Mapping alcohol and tobacco tax policy interventions to inform health and economic impact analyses: A United Kingdom based qualitative framework analysis

Jenny Hatchard, Penny Buykx, Luke Wilson, Alan Brennan, Duncan Gillespie

Research output: Contribution to journalArticlepeer-review


Background: Alcohol and tobacco have different policy regimes and there is little understanding of how changes to policy on each commodity might combine to affect the same outcomes or to affect people who both drink and smoke. The aim of this study was to deepen understanding of the policy objectives of UK alcohol and tobacco tax options being considered at the time of the interviews with a set of UK policy participants in 2018, and the factors affecting the implementation and outcomes of the policy options discussed. Methods: Ten tax policy experts were recruited from government arms-length organisations and advocacy groups in England and Scotland (4 alcohol, 4 tobacco, 2 alcohol and tobacco). Alcohol and tobacco experts were interviewed together in pairs and asked to discuss alcohol and tobacco tax policy objectives, options, and the mechanisms of effect. Interviews were semi-structured, supported by a briefing document and topic guide, audio-recorded, transcribed and then analysed deductively using framework analysis. Results: Alcohol and tobacco tax policy share objectives of health improvement and there is a common set of policy options: increasing duty rates, duty escalators, multi-rate tax structures, industry levies and the hypothecation of tax revenue for investment in societal benefits. However, participants agreed that the harms caused by alcohol and tobacco and their industries are viewed differently, and that this influences the impacts that are prioritised in tax policymaking. Working-out how alcohol and tobacco taxes could work synergistically to reduce health inequalities was seen as desirable. Participants also highlighted the importance of avoiding the combined effects of price increases on alcohol and tobacco widening economic inequalities. Conclusions: Impact analyses should consider the combined effects of alcohol and tobacco tax policies on health and economic inequalities, and how the effects of changes to the tax on each commodity might trade-off.

Original languageEnglish
Article number104247
JournalInternational Journal of Drug Policy
Early online date6 Nov 2023
Publication statusPublished - 31 Dec 2023

Bibliographical note

Funding Information:
This project is funded by the National Institute for Health and Care Research (NIHR) under its Public Health Research programme (Project Ref 16/105/26 ). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. DG and AB are members of SPECTRUM a UK Prevention Research Partnership Consortium. UKPRP is an initiative funded by the UK Research and Innovation Councils, the Department of Health and Social Care (England) and the UK devolved administrations, and leading health research charities.

Our thanks to the wider SYNTAX project team and advisory board for their input to this research. We would also like to thank the organisers and members of the three public involvement panels attended. The authors thank John Holmes for comments to improve the manuscript. For the purpose of open access, the author has applied a Creative Commons Attribution (CC BY) licence to any Author Accepted Manuscript version arising.


  • Commercial determinants of health
  • Public health
  • Unhealthy commodities

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Health Policy


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