[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-detail-108817-en":3,"doc-seo-108817-105":29,"detail-sidebar-cat-0-en-105":91},{"code":4,"msg":5,"data":6},0,"success",{"doc_id":7,"user_id":8,"nickname":9,"user_avatar":10,"doc_module":4,"category_id":11,"category_name":12,"doc_title":13,"doc_description":14,"doc_content":15,"file_id":16,"file_url":17,"file_type":18,"file_size":19,"view_count":20,"is_deleted":4,"is_public":21,"is_downloadable":21,"audit_status":21,"page_count":11,"language":22,"language_code":23,"site_id":24,"html_lang":23,"table_of_contents":25,"faqs":26,"seo_title":13,"seo_description":14,"update_tm":27,"read_time":28},108817,2336464648746,"Skyler","https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c",8,"Research & Report","Policy Note - Key Findings from the NCD Taxation Evaluation - Report Highlight","Noncommunicable diseases (NCDs) are a major driver of premature death and disability in Tonga, with most adults aged 25–64 facing moderate to high NCD risk. Rising behavioral risk factors—smoking, unhealthy diets, harmful alcohol intake, and physical inactivity—contribute to this burden, alongside unhealthy environments. In response, Tonga introduced NCD-focused taxation, including a near-50% increase in excise tax on imported manufactured cigarettes in July 2016. The evaluation assesses behavioral change, revenue-related monitoring, and policy recommendations using mixed quantitative and qualitative methods.","Public Disclosure Authorized Public Disclosure Authorized Public Disclosure Authorized Public Disclosure Authorized  \nCurrent state of health in Tonga  \nTonga has experienced a high burden of noncommunicable diseases (NCDs) in the past two decades. Data indicates the continuing rise of four major NCDs – cardiovascular disease, diabetes, cancer, and respiratory diseases – as the leading causes of premature death and disability. Currently NCDs accounted for four out of five leading causes of mortality in Tonga, and 99.9 percent of Tongan adults aged 25–64 are at moderate to high risk of developing an NCD.  \nThe increase in behavioral-related risk factors such as smoking, poor diet (e.g. high in sugar, salt, trans-fat and saturated fat, and low in fruit, vegetables, legumes, fish etc.), harmful alcohol intake, and physical inactivity are acknowledged as the major contributing factors to the rise in NCDsin Tonga. According to its 2012 STEPS Survey, Tonga has one of the highest rates of overweight and obesity (≥25 kg/m2) in the world – reaching 90.7 per cent among some population groups. Both obesity and overweight are common at younger ages. Furthermore, almost one in two men smoke, which is one of the highest rates in the Pacific; and smoking appears to be increasing among young women. These are all strongly linked to “unhealthy environments”, and require upstream approaches such as policies, regulations and legislation interventions that influence these behavioral risk factors, among others.  \nIn response to the rise in NCDs, in recent years the Government of Tonga has gradually introduced taxation measures to influence consumption behaviors of the population. The increase in excise tax on imported manufactured cigarettes in July 2016 was of particular significance. Unlike the small,  \nThis policy note is prepared based on the findings and recommendations from Osornprasop, S. et al, Using Taxation to Address Noncommunicable Diseases:  \nLessons from Tonga, World Bank, 2019. If you need more information, the full report is available at the following website: [http://documents.worldbank.org/curated/](http://documents.worldbank.org/curated/)[ ](http://documents.worldbank.org/curated/)[en/844811561475012529/Using-Taxation-to-Address-Noncommunicable-Diseases-](en/844811561475012529/Using-Taxation-to-Address-Noncommunicable-Diseases-)[Lessons-from-Tonga](Lessons-from-Tonga)  \nPolicy Note: Key findings from the NCD taxation evaluation REPORT HIGHLIGHT  \nincremental increases of previous years, the excise tax in July 2016 was raised by nearly 50 percent to T$380/1,000 sticks, compared with T$255/1,000 sticks in the previous year. At the same time, the government waived consumption tax on imported fruits, in anticipation that the price would fall, and that the population would in turn increase its consumption of these more healthy products.  \nEvaluation of taxation policy interventions  \nThe World Bank, in partnership with the Government of Tonga studied the impact the NCD taxation policy has had on the consumption behaviors of the community. The aim of the study was to strengthen the monitoring and evaluation of NCD-related fiscal policies, not only of behavior change but also revenue generation. The evaluation provided recommendations to improve NCD taxation policies as well as provide additional non-fiscal policy improvement opportunities. This study will not only be of benefit to the Government of Tonga, but other Pacific Island Countries who are also experiencing similar NCD and obesity burdens.  \nThe study used a number of assessment tools and data sources including; government administrative data, household surveys, retail surveys, tobacco taxation simulation modeling (TaXSiM) and qualitative focus group discussions and key-informant interviews.  \nFindings from the study  \nThere were mixed findings overall from the study with positive impacts observed in behavior change in tobacco use, alcohol consumption and unhealthy food consump","cbCaii02e8QQLhcb","https://ap.wps.com/l/cbCaii02e8QQLhcb","pdf",13853037,5,1,"English","en",105,"# Current NCD burden in Tonga\n## Key behavioral risk factors\n# Taxation policy interventions\n## Excise tax change in July 2016\n# Evaluation approach\n## Data sources and assessment tools\n# Key findings\n## Tobacco use and affordability effects\n## Shift to locally produced tobacco","[{\"question\":\"What NCD burden and risk levels are described for Tonga?\",\"answer\":\"The document states that NCDs account for four out of five leading causes of mortality, and 99.9% of adults aged 25–64 are at moderate to high risk of developing an NCD.\"},{\"question\":\"Which taxation measure received major emphasis, and what changed in 2016?\",\"answer\":\"It highlights the increase in excise tax on imported manufactured cigarettes in July 2016, raising the rate nearly 50% to T$380 per 1,000 sticks compared with T$255 the previous year.\"},{\"question\":\"What were the main findings on tobacco use behavior?\",\"answer\":\"Tobacco tax led to reduced tobacco use and less cigarette affordability, with stronger effects among lower wealth quintiles; however, some benefits were diluted by a shift toward locally produced, untaxed tobacco.\"}]",1784474136,20,{"code":4,"msg":30,"data":31},"ok",{"site_id":24,"language":23,"slug":32,"title":13,"keywords":33,"description":14,"schema_data":34,"social_meta":86,"head_meta":88,"extra_data":90,"updated_unix":27},"policy-note-key-findings-from-the-ncd-taxation-evaluation-report-highlight","",{"@graph":35,"@context":85},[36,53,68],{"@type":37,"itemListElement":38},"BreadcrumbList",[39,43,47,50],{"item":40,"name":41,"@type":42,"position":21},"https://docshare.wps.com","Home","ListItem",{"item":44,"name":45,"@type":42,"position":46},"https://docshare.wps.com/document/","Document",2,{"item":48,"name":12,"@type":42,"position":49},"https://docshare.wps.com/document/research-report/",3,{"item":51,"name":13,"@type":42,"position":52},"https://docshare.wps.com/document/policy-note-key-findings-from-the-ncd-taxation-evaluation-report-highlight/108817/",4,{"url":51,"name":13,"@type":54,"author":55,"headline":13,"publisher":57,"fileFormat":60,"inLanguage":23,"description":14,"dateModified":61,"datePublished":62,"encodingFormat":60,"isAccessibleForFree":63,"interactionStatistic":64},"DigitalDocument",{"name":9,"@type":56},"Person",{"url":40,"name":58,"@type":59},"DocShare","Organization","application/pdf","2026-07-30","2026-07-19",true,{"@type":65,"interactionType":66,"userInteractionCount":20},"InteractionCounter",{"@type":67},"ViewAction",{"@type":69,"mainEntity":70},"FAQPage",[71,77,81],{"name":72,"@type":73,"acceptedAnswer":74},"What NCD burden and risk levels are described for Tonga?","Question",{"text":75,"@type":76},"The document states that NCDs account for four out of five leading causes of mortality, and 99.9% of adults aged 25–64 are at moderate to high risk of developing an NCD.","Answer",{"name":78,"@type":73,"acceptedAnswer":79},"Which taxation measure received major emphasis, and what changed in 2016?",{"text":80,"@type":76},"It highlights the increase in excise tax on imported manufactured cigarettes in July 2016, raising the rate nearly 50% to T$380 per 1,000 sticks compared with T$255 the previous year.",{"name":82,"@type":73,"acceptedAnswer":83},"What were the main findings on tobacco use behavior?",{"text":84,"@type":76},"Tobacco tax led to reduced tobacco use and less cigarette affordability, with stronger effects among lower wealth quintiles; 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