What tobacco control could do to the world
Policies to control tobacco use, including tobacco tax and price increases can generate significant government revenues for health and development work, according to a new landmark global report from World Health Organisation (WHO) and the National Cancer Institute of the United States of America. Such measures can also greatly reduce tobacco use and protect people's health from the world's leading killers, such as cancers and heart disease.
But left unchecked, the tobacco industry and the deadly impact of its products cost the world's economies more than US$ 1 trillion annually in healthcare expenditures and lost productivity, according to findings published in The economics of tobacco and tobacco control.
Currently, around 6 million people die annually as a result of tobacco use, with most living in developing countries. The monograph examines existing evidence on two broad areas:
• The economics of tobacco control, including tobacco use and growing, manufacturing and trade, taxes and prices, control policies and other interventions to reduce tobacco use and its consequences; and
• The economic implications of global tobacco control efforts.
"The economic impact of tobacco on countries, and the general public, is huge, as this new report shows," says Dr Oleg Chestnov, WHO's Assistant Director-General for Non Communicable Diseases (NCDs) and mental health. Globally, there are 1.1 billion tobacco smokers aged 15 or older, with around 80% living in low- and middle-income countries. Approximately 226 million smokers live in poverty.
The monograph states that annual excise revenues from cigarettes globally could increase by 47%, or US$ 140 billion, if all countries raised excise taxes by about US$ 0.80 per pack. Additionally, this tax increase would raise cigarette retail prices on average by 42%, leading to a 9% decline in smoking rates and up to 66 million fewer adult smokers.
The monograph's major conclusions include:
• The global health and economic burden of tobacco use is enormous and is increasingly borne by low- and middle-income countries (LMICs). Around 80% of the world's smokers live in LMICs.
• Demand reduction policies and programmes for tobacco products are highly cost-effective. Such interventions include significant tobacco tax and price increases; bans on tobacco industry marketing activities; prominent pictorial health warning labels and smoke-free policies.
• Control of illicit trade in tobacco products is the key supply-side policy to reduce tobacco use and its health and economic consequences. In many countries, high levels of corruption, lack of commitment to addressing illicit trade, and ineffective customs and tax administration, have an equal or greater role in driving tax evasion than do product tax and pricing.
• Tobacco control reduces the disproportionate health and economic burden that tobacco use imposes on the poor. Tobacco use is increasingly concentrated among the poor and other vulnerable groups.
• Progress is being made in controlling the global tobacco epidemic, but concerted efforts are needed to ensure progress is maintained or accelerated.
• The market power of tobacco companies has increased in recent years, creating new challenges for tobacco control efforts. Policies aimed at limiting the market power of tobacco companies are largely untested but hold promise for reducing tobacco use.
Tobacco control is a key component of WHO's global response to the epidemic of NCDs, primarily cardiovascular disease, cancers, chronic obstructed pulmonary disease and diabetes. NCDs account for the deaths of around 16 million people prematurely (before their 70th birthdays) every year. Reducing tobacco use plays a major role in global efforts to achieve the Sustainable Development Goal of reducing premature deaths from NCDs by one-third by 2030.
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