Health, Nutrition, and Population
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Health, Nutrition, and Population
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Last updated January 31, 2023
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Publication(World Bank, Washington, DC, 2008-03) Iglesias, Roberto ; Jha, Prabhat ; Pinto, Márcia ; Costa e Silva, Vera Luiza da ; Godinho, JoanaAvailable evidence indicates that there was a significant decline in smoking in Brazil between 1989 and 2006. About two decades ago, the government launched a tobacco control program, with a marked acceleration of efforts since 1990, focusing on non-price interventions such as bans on advertising, restrictions on smoking in public places, and other activities. Although the Brazil tobacco control program is considered one of the most comprehensive in the developing world, no formal evaluation has been carried out. A recent study assessed the smoking situation in Brazil and the role of the tobacco control program, and compared it to experience in other countries. The study assessed key trends in smoking rates and lung cancer in Brazil, and reviewed price and non-price interventions. A discussion of fiscal instruments and smuggling is also included in the report. The study found that a 10 percent increase in smoking restrictions (legal and other restrictions), will reduce consumption by 2.3 percent in the long term, a 10 percent price increase will reduce consumption by about 4.8 percent in the long-term. The study shows that an increase of 72 percent in the cigarette specific tax will increase prices by about 14 percent, decrease consumption per adult 7 percent, and increase fiscal income from tobacco by 60 percent. Econometric studies, such as those included in this report, may contribute to appraise policy impact on public health. Analyzes of the costs of smoking to households the health system, labor market, and the economy, as well as the impact of price and tax increases on smoking habits, and on the burden of disease, will provide useful contributions for further development of public policy in this area.
Sin Tax Reform in the Philippines: Transforming Public Finance, Health, and Governance for More Inclusive Development(Washington, DC: World Bank, 2016-07-06) Kaiser, Kai ; Bredenkamp, Caryn ; Iglesias, RobertoExcise taxes on tobacco and alcohol products can be an effective instrument for promoting public health through curbing smoking and excessive drinking, while raising significant revenues for development priorities. In 2012, the Philippines successfully passed a landmark tobacco and alcohol tax reform—dubbed the “Sin Tax Law.” This book describes the design of the Philippines sin tax reform, documents the technical and political processes by which it came about, and assesses the impact that the reform has had after three years of implementation.
Learning from the Mexican Experience with Taxes on Sugar-Sweetened Beverages and Energy-Dense Foods of Low Nutritional Value: Poverty and Social Impact Analysis(World Bank, Washington, DC, 2016-06) Bonilla-Chacin, Maria Eugenia ; Iglesias, Roberto ; Suaya, Agustina ; Trezza, Claudia ; Macías, ClaudiaFaced with a large and increasing obesity epidemic, the Mexican Government in the last years has increased efforts to prevent and control it. In October 2013, Mexico’s Congress passed legislation imposing taxes on sugar-sweetened beverages (SSBs) and calorie-dense foods of low nutritional value. These taxes were part of a comprehensive strategy to prevent and control obesity, overweight and diabetes. In addition to fiscal policy and regulation, this strategy included other health promotion and prevention interventions as well as measures to ensure better access to effective health care services. The decision to implement this fiscal policy was the result of a long advocacy process in which different actors participated, including civil society organizations and government agencies, which provided needed evidence on the status of the epidemic and options to fight against it. The taxes were designed to avoid, as much as possible, the substitution of consumption of the taxed goods for other unhealthy foods and beverages not subject to taxation. These taxes have been successful in increasing both the fiscal revenues and the price of the products taxed. There is also evidence that they have reduced consumption, particularly of SSBs. The taxes seem to have the highest impact among people in the poorest quintiles of the income distribution, who had experienced the highest increase in consumption of the goods under taxation in the last years. A debate remains on the actual impact of the taxes, particularly on health outcomes. Thus it is important to continue monitoring the impact of the taxes through the development of price and volume indicators, based on publicly available data, as well as health outcome indicators.
Publication(World Bank, Washington, DC, 2007-08) Iglesias, Roberto ; Jha, Prabhat ; Pinto, Márcia ; da Costa e Silva, Vera Luiza ; Godinho, JoanaThe objective of this study was to assess the smoking situation in Brazil, and the role of the tobacco control program, and compare it to experience in other countries. The study assessed key trends in smoking rates and lung cancer in Brazil, and reviewed price and non-price interventions. A discussion of fiscal instruments and smuggling is also included in this report. This study aimed at further evaluating the smoking situation in Brazil, the role of the tobacco control program in the country, and compares it to global best practice and experience in other countries. The study report is structured into three main parts: in the first chapter, trends in smoking prevalence, consumption, and cigarette expenditures in Brazil are reviewed, including the illegal market; in the second chapter, trends in lung cancer mortality and health care costs of smoking-related diseases in the country are analyzed; in the third chapter, non-price and price interventions are reviewed, including those taken by the Brazil tobacco control program, as well as the impact increases in cigarette prices and taxes would have on smoking prevalence and tax revenue. The report concludes with recommendations for further action to protect the Brazilian population from premature death and disease caused by smoking, and to reverse the negative impact of smoking on public expenditures.