{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T18:32:36Z","timestamp":1787164356999,"version":"build-2736575974"},"update-to":[{"DOI":"10.12688\/gatesopenres.13051.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2020,4,28]],"date-time":"2020-04-28T00:00:00Z","timestamp":1588032000000}}],"reference-count":34,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2020,4,28]],"date-time":"2020-04-28T00:00:00Z","timestamp":1588032000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004421","name":"World Bank Group","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004421","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP51447"],"award-info":[{"award-number":["OPP51447"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["gatesopenresearch.org"],"crossmark-restriction":false},"short-container-title":["Gates Open Res"],"abstract":"<ns5:p>\n                    <ns5:bold>Background:<\/ns5:bold>\n                    Vietnam had about 15 million male smokers in 2015. To reduce adult tobacco use in Vietnam through an increase in the excise tax of cigarettes, we conducted an extended cost-effectiveness analysis to examine the impact of two scenarios of cigarette price increases.\n                  <\/ns5:p>\n                  <ns5:p>\n                    <ns5:bold>Methods:<\/ns5:bold>\n                    We estimated, across income quintiles, the life-years gained, treatment cost averted, number of men avoiding catastrophic health expenditure and extreme poverty, and additional tax revenue under a 32% and a 62% increase in cigarette price through increased excise tax. We considered only male smokers as they constitute majority of the smokers. We used the average price elasticity of demand for cigarettes in Vietnam of -0.53.\n                  <\/ns5:p>\n                  <ns5:p>\n                    <ns5:bold>Results:<\/ns5:bold>\n                    Under both scenarios of price increase, men in the poorest quintile would gain about 2.8 times the life-years and avert 2.5 times the treatment cost averted by the richest quintile. With a 32% price increase, about 285,000 men would avoid catastrophic health expenditure; as a result, about 95,000 men, more than half of whom in the poorest quintile, would avoid falling into extreme poverty. In contrast to the distribution of health benefits, the extra revenue generated from men in the richest quintile would be 1.2 times that from the poorest quintile. With a 62% price increase, about 553,000 men would avoid catastrophic health expenditure, and about 183,000 men, more than half of whom in the poorest quintile, would avoid falling into extreme poverty. The extra revenue generated from men in the richest quintile would be 3.8 times that from the poorest quintile.\n                  <\/ns5:p>\n                  <ns5:p>\n                    <ns5:bold>Conclusions:<\/ns5:bold>\n                    Higher cigarette prices would particularly benefit the poorest income quintile of Vietnamese, in terms of health and financial outcomes. Thus, tobacco taxes are an effective way to improve health and reduce poverty in Vietnam.\n                  <\/ns5:p>","DOI":"10.12688\/gatesopenres.13051.2","type":"journal-article","created":{"date-parts":[[2020,4,28]],"date-time":"2020-04-28T10:45:07Z","timestamp":1588070707000},"page":"1516","update-policy":"https:\/\/doi.org\/10.12688\/gatesopenres.crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Impact of cigarette price increase on health and financing outcomes in Vietnam"],"prefix":"10.12688","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6700-9996","authenticated-orcid":false,"given":"Daphne C.","family":"Wu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prabhat","family":"Jha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheila","family":"Dutta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricio","family":"Marquez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2560","published-online":{"date-parts":[[2020,4,28]]},"reference":[{"key":"ref-1","article-title":"Global Adult Tobacco Survey (GATS) Vietnam 2010","year":"2010"},{"key":"ref-2","article-title":"Tobacco taxes in Viet nam. Questions and answers","year":"2018"},{"key":"ref-3","article-title":"Viet nam \u2013 first comprehensive tobacco control law adopted","year":"2013"},{"key":"ref-4","article-title":"Global Adults Tobacco Survey, Viet nam 2015","year":"2016"},{"key":"ref-5","doi-asserted-by":"publisher","first-page":"k1162","DOI":"10.1136\/bmj.k1162","article-title":"The health, poverty, and financial consequences of a cigarette price increase among 500 million male smokers in 13 middle income countries: compartmental model study.","volume":"361","year":"2018","journal-title":"BMJ."},{"key":"ref-6","article-title":"WHO framework convention on tobacco control. 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Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/gatesopenresearch.org\/articles\/3-1516\/v2\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/gatesopenresearch.org\/articles\/3-1516\/v2\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/gatesopenresearch.org\/articles\/3-1516\/v2\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,5,11]],"date-time":"2020-05-11T05:45:12Z","timestamp":1589175912000},"score":1,"resource":{"primary":{"URL":"https:\/\/gatesopenresearch.org\/articles\/3-1516\/v2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,4,28]]},"references-count":34,"URL":"https:\/\/doi.org\/10.12688\/gatesopenres.13051.2","relation":{"has-review":[{"id-type":"doi","id":"10.21956\/gatesopenres.14315.r28807","asserted-by":"subject"},{"id-type":"doi","id":"10.21956\/gatesopenres.14315.r28807","asserted-by":"object"},{"id-type":"doi","id":"10.21956\/gatesopenres.14315.r28809","asserted-by":"object"}]},"ISSN":["2572-4754"],"issn-type":[{"value":"2572-4754","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,4,28]]},"assertion":[{"value":"Indexed","URL":"https:\/\/gatesopenresearch.org\/articles\/3-1516\/v2#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.21956\/gatesopenres.14178.r27684, Nigar Nargis, Economic and Health Policy Research, American Cancer Society, Washington, DC, USA, 10 Sep 2019, version 1, 3 approved with reservations","URL":"https:\/\/gatesopenresearch.org\/articles\/3-1516\/v1#referee-response-27684","order":0,"name":"referee-response-27684","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/gatesopenres.14315.r28807, Guillermo Paraje, Business School, Universidad Adolfo Ib\u00e1\u00f1ez, Santiago, Chile, 11 May 2020, version 2, indexed","URL":"https:\/\/gatesopenresearch.org\/articles\/3-1516\/v2#referee-response-28807","order":1,"name":"referee-response-28807","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/gatesopenres.14178.r27815, Alfred Kechia Mukong, Department of Economics, University of Namibia, Windhoek, Namibia, 01 Nov 2019, version 1, 3 approved with reservations","URL":"https:\/\/gatesopenresearch.org\/articles\/3-1516\/v1#referee-response-27815","order":2,"name":"referee-response-27815","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Daphne C. Wu<\/b>; \n<i>Posted: 16 Apr 2020<\/i>;  Using the overall average price elasticity of demand for cigarettes across the income quintile reduces the validity for comparing the estimates across the different income quintiles. It is evidence that the price elasticity of demand for cigarettes is generally different across the different income quintile. As a solution, you either estimate price elasticities by income quintile or take average elasticity for each quantile, if such elasticities exist for Vietnam. \n<i>Response<\/i>- For those in the bottom and top income groups, we used the price elasticities of -0.85 and -0.35 respectively, as reported by Kinh and colleagues in Vietnam (please see page 5). The authors highlighted that the paper is part of the effort of the World Bank Global Tobacco Control Program to inform the government of Vietnam on the estimated impact of cigarette price increase across five income groups. Assuming demands elasticities are equal across the five groups when they are not in really therefore provide misleading estimates. The authors need to think critically on how to address this problem. \n<i>Response-<\/i> We used different price elasticities for those in the top and bottom income quintile (please see our response to comment 1 above).&nbsp; Another challenge is assuming levels of educations as proxies for income groupings. The fact that the prevalence of tobacco use is similar when classified by income quintiles and education levels, does not mean the level of responsive to price will be similar too. If this is the case then education level will not be a good proxy for income group, hence the estimates in the paper are far from valid. Is it possible to compute price elasticity by educational attainment in Vietnam for consistency of the analysis in this paper (since education level is used as a proxy for income)?&nbsp;\n<i>Response- <\/i>As mentioned in the Discussion section, one of the limitations of our study is the assumption on price elasticity. Most studies examining the price elasticity of cigarette demand in Vietnam reports the price elasticity by income groups, and due to data limitations, we are not able to compute the price elasticity by education level. However, as our sensitivity analysis shows, variation in elasticity did not significantly change our overall conclusions. Another concern is the use of the price of the most-sold brand of cigarettes in Vietnam. What share of the market for cigarette does this brand occupy? If this is less than 80%, then the average price of cigarettes sold in Vietnam will be more appropriate than the price of the most sold brand. If the price most-sold brand of cigarettes is not the lowest, such a policy change may see consumers moving for the high priced brand to the low priced brands (not necessary reducing or quitting or reducing consumption of cigarettes).\n<i>Response-<\/i> We have added this as a limitation of our study. The average income in each quintile is used and obtained from Statistical Yearbook of Vietnam 2016. If education level is used as a proxy for income quintile, then for consistency, the income for each education level should be considered.&nbsp;\n<i>Response- <\/i>Due to data limitations, we could not obtain the income by education level. We have added this as a limitation of our study. The paper assumes two scenarios \u2013 scenario A considers a 32% increase in price and scenario B considers a 62% increase in price. However, there are no discussions to justify the choice of the different scenarios. If it is what the government of Vietnam intend to do then the authors need to clearly state this in the work.&nbsp;\n<i>Response- <\/i>We have added this to the Methods section. In the abstract, it is stated that Vietnam has over 15 million male smokers but in the study population section, the authors argued that their focus is on male smokers aged 15 years and older, because males comprised the vast majority of cigarette smokers in Vietnam (about 12.1 million out of 12.4 million overall). There is not information about the 2.9 million of the 15 million. What do the smoke? Or are they less than 15 years. This need to be made clear.&nbsp;\n<i>Response- <\/i>We have now corrected this. A total of about 15.2 million men smoked tobacco in Vietnam in 2015: about 12.1 million (out of 12.4 million cigarette smokers) are males (or 98% of total cigarette smokers); about 3.1 million men smoked hand-rolled tobacco, traditional bamboo waterpipe, shisha waterpipe, pipe, cigars\/cheroots\/cigarillos, and other forms of smoking tobacco.","URL":"https:\/\/gatesopenresearch.org\/articles\/3-1516\/v2#referee-comment-3312","order":3,"name":"referee-comment-3312","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"This study was funded by the Bill & Melinda Gates Foundation [OPP 51447] and the World Bank Group Global Tobacco Control Program.","order":4,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}