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Assessing the Impacts of Revising the Tobacco Products Directive

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Assessing the Impacts of Revising the Tobacco Products Directive Assessing the Impacts of Revising the Tobacco Products Directive Study to support a DG SANCO Impact Assessment Final report JAN TIESSEN, PRISCILLIA HUNT, CLAIRE CELIA, MIHALY FAZEKAS, HAN DE VRIES, LAURA STAETSKY, STEPHANIE DIEPEVEEN, LILA RABINOVICH, HELEN RIDSDALE, TOM LING TR- 823-EC September 2010 Prepared for the European Commission Directorate-General for Health and Consumer Protection Preface The European Commission Health and Consumer Directorate-General (DG SANCO) commissioned RAND Europe to provide support in assessing the impacts of revising the Tobacco Products Directive 2001/37/EC. The research conducted by RAND Europe examines the evidence available for the key health, social and economic impacts that could be expected from the implementation of five policy options currently considered by DG SANCO for the revision of the Tobacco Products Directive 2001/37/EC. This research used a variety of qualitative and quantitative methods to assess the economic and health effects of future regulation, including rapid evidence reviews and econometric and health-economic modelling techniques. This report will serve as an input to DG SANCO’s own regulatory impact assessment exercise, which is a mandatory part of the legislative process in the European Union (EU), but the report also provides an up-to-date overview of the evidence and basis for current tobacco product regulation that may be of interest to a wider audience interested in tobacco control policies. RAND Europe’s work is objective, multidisciplinary and based upon the core value of quality. All our products are peer reviewed before final dissemination as part of our quality assurance procedures. For more information about RAND’s quality standards please see http://www.rand.org/standards. For more information about this document or RAND Europe, please contact: Tom Ling RAND Europe Westbrook Centre Milton Road Cambridge CB4 1YG United Kingdom Tel. +44 (1223) 353 329 [email protected] i Assessing the Impacts of Revising the Tobacco Products Directive RAND Europe Contents Preface .......................................................................................................................... i Contents ...................................................................................................................... ii List of figures ............................................................................................................... ix List of tables .............................................................................................................. xiii List of acronyms and abbreviations ........................................................................... xvii Summary ................................................................................................................... xxi CHAPTER 1 Introduction .................................................................................... 1 1.1 The challenge of tobacco ................................................................................... 1 1.2 Tobacco control in the EU ................................................................................ 2 1.3 Tobacco Products Directive 2001/37/EC .......................................................... 3 1.4 RAND Europe’s assignment .............................................................................. 4 1.5 This report ........................................................................................................ 6 CHAPTER 2 Approach and methodology ............................................................. 7 2.1 Approach: supporting an impact assessment ...................................................... 7 2.2 Evidence and literature review ........................................................................... 8 2.2.1 Sources of evidence .............................................................................. 8 2.2.2 Key terms ............................................................................................ 9 2.2.3 Inclusion criteria ................................................................................ 10 2.2.4 Capturing relevant information from the sources identified ............... 10 Qualitative information ................................................................................... 10 Quantitative information ................................................................................ 11 2.3 Modelling of health impacts and healthcare costs ............................................ 11 2.3.1 Data .................................................................................................. 12 2.3.2 Key assumptions of the approach ....................................................... 13 2.3.3 Steps of the approach ......................................................................... 15 2.3.4 Limitations ........................................................................................ 20 2.4 Forecasting future prevalence and modelling macroeconomic impacts ............. 21 2.5 Assessing administrative burden ...................................................................... 23 2.6 Comparing measures and options .................................................................... 26 2.7 Types of impacts assessed ................................................................................ 27 CHAPTER 3 Background for tobacco use and its health effects .......................... 28 ii RAND Europe Content 3.1 Introduction .................................................................................................... 28 3.2 Tobacco use in the EU ..................................................................................... 29 3.2.1 Smoking prevalence is declining in the EU ......................................... 29 3.2.2 Differences among Member States ...................................................... 31 3.2.3 Smoking prevalence among men and women ..................................... 37 3.2.4 Young smokers ................................................................................... 39 3.2.5 Socioeconomic differences .................................................................. 41 3.2.6 Use of different tobacco products ....................................................... 42 3.3 The health effects of tobacco use ...................................................................... 45 3.3.1 Toxicology of tobacco use ................................................................... 45 3.3.2 The link between tobacco use and morbidity and mortality ................ 45 3.3.3 Linking future mortality and morbidity to changes in prevalence ........ 47 3.3.4 Tobacco use and the burden of disease ............................................... 49 3.3.5 The social costs of tobacco use ............................................................ 51 CHAPTER 4 Economic and financial description of the tobacco sector .............. 55 4.1 Value of tobacco industry ................................................................................. 55 4.1.1 The sectors of industry ....................................................................... 55 4.1.2 The value of trade across sectors of the tobacco industry ..................... 58 4.2 Prices ............................................................................................................... 60 4.2.1 Prices of different tobacco products .................................................... 61 4.2.2 Responsiveness of consumers to changes in price ................................ 64 4.2.3 Market structure ................................................................................. 65 4.2.4 Description of the top businesses involved in manufacturing and sales of tobacco products ..................................................................... 67 4.2.5 Gross turnover associated with manufacture, wholesale and retail sale of tobacco products across European countries ............................. 70 4.2.6 Number of enterprises involved in tobacco across European countries ............................................................................................. 71 4.2.7 Employment across European countries ............................................. 72 4.3 Tax rates and revenues in tobacco .................................................................... 73 4.4 Smuggling of tobacco products ........................................................................ 74 CHAPTER 5 Administrative burden of the current tobacco directive .................. 77 5.1.1 Overview of administrative burden for business .................................. 77 5.1.2 Businesses’ administrative burden in labelling tobacco products ......... 78 5.1.3 Businesses’ administrative burden of reporting on tobacco products ............................................................................................. 81 5.1.4 Overview of administrative burden for EU Member States ................. 84 CHAPTER 6 Baseline scenario ............................................................................ 87 6.1 Smoking prevalence ......................................................................................... 87 6.2 Mortality and morbidity .................................................................................. 89 6.3 Healthcare costs: direct and indirect ................................................................. 97 iii Assessing the Impacts of Revising the Tobacco Products Directive RAND Europe 6.4 Employment ................................................................................................
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