Tobacco Control Policy Analysis & Intervention Evaluation in China and Tanzania

描述(申请人提供)：根据《世界卫生组织烟草控制框架公约》(《烟草控制框架公约》)，有两个主要战略来控制烟草使用：价格控制(税收/价格)和非价格控制(无烟公共场所、健康警告等)。这项建议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管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，该市于2011年5月颁布了室内公共场所禁烟规定。在本次资助下，我们的研究团队在中国关于烟草产品供求的经济分析和提高额外烟草税的合理性的建议方面取得了进展。然而，对2009年实行的税收调整的影响分析表明，有效利用这一价格控制措施存在许多障碍。这项竞争性续期赠款建议进行后续的税收政策相关分析，以解决这些障碍。政府还提出了一项针对特定消费税增加的试点试验，以及一项关于烟草相关疾病对政府农村医疗支出影响的研究。该提案还包括评估一项非价格措施，即2011年关于无烟室内公共场所的规定，以评估社区对健康风险的了解和对此类规定的支持。通过专业接触，坦桑尼亚达累斯萨拉姆大学与我们的研究团队接洽，将我们的研究经验和能力建设从中国扩展到坦桑尼亚：烟草产品的需求和供应，以便为坦桑尼亚政府实施烟草控制提供理由。如果得到资助，我们在坦桑尼亚的研究团队的工作将是开创性的，并将为该国的烟草控制研究奠定基础。这一竞争更新有以下目标：1)在四个领域继续中国烟草控制研究：监测和评估2009年烟草税调整；开发烟草税试点试验；研究吸烟对政府农村医疗支出的影响；以及评估2011年5月无烟公共场所法规的影响。2)在三个领域开展坦桑尼亚烟草控制研究：吸烟的经济成本；卷烟需求分析，以模拟税收对消费和政府收入的影响；以及研究烟草种植的经济回报。3)中国和坦桑尼亚控烟科研人员的能力建设。4)通过政策工作组和会议让两国的政策制定者参与进来。开展这些研究的机构包括中国的四川大学、国家税务总局、中国疾病控制中心和中国烟草控制协会，以及坦桑尼亚的达累斯萨拉姆大学和坦桑尼亚烟草控制论坛。 公共卫生相关性：这项拟议的研究与国家卫生研究院、福格蒂国际中心的任务相关，因为它旨在从事烟草控制研究和能力建设，以预防和控制与吸烟有关的疾病。预计这项研究计划将改善中国和坦桑尼亚的人口健康。

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.