{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T17:08:28Z","timestamp":1779469708058,"version":"3.53.1"},"reference-count":80,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T00:00:00Z","timestamp":1763683200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Bernard Lown Scholars in Cardiovascular Health Program"},{"name":"Harvard T.H Chan School of Public Health"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,22]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Tobacco use is a major global health risk, causing over eight million deaths annually. The World Health Organization Framework Convention on Tobacco Control requires member countries to adopt a raft of comprehensive policy measures, including taxation. In India, 28% of adults consume tobacco, with a high prevalence of both combustible and smokeless forms, contributing to a substantial health burden. To inform tobacco tax policy in India, we estimated the potential impact of taxation on lowering the prevalence of use and the associated health and economic burden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We employed a Markov probabilistic microsimulation to simulate the impact of increasing tobacco taxes on tobacco-related diseases, healthcare costs, productivity losses, and quality of life over a lifetime horizon.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Combustible tobacco use in India is responsible for ~922\u2009000 deaths and 8.9 million disease events annually. Smokeless tobacco (SLT) contributes to 165\u2009000 deaths and 400\u2009000 disease events. The economic burden of direct and indirect costs is substantial: INR 3.56 trillion for combustible tobacco and INR 358 billion for SLT. Increasing tobacco taxes by 50% could avert 1.8 million deaths (~9.8% of tobacco-attributable deaths over 10\u00a0years), 66.8 million healthy life-years lost, and provide economic benefits exceeding INR 11.9 trillion over 10\u00a0years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Tobacco use remains a major health and economic burden in India. Both combustible and SLT cause high mortality and morbidity. Taxation emerges as a potentially effective tool to reduce deaths, life years lost, and economic losses, with economic benefits reported exclusive of additional tax revenue.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications<\/jats:title>\n                    <jats:p>Our study adds to the existing body of evidence by providing a detailed, India-specific analysis that distinguishes between the health and economic impacts of combustible versus smokeless tobacco. We estimated the disease burden and economic costs attributable to each form of tobacco and projected the potential benefits of increased tobacco taxation. Our findings show that a 50% increase in tobacco taxes could prevent 1.8 million deaths and save nearly INR 11.9 trillion over 10\u00a0years. This study uniquely quantifies the differential impacts of various tobacco products and offers robust evidence to support targeted tobacco control policies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ntr\/ntaf242","type":"journal-article","created":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T12:46:51Z","timestamp":1763470011000},"page":"925-934","source":"Crossref","is-referenced-by-count":1,"title":["Estimating the Expected Health and Economic Benefits of Price Increases Via Taxation to Counter the Dual Combustible and Smokeless Tobacco Epidemics in India"],"prefix":"10.1093","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4437-0073","authenticated-orcid":false,"given":"Ariel","family":"Bardach","sequence":"first","affiliation":[{"name":"Institute for Clinical Effectiveness and Health Policy (IECS) , Buenos Aires ,","place":["Argentina"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aswathy","family":"Sreedevi","sequence":"additional","affiliation":[{"name":"Amrita Institute of Medical Sciences (AIMS) , Kochi, Kerala ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6277-2469","authenticated-orcid":false,"given":"Juan M","family":"Sambade","sequence":"additional","affiliation":[{"name":"Institute for Clinical Effectiveness and Health Policy (IECS) , Buenos Aires ,","place":["Argentina"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emiliano","family":"Navarro","sequence":"additional","affiliation":[{"name":"Institute for Clinical Effectiveness and Health Policy (IECS) , Buenos Aires ,","place":["Argentina"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G K","family":"Mini","sequence":"additional","affiliation":[{"name":"Global Institute of Public Health (GIPH), Ananthapuri Hospitals and Research Institute (AHRI) , Thiruvananthapuram, Kerala ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Radhakrishnan","family":"Jayakrishnan","sequence":"additional","affiliation":[{"name":"Regional Cancer Centre , Trivandrum, Kerala ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Estefania","family":"Capriata","sequence":"additional","affiliation":[{"name":"Institute for Clinical Effectiveness and Health Policy (IECS) , Buenos Aires ,","place":["Argentina"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aparna","family":"Ajay","sequence":"additional","affiliation":[{"name":"Amrita Institute of Medical Sciences (AIMS) , Kochi, Kerala ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vishnu B","family":"Menon","sequence":"additional","affiliation":[{"name":"Amrita Institute of Medical Sciences (AIMS) , Kochi, Kerala ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0066-8583","authenticated-orcid":false,"given":"Pranil M S","family":"Pradhan","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Institute of Medicine, Tribhuvan University ,","place":["Nepal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Esp\u00ednola","sequence":"additional","affiliation":[{"name":"Institute for Clinical Effectiveness and Health Policy (IECS) , Buenos Aires ,","place":["Argentina"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Alcaraz","sequence":"additional","affiliation":[{"name":"Institute for Clinical Effectiveness and Health Policy (IECS) , Buenos Aires ,","place":["Argentina"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Augustovski","sequence":"additional","affiliation":[{"name":"Institute for Clinical Effectiveness and Health Policy (IECS) , Buenos Aires ,","place":["Argentina"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vaughan W","family":"Rees","sequence":"additional","affiliation":[{"name":"Department of Social and Behavioral Sciences, Center for Global Tobacco Control, Harvard T.H. 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