Original Article

Early Assessment of Impact of Increased Value Added Tax on Smoking Behaviors and Financing among Adult Smokers in Saudi Arabia

Abstract

Background: Cigarette smoking has been identified as most perilous risk factor for several health ailments. Increased price may discourage smoking habits. There is limited literature available on impact of price rise on smoking behaviors in Saudi Arabia, which is the fourth largest importer of cigarettes and this study assessed the impact of tax increase (in 2020) on smoking behaviors.

Methods: A cross-sectional survey was carried out between July 2021 and December 2021.i.e.one year after new value added tax (VAT) system came into force. Data was collected with 14-item pretested questionnaire from 721 adult smokers in Al-Jouf Region of Saudi Arabia selected through stratified cluster ransom sampling. We measured effects of tax increase on smoking behaviors, its impact on decision to quit and perceived health improvements as outcome variables.

Results: Nearly 40% of the respondents said that increased price lead them to smoke less number of cigarettes per day (P=0.000), decreased smoking improved their health in terms of breathing capacity, mood, ability to exercise and sleep in hierarchy. 67.4% of the participants are currently thinking of quitting smoking due to increased prices (P=0.001) and logistic regression models identified reduced smoking due to tax rise (Odds=5.68), improvement in health (Odds=2.94) and excess spending of above 20% (Odds=1.72) significantly associated with intentions to quit smoking.

Conclusion: Increased price of cigarettes due to VAT significantly decreased smoking behaviors and has impact on smokers’ decision to quit smoking. Future studies needed to assess the long-term effect of increased tax on smoking behaviors and its relapse.

1. Khodadost M, Maajani K, Abbasi-Ghahramanloo A, et al (2020). Preva-lence of Hookah Smoking among Uni-versity Students in Iran: A Meta-Analysis of Observational Studies. Iran J Public Health, 49(1):1-13.
2. Itumalla R, Aldhmadi B (2020). Combating tobacco use in Saudi Arabia: a review of recent initiatives. East Mediterr Health J, 26(7):858-863.
3. Qattan AMN, Boachie MK, Immurana M, Al-Hanawi MK (2021). Socioeconomic Determinants of Smoking in the King-dom of Saudi Arabia. Int J Environ Res Public Health, 18(11):5665.
4. Maziar Moradi-Lakeh, Charbel El Bche-raoui, Marwa Tuffaha, et al (2015). To-bacco consumption in the Kingdom of Saudi Arabia, 2013: findings from a na-tional survey. BMC Public Health, 15: 611.
5. Altowiher NS, Bustami R, Alwadey AM and Alqahtani M (2022). Tobacco Taxation Influences the Smoking Habits of Adult Smokers Attending Smoking Cessation Clinic in Saudi Arabia. Front Public Health, 10:794237.
6. Report on Tobacco Control Program of Ministry of Health In Saudi Arabia. Min-istry of Health, Riyadh. https://www.moh.gov.sa/en/Ministry/Struc-tu-re/Programs/TCP/Pages/Achievements.aspx. Accessed on: 12/1/2021
7. Almutairi KM (2015). Trends in Current Tobacco Use, Smoking Rates and Quit Attempts among Saudi Population dur-ing Periods of 17 Years (1996-2012): Narrative Review Article. Iran J Public Health, 44(2):170-175.
8. Kim Y, Cho WK (2014). Factors Associated with Successful Smoking Cessation in Korean Adult Males: Findings from a National Survey. Iran J Public Health, 43(11):1486-96.
9. Khazaei S, Mohammadian-Hafshejani A, Salehiniya H (2016). Role of Smoking in Lung Cancer in United States. Iran J Pub-lic Health, 45(9):1245-1246.
10. Jha P, Peto R (2014). Global effects of smoking, of quitting, and of taxing to-bacco. N Engl J Med, 370(1):60–8.
11. Omar A. Al-Mohrej, Sara I. AlTraif, Hani M. Tamim, Hana Fakhoury (2014). Will any future increase in cigarette price re-duce smoking in Saudi Arabia? Ann Thorac Med, 9(3): 154–157.
12. Alotaibi HF, Alsanea NA (2022). Impact of taxation policy on tobacco consumption in Saudi Arabia. Ann Saudi Med, 42(1): 1-7.
13. WHO Framework Convention on Tobacco Control. Available at: https://fctc.who.int/who-fctc/overview/history-of-the-who-fctc. Accessed: 10/1/2021
14. VAT guidelines in KSA. Zakat, Tax and Customs authority. Available at: https://zatca.gov.sa/en/HelpCenter/guide-lines/Documents/VAT%20Guideline%20-%20Government%20Bodies.pdf. Ac-cessed on: 20/1/2021.
15. Amin TT, Amr MA, Zaza BO (2011). Psy-chosocial predictors of smoking among secondary school students in AlHassa, Saudi Arabia. J Behav Med, 34(5):339–350.
16. Alghamdi A, Fallatah A, Okal F, et al (2020). Smoking behaviour after enforcement of a 100% tax on tobacco products in Saudi Arabia: a cross-sectional study. East Mediterr Health J. 26(1):39–46.
17. Dorothy S etal Szinaya I, Tomborb, et al (2019). Associations between self-esteem and smoking and excessive alcohol con-sumption in the UK: A cross-sectional study using the BBC UK Lab database. Addict Behav Rep, 10: 100229.
18. Begh, R, Lindson-Hawley N, Aveyard P (2015). Does reduced smoking if you can’t stop make any difference? BMC Med, 13:257.
19. Aljuaid SO, Alshammari SA, Almarshad FA, et al (2020). Taxation and tobacco plain packaging effect on Saudi smokers quit-ting intentions in Riyadh city, Saudi Arabia. Saudi Med J, 41(10):1121-29.
20. Betzner A, Boyle RG, St Claire AW (2016). Price-minimizing behaviors in a cohort of smokers before and after a cigarette tax increase. Int J Environ Res Public Health, 13(6):608.
21. Goodchild M, Zhengb R (2018). Early as-sessment of China’s 2015 tobacco tax increase. Bull World Health Organ, 96(7):506–512.
22. Sharbaugh MS, Althouse AD, Thoma FW, Lee JS, Figueredo VM, Mulukutla SR (2018) Impact of cigarette taxes on smoking prevalence from 2001-2015: A report using the Behavioral and Risk Factor Surveillance Survey (BRFSS). PLoS One, 13(9): e0204416.
23. Zheng Y, Wu Y, Wang M, Wang Z, et al (2020). Impact of a comprehensive to-bacco control policy package on acute myocardial infarction and stroke hospi-tal admissions in Beijing, China: inter-rupted time series study. Tob Control, 30(4): 434-442.
24. Chapter 4. The Health Benefits of Smoking Cessation. United States Public Health Service Office of the Surgeon General; National Center for Chronic Disease Prevention and Health Promotion (US) Office on Smoking and Health. Wash-ington (DC): US Department of Health and Human Services; 2020.
25. Hahn EJ, Ickes MJ, Wiggins A, et al (2019). Short- and Long-Term Effects of a To-bacco-Free Executive Order on Em-ployee Tobacco Use. Policy Polit Nurs Pract, 20(2):74-81.
26. Lee EJ (2020). Long-Term Effects of Smok-ing Cessation on Depressive Symptoms, Resilience, Coping Skills, and Serotonin. Psychiatr Q, 91(2):263-271.
Files
IssueVol 52 No 10 (2023) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/ijph.v52i10.13845
Keywords
Cigarette Increased price Smoking cessation Taxation Saudi Arabia

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Vundavalli S, Alarjan ABR, Doppalapudi R, Prabhu N, Issrani R, Aljunaydi NA, Nadeem Baig M. Early Assessment of Impact of Increased Value Added Tax on Smoking Behaviors and Financing among Adult Smokers in Saudi Arabia. Iran J Public Health. 2023;52(10):2073-2082.