Impact case study database

[Letters A to I in square brackets refer to references in Section 5].

Until November 2017, tobacco companies were absorbing taxes on their cheaper cigarettes, while raising the prices of their expensive brands, to cover the tax increases. This meant that cheap tobacco was still available, and the intention of government was thereby defeated – to use pricing as a means of reducing consumption, especially by the young and the poor, and to improve public health.

Between 2011 and 2015, Gilmore and her colleagues regularly took their research findings on tobacco company behaviour to the UK Government.  This led directly to a change in policy in 2017, in the form of a new minimum excise tax (MET), which would directly raise the price of each cigarette.  This has contributed to reducing smoking rates among the young and a stabilisation in the previously widening gap in smoking between rich and poor. These changes are all associated with significant public health benefits.

1. Changing government thinking, policy and legislation: the impact chain from research findings to policy change

Gilmore first presented their preliminary research findings on tobacco industry pricing to a meeting held at Her Majesty’s Treasury (HMT), also involving Her Majesty's Revenue and Customs (HMRC) and Department of Health (DH) civil servants (1 November 2011). Subsequent publications and meetings established a clear case for the introduction of a minimum excise tax (MET) on tobacco and linked efforts helped steer the policy to implementation. In the words of a senior UK civil servant:

“Gilmore and colleagues played a pivotal role in steering and securing the implementation of a Minimum Excise Tax (MET) on cigarettes …. Their work not only made the case for the MET but also made clear the policy was both feasible and would not result in the unintended consequences suggested by the tobacco industry” [see A].

From 2012 onwards, Gilmore and Branston summarised the research findings and the relevant policy recommendations in annual Budget submissions sent to the Treasury . These submissions were prepared by Action on Smoking and Health (ASH), the leading tobacco control NGO in the UK, and the UK Centre for Tobacco Control Studies (UKCTCS, later the UK Centre for Tobacco and Alcohol Studies, UKCTAS) – the UK research consortium of which we were part. They drew extensively on our research [see B]. They were endorsed by up to 80 other public health organisations including the Royal College of Physicians, the Royal College of General Practitioners, Royal College of Radiologists, British Heart Foundation, British Lung Foundation, Cancer Research UK, Faculty of Public Health etc. They were often press released, with Gilmore being cited in 7 ASH press releases from 2013 – 2020 and linked National press coverage in the Guardian in 2015 and 2017 [ see C].

In support of these Budget submissions, Gilmore and/or Branston met annually with a Minister to present their latest research findings on tobacco price and profits [ see E].

All this led to the April 2014 Budget announcing that HMG would consult on a MET. This consultation, run by (HMT), cited and directly reproduced our work [see A and D]. ASH chief executive noted:

“The research by Gilmore et al was included in the consultation on MET carried out by HMT and was instrumental in securing the decision by Government to proceed with the policy” [see E].

The MET was not introduced immediately. Efforts to underline the need for it therefore continued, with University of Bath staff playing a key role. For example, Gilmore and Branston presented the research findings in person to the All-Party Parliamentary Group on Smoking and Health Inquiry. That Inquiry in turn made a representation to the 2015 Comprehensive Spending Review , recommending a MET and referring directly to our presentation contents and citing 6 pieces of our research [see F]. The ASH written submission to the Comprehensive Spending Review made a similar recommendation and again cited our work at references 30 and 31. (These documents promote either a MET (a minimum level of excise duty) or a “ minimum consumption tax” which is almost identical to a MET but includes VAT in addition to a minimum excise duty).

The 2016 Budget announced the introduction of a MET via the 2017 Finance Bill (clause 69), with the MET taking effect from November 2017, once the 2017 Budget had announced the rate of the MET. In the 2018 budget the MET was uprated from GBP5.60 to GBP5.88 (per 20 stick pack), this being the most significant change to tobacco tax policy in that budget . In the 2020 budget, the MET was uprated again, with an increase by retail price index (RPI) plus 2% on all tobacco products, and an increase of RPI plus 6% on hand-rolling tobacco . In the 2018 and 2020 budgets, the MET was uprated in line with recommendations made in the ASH/UKCTAS budget submissions, which again extensively cited Bath’s research [see B].

1. From policy change to reducing smoking among the young and less well off

Our recent research using time series analysis of tobacco sales [see G] shows that the MET has increased the price of the cheapest cigarettes and contributed (alongside standardised packaging of tobacco products) to reductions in cigarette sales. Post-implementation, the average monthly decrease in cigarette stick sales was 20,400,000, almost doubling the pre-legislation rate of decline. In addition, sales of the cheapest factory-made brands, previously increasing, plateaued after implementation, showing a specific impact of the policy on the products it targeted [see G].

MET contributed to reduced tobacco sales overall and to reduced smoking rates, particularly among the young. Thus, UK smoking prevalence has continued to decrease steadily from 20.2% in 2011 to 14.1% in 2019 with the largest reduction among 18- to 24-year olds, from 25.7% to 16.0% (ONS Annual Population Surveys). MET also helped stabilise the previously widening gap in smoking between the most and least well off, with important benefits to health and health inequalities [see G].

1. Stimulating awareness around the world

A senior UK civil servant speaks of “ the importance of Gilmore and colleagues’ work to UK public health and its knock-on impacts for global public health research and practice” [see A].

This impact reflects the extensive efforts of Gilmore, Hiscock and Branston to disseminate the research internationally to academics, policy makers and the public. In addition to the publications and press releases detailed above, they have presented it at numerous international policy conferences [see H] and made the MET research publicly accessible in diverse and easily understandable formats. These include a MET web page on their knowledge exchange platform, TobaccoTactics; and a summary on the website of STOP;), a global tobacco industry watchdog in which TCRG is the research partner.

This work has directly informed and been cited in similar research in other jurisdictions including Indonesia, Bangladesh, Turkey, Taiwan, New Zealand, Mexico, USA, a study on 5 Southeast Asian Countries, and another on 23 European countries. [see I].

As Chief Executive of ASH explains: “ this research on tobacco industry pricing of cigarettes …has stimulated global interest on both the research and policy front … This impact of Bath’s work will only grow over time as more countries seek to address the tobacco industry’s pricing strategies and maximise the impact of tobacco tax policies in reducing tobacco use” [ see E].