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Table 7 Second stage filter analysis of a fuel excise taxation intervention

From: Obesity-related health impacts of fuel excise taxation- an evidence review and cost-effectiveness study

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Summary

Decision points

Level of evidence

Quantity and quality of evidence supporting association between fuel price or taxation and AT is limited.

May be effective:

No Level I or II evidence

Modelling based on hypothetical scenario analysis

Weak evidence of effectiveness

Equity

Equity concerns:

Disproportionate effect across low, middle and high-income households. Middle-income households most affected as a proportion of overall weekly household expenditure. High-income households least affected as proportion of overall weekly expenditure.

Evidence suggests that public transport is less accessible for persons with disabilities, the elderly, those living in areas not well-serviced by comprehensive networks and those from disadvantaged backgrounds.

Moderate issue

Acceptability

Would require measures to be put into place to increase acceptability (for instance, revenue reinvestment to deal with potential regressivity and to ensure comprehensive public transport accessibility).

Moderate issue

Feasibility

The intervention is feasible.

The feasibility of modal switch to public transport as a result of the intervention may be limited in rural areas or areas not currently well-serviced by comprehensive public transport networks. A recent Australian survey found that 30% of respondents did not use public transport to work or full-time study due to the fact that no service was available at all, with 5.5% of respondents reporting that services were located too far from home [109].

Not a major issue

Sustainability

The sustainability of effect is relatively unknown.

Consumers may adjust behaviour to price rises over the longer term.

Weak evidence of sustainability

Side-effects

Positive:

Potential for less traffic, pollution, safer environments for pedestrians and cyclists

Negative:

Potential strain on public transport networks

Significant wider positive side-effects

Policy considerations: The intervention demonstrates potential for cost-effectiveness, but is limited in terms of quality of evidence of effect and sustainability. Concerns around equity and acceptability would need to be addressed.