Perceived Health Taxation and Sustainable Public Welfare: An Integrated Behavioral Framework in a Pre-Implementation Policy Context

Health taxation has become an increasingly important fiscal policy instrument for promoting healthier consumption and improving public welfare. However, limited evidence exists regarding public perceptions of health taxation in countries where such policies have not yet been implemented. This study develops and empirically tests an integrated behavioral framework that examines the relationships among perceived health taxation, healthy consumption behavior, and sustainable public welfare, while considering the moderating roles of chronic disease in the family, trust in public health policy, and generation. Data were collected through a structured questionnaire administered to 402 adult respondents in Azerbaijan and analyzed using Structural Equation Modeling. The results indicate that perceived health taxation is positively associated with sustainable public welfare but negatively associated with respondents’ self-reported healthy consumption behavior. In contrast, healthy consumption behavior is positively associated with sustainable public welfare. Furthermore, chronic disease in the family negatively moderates the relationship between perceived health taxation and sustainable public welfare, whereas trust in public health policy and generation positively moderate the proposed relationships. The study contributes to the health taxation literature by providing evidence from a pre-implementation policy context. These findings offer practical implications for designing socially acceptable and effective preventive fiscal policies.