SYNTAX PROJECT: Integrated evidence synthesis for joint appraisal of tobacco and alcohol tax interventions for harm reduction in the UK

Universities of Sheffield and Bath, 2018-2021

both part of the Uk Centre for Tobacco and Alcohol Studies (UKCTAS)


During this 3-year project, funded by the NIHR Public Health Research Programmee, we aim to investigate how tobacco and alcohol taxation can be changed to improve health for all. We will talk with consumers, policymakers and experts and use survey and sales data to look at how tobacco and alcohol tax can work together: to change consumer behaviour and health; to benefit disadvantaged communities; and reduce NHS costs at a time of limited budgets.


One in five adults in the UK smokes and one in five adults drinks alcohol in hazardous or harmful ways. These
‘lifestyle factors’ are leading causes of preventable illness and death, including from heart disease and
cancers. Over 80,000 people a year die earlier than they should from diseases caused by drinking or
smoking. For those who smoke and drink alcohol, the risk of developing these preventable diseases is even
greater. This preventable human loss is compounded by an annual cost to the NHS of over £6 billion.
There is evidence that people buy less cigarettes and alcoholic drinks when the price increases. Health
advocates are therefore calling for higher taxes and changes to tax structures on alcohol and tobacco
products to encourage people to quit smoking and reduce their drinking. However, it is not clear what effect
this would have on tax revenues and the wider economy. There is uncertainty about the effects of tax
increases on smokers and drinkers who are on a low income or unemployed. Consumers can change their
behaviour in response to changes in prices (for example, by switching to cheaper or illegal products).
Uncertainty can also arise because tobacco and alcohol companies and retailers can alter prices to ensure
some products stay affordable despite tax increases. The planned research will address these areas of


The project will involve:

1) A UK-focused rapid review of tobacco and alcohol tax policy options and interviews with taxation
policymakers and experts that capture how they understand and prioritise options for tobacco and alcohol

2) Analysis of social patterns in spending on tobacco and alcohol products using data from the nationally
representative Living Costs and Food Survey.

3) Analysis of how industry and consumers are likely to respond to tax changes using several years of data on
retail prices and consumer spending.

4) A population forecast to estimate how tax options might differ in their effects on consumer spending,
health and health inequalities, costs of ill-health to the NHS, the tax revenue to government and outcomes
to the wider economy in terms of sickness absence from work.


Three established public involvement panels will be involved in the research: smokers; general drinkers; and
people recovering from alcohol dependence or their families. Findings will be communicated direct to these
panels, to taxation policymakers and experts through policy briefings and meetings, and to other scientists
via conferences and journal articles.


As part of the project, in early summer 2018, Dr Jenny Hatchard of the University of Bath and Dr Penny
Buykx of the University of Sheffield will be conducting interviews with stakeholders with knowledge of
tobacco and alcohol tax policy.

We hope to interview experts from HM Treasury, Department of Health, Public Health England, HM Revenue
and Customs, National Institute of Health and Care Excellence, Action on Smoking and Health, Institute of
Alcohol Studies.

Interviews will cover the following questions:

- What options are there for separate and joint tobacco and alcohol taxation for the UK?
- Which policy effects are the most important?
- What additional factors influence policy outcomes?
- How complete is the evidence base for each policy option?

The SYNTAX team will use these interviews to understand how tobacco and alcohol taxation changes take
place, co-exist and interact. Findings will contribute to the SYNTAX project’s development of an effective
tool for estimating how tax options might differ in their effects on: 1) consumer spending; 2) health and
health inequalities; 3) costs of ill-health to the NHS; and 4) tax revenue to the Government.


Please get in touch if you would like to hear more about the project, or participate in the stakeholder

Project Co-ordinators

  • Prof Alan Brennan,
  • Dr Duncan Gillespie,

Stakeholder Interview Team

  • Dr Jenny Hatchard,
  • Dr Penny Buykx,

Others involved in the project

  • Anna Gilmore, Professor of Public Health, Department for Health, University of Bath,
  • Petra Meier, Professor of Public Health, School of Health and Related Research, University of Sheffield,
  • John Holmes, Senior Research Fellow, School of Health and Related Research, University of Sheffield,
  • Colin Angus, Research Fellow, School of Health and Related Research, University of Sheffield,
  • Rosemary Hiscock, Research Associate, Department for Health, University of Bath,
  • Robert Pryce, Research Associate, School of Health and Related Research, University of Sheffield,