Key factors in achieving increased tobacco taxation: Experience from the island of Saint Helena
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Health Directorate, Saint Helena Government, Jamestown, Saint Helena
WHO FCTC Secretariat Knowledge Hub on Taxation, South Africa National Department of Health, Cape Town, South Africa
School of Economics and Finance, University of the Witwatersrand, Johannesburg, South Africa
Angela Jackson-Morris   

Health Directorate, Saint Helena Government, Jamestown, Saint Helena
Publication date: 2020-06-16
Submission date: 2020-02-26
Final revision date: 2020-04-17
Acceptance date: 2020-05-14
Tob. Prev. Cessation 2020;6(June):38
Concerted efforts by government officials and technical assistance from the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) Secretariat Knowledge Hub on Tobacco Taxation and Illicit Trade, resulted in an increase in tobacco taxation in Saint Helena during 2019. This formed part of a broader package of Tobacco Control measures to reduce the burden of noncommunicable diseases (NCD) on the island. We elaborate on key contextual and contributing factors that resulted in positive policy change in a relatively short period of time. These included political support for a strategic approach to address prevalent NCD in the context of an ageing population, high overseas health care costs and Overseas Development Aid dependency. Previous experience of impact from sugar-sweetened beverage taxation when combined with wider system measures, and the similar accompaniment of the tobacco taxation proposals with wider measures, encouraged policymakers to use tobacco taxation to curb cigarette consumption. These factors created readiness, and tailored technical assistance from an international, donor-funded partner and specifically modelling to provide evidence-based predictions of impact augmented confidence of policy benefit and enabled passage. This experience may serve as a point of reference for other countries that wish to implement similar policy changes.
Our thanks to Members of the Public Health Committee of the Saint Helena Government (SHG), who championed the tobacco taxation proposals, and to the SHG Finance and Statistics teams who provided data and support to the proposals.
The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none was reported.
The WHO FCTC Knowledge Hub on Tobacco Taxation and Illicit Trade receives funding from Cancer Research UK (Grant number: C62640/ A24723).
Not commissioned; externally peer reviewed.
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