Summary

Summary:
Tobacco smoking is the leading epidemic in United States causing 480,000 deaths each year. Tobacco smoking causes 90% of the lung cancer deaths and 80% of chronic obstructive pulmonary disease (COPD). Recent studies have shown that the tobacco smoking can increase the risk of coronary heart diseases by 4 times, stroke by 4 times, lung cancer in men by 25 times and in women by 25.7 times. Smokers are at great risk for the cardiovascular and respiratory diseases. Further, tobacco smoking can lead to increasing the risk of dying with cancer and also risks as preterm delivery, low birth weight during child birth, affect bone health, teeth and gums. Further, smoking is a cause for type 2 diabetes mellitus, rheumatoid arthritis, general adverse effects on body including inflammation and decreased immune function. Furthermore, studies suggest that if nobody smoked 33.33% of death rate because of cancer can be reduced (Centres for Disease Control and Prevention, 2018).
Tobacco smoking is the preventable disease which needs to be curbed at its initiation. Research shows that 9 out of 10 cigarette smokers have tried smoking by age of 18 and 98% by 26. Every day in the United States, more than 3200 adoles (Centres for Disease Control and Prevention, n.d.)cents try their first cigarette and 2100 youth and young adults turn into daily smokers. Owing to the new tobacco flavors and changing trends in tobacco use research shows that 73% of school students and 56% of middle school students have smoked in 2014. There have been many policies in past aimed at curbing the smoking epidemic. Policies include comprehensive smoke-free laws, Cigarette Excise Tax Increases, Smoke-Free Laws for Worksites, Restaurants, and Bars, Smoking Restrictions in U.S. Large-Hub Airports, Use of Tobacco Tax Stamps to prevent and Reduce Illicit Tobacco Trade and the list goes on. These policies have played their roles in the tobacco smoking epidemic.
Although, there have been laws relating to tobacco smoking the prevalence of the tobacco smoking has been observed in other forms as smokeless tobacco, hookahs, electronic cigarettes than just the cigarettes, cigars. The laws have been able to curb percentage of cigarette smoking in future generations as adolescents and youth but, the percentage of electronic cigarettes, hookahs, smokeless tobacco has been rising. Electronic cigarette smoking among middle school students has gone to 3.3% in 2017 compared to .6% in 2011, in High school students it is 11.7% in 2017 compared to 1.5% in 2011.Similarly, hookah smoking percentages in middle school students have gone form 1% in 2011 to 1.4% in 2017, in high school students its 4.1% in 2011 to 3.3% in 2017 (Centres for Disease Control and Prevention, n.d.).
In the attempt of fighting tobacco smoking, the taxes were increased on cigarettes since 1951 till 2018 in notable steps. The 2009 federal excise tax was major in terms of impact and magnitude compared to any other tax increases. For instance, 2009 federal excise tax raised the tax by 158% on 20 pack cigarettes from 39 cents per pack to 100.66 cents per pack (Excise-Taxes, n.d.). The other notable tax increase was 1983 federal cigarette tax increase which doubled the taxes from 8 cents to 16cents per pack. Today the average cost of a pack of cigarette is $6.83 with a 53% of government taxes and fees (Excise-Taxes, n.d.). Not only the federal excise tax, but also state excise tax adds up to increase the average cost of per pack of cigarettes.
This review studies the consolidated effect of tobacco excise tax policy in reducing tobacco smoking among adolescents and youth age group. The impact of tobacco excise tax policy in the smoking initiation is studied. The rise in cigarette prices and the effect in rates of tobacco smoking, other alternatives have been studied. There have been several studies working on the impact of policies in adolescents and youth but, the studies have a mixed results. This review aims to contribute to this specific debate by concentrating on findings in recent studies on impact of the policies in adolescents and utilizing them for future policy making.
METHODS
Keywords: adolescents, Youth, excise tax policy, smoking cessation
OPERATIONAL DEFINITIONS:
The search included keywords as adolescents, youth, excise tax policy and smoking cessation. The operational definition of adolescents as per World Health Organization (WHO) is any person between ages 10 and 19. Similarly, youth has been any person between 15 and 24 as per WHO. Medline plus defines smoking cessation as quitting smoking. We have searched Pubmed databases with no time restriction. We have found 247 papers on the Pubmed and we have gone through the reference articles and similar articles to avoid missing any relevant work. The studies for the review were selected in 3 stages. First, titles and abstracts of the articles were screened to validate the eligibility. Then, the articles meeting the criteria were retrieved as full texts. Finally, the studies that outlined the outcome of interest were chosen for review. This review includes 12 studies based on the inclusion and exclusion criteria mentioned.

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