吸烟与贫困：健康效应与挤出效应分析

Poverty is the short stave. To build a moderately well-off society in all-around way we should put forth efforts to lengthen it. There are many reasons leading to poverty, disease risk is more serious. About 42% rural households are impoverished from medical expenses. Dietary composite factor, high blood pressure and smoking are the three major risk factors for deaths and diseases. Some research had found that the excessive medical spending attributable to smoking and the consumption spending on cigarettes may have caused the poverty rate to increase. But they did not reveal the causal relationship between smoking and poverty. Sustainable livelihood analysis frameworks would be employed to build a new framework on smoking and poverty analysis. A variety of methods is going to be used to build econometrics models and mathematical models to estimate all the economic costs attributable to smoking, including two-step model, quadratic almost ideal demand system, logistic model for panel data, full income approach, focus group discussion and in-depth interview, etc. The influence of economic burden of disease attributable to smoking on China’s economy and family economy will be discovered. Tobacco consumption crowds-out consumption of basic needs will be examined. The income poverty and capability poverty caused by smoking should be measured. Panel data will be utilized to fitting econometric model to identify the causal relationship between smoking and poverty. The short-term and long-term effects of smoking on poverty will be evaluated dynamically. Based on the empirical research and qualitative research evidence, the project aims to carry out our suggestions on tobacco control strategies and taking targeted measures for poverty alleviation which principle is the policies should be suitable to local conditions, to local people and to the type of poverty.

贫困是全面建成小康社会最大的短板。导致贫困的原因很多，因病致贫比例高达42%。吸烟、膳食因素和高血压是引起人群发病和死亡的三大危险因素。已有研究测算了吸烟的直接支出和吸烟有关疾病医疗费用支出带来家庭收入降低，但未能揭示吸烟与贫困之间的因果关系。本研究运用可持续生计分析框架理论构建吸烟与贫困的分析框架，集成两步模型，二次近似理想需求系统模型，面板数据logistic模型，全收入法，焦点小组讨论以及深入访谈等方法构建计量经济学和数学模型，全面梳理吸烟带来的经济损失。揭示归因于吸烟的疾病经济负担对社会和家庭经济的影响，吸烟对家庭物品消费的挤出效应；描述吸烟行为后果导致的收入贫困和因收入获取能力降低而带来的能力贫困；采用面板数据微观验证吸烟与贫困的因果关系，动态评价吸烟对贫困的短期和长期影响。为国家从控制烟草危害角度制定出因人因地施策，因贫困原因施策，因贫困类型施策的精准扶贫政策提供科学依据。

贫困是全面建成小康社会最大的短板，导致贫困的原因很多，因病致贫比例高达42%。烟草是引起人群发病和死亡的危险因素之一，中国作为世界上最大的烟草生产、制造和消费国，降低吸烟率不仅是公共卫生关注的问题，也是与减少贫困密切相关的问题。本研究通过采用疾病别法和全病因法估算归因于吸烟的疾病经济负担，综合评价吸烟对社会造成的经济损失,分析和测算了各吸烟相关疾病的疾病经济负担；采用面板logistic模型和面板Tobit模型分别分析吸烟对中国家庭灾难性卫生支出以及强度的影响，评估吸烟给家庭带来的经济风险，探究吸烟对家庭经济的影响；采用Hausman-Taylor模型和面板随机效应模型分析不同吸烟状态对居民个人收入的影响，观察贫困发生率的变化。通过量化吸烟对社会、家庭和个人经济状况的影响，全面梳理吸烟带来的经济损失，让政府和公众多角度、多层次了解吸烟带来的危害，为政府进一步制定和完善烟草相关控制策略和措施提供支持，也将为政策制定者把控政策的调控力度提供决策依据。

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