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Arab Emirates and Yemen), with a population of nearly 679 million people (3). The prevalence of use of smoking tobacco products (including but not limited to cigarettes and water pipes) by males aged 15 years or older is decreasing in all WHO regions apart from the EMR, where it continues to increase (4). In EMR countries, approximately 14% of the population aged 15 years or more are current cigarette smokers, with prevalence noticeably higher among males (25%) when compared to females (2%) (5). The World Health Organization Framework Convention on Tobacco Control (WHO FCTC) and its implementation guidelines provide an evidence-based framework for governmental action to reduce tobacco use (6). Article 6 of the WHO FCTC outlines the "Price and tax measures to reduce the demand for tobacco" (6). Effective tobacco tax policies can significantly improve health and economic outcomes for individuals, households, and the country, especially in low-income settings (5,7-9). Evidence shows that raising tax on tobacco increases the real price of tobacco and reduces tobacco consumption (6). Approximately half of the impact of a price increase is on the prevalence of use and half is on the intensity of consumption among users (6). Therefore, taxation must increase prices more than any growth in average income occurring at the same time in order to prevent tobacco becoming more affordable (6). Research has suggested that tobacco affordability benchmarks may be more effective than tax incidence benchmarks, since tax incidence benchmarks do not respond to changes in average income (10). Rising incomes may undermine pre-existing high levels of taxation unless tobacco taxes are raised in response to changes in income. This argument is particularly pertinent in the case of lower middle-income countries experiencing rapid economic growth (10). Previous research has shown that globally the most sold brand of cigarettes in countries are becoming less affordable in upper middle and high-income countries and more affordable in low and lower middle-income countries (5,11,12).

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