduct evaluation of a non-price control policy in China, which has promulgated regulations for smoke-free indoor public places in May 2011. Our research team has made progress in China under the current grant on the economic analysis of the demand and supply of tobacco products and recommendations on the justification of raising additional tobacco tax. However, analysis of the impact of a tax adjustment instituted in 2009 showed that there are many hurdles to effective use of this price control measure. This competing renewal grant proposes to do follow-up tax policy related analysis to address these hurdles. A pilot experiment for a specific excise tax increase is also proposed, as well as a study of the impact of tobacco-related diseases on government rural healthcare expenditure. The proposal also includes an evaluation of a non-price measure, the 2011 regulation on smoke-free indoor public places, to assess the community's knowledge of health risks and support for such regulations. Through professional contact, our research team was approached by the University of Dar-es-Salaam in Tanzania to extend our research experiences and capacity building from China to Tanzania: the demand and supply of tobacco products in order to provide the justification for the Tanzania government to implement tobacco control. If funded, work by our research team in Tanzania will be ground-breaking and will build the foundation of tobacco control research in that country. This competing renewal has the following goals: 1) Continue Chinese tobacco control research in four areas: monitor and evaluate the 2009 tobacco tax adjustment; develop a pilot tobacco tax experiment; study the impact of smoking on government rural health care expenditures; and evaluate the impact of the May 2011 smoke-free public places regulation. 2) Develop Tanzania tobacco control research in three areas: the economic cost of smoking; demand analysis for cigarettes to simulate the impact of tax on consumption and government revenue; and to study the economic return of tobacco farming. 3) Capacity building for tobacco control researchers in China and Tanzania. 4) Engage policymakers in both countries through policy working groups and conferences. The consortium of institutions conducting these studies includes China's Sichuan University, the State Administration of Taxation, and China Centers for Disease Control and the Chinese Association on Tobacco Control, as well as Tanzania's University of Dar-es-Salaam and the Tanzania Tobacco Control Forum. PUBLIC HEALTH RELEVANCE: This proposed research is relevant to the missions of the National Institutes of Health, Fogarty International Center because it aims to engage in tobacco control research and capacity building to prevent and control smoking-related illnesses. It is anticipated that this research program will improve population health in China and Tanzania.