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Tripling tobacco tax globally could cut smoking by a third. Maybe. (2014-01-06)

Tripling tobacco tax globally would cut smoking by a third, and prevent 200 million premature deaths this century from lung cancer and other diseases, according to a Cancer Research UK review published in the New England Journal of Medicine. But in a globalizing world it might be useful to know that U.S. NIH’s 2013 Monitoring the Future Survey shows that Cigarette smoking continues to decline.

 


 

For the first time, the percentage of students in all three grades combined who say they smoked in the past month is below 10 percent (9.6 percent) compared to 16.7 percent 10 years ago and 24.7 percent in 1993. However, 21.4 percent of seniors report smoking tobacco with a hookah in the past year, more than 3 percent above the rate teens reported in 2012 (18.3 percent)". The survey reports that 39.5 percent of 12th graders view regular marijuana use as harmful, down from last year’s rate of 44.1 percent, and considerably lower than rates from the last two decades. Overall, 41,675 students from 389 public and private schools participated in this year's Monitoring the Future survey. Since 1975, the survey has measured drug, alcohol, and cigarette use and related attitudes in 12th–graders nationwide. See "Sixty percent of 12th graders do not view regular marijuana use as harmful".

Boosting the tax by a large fixed amount per cigarette would narrow the price gap between the most and least expensive cigarettes, so it would encourage people to quit smoking altogether rather than switch to a cheaper brand, and would help stop young people from starting.

This would be especially effective in low-to-middle-income countries where the cheapest cigarettes are relatively affordable. But it would also be effective in richer countries: France halved cigarette consumption from 1990 to 2005 by raising taxes well above inflation.

Study co-author Professor Sir Richard Peto, Cancer Research UK epidemiologist based at the University of Oxford, said: “The two certainties in life are death and taxes. We want higher tobacco taxes and fewer tobacco deaths. It would help children not to start, and it would help many adults to stop while there’s still time.

The review examined 63 research papers on the causes and consequences of tobacco use in many different countries.

“Globally, about half of all young men and one in ten of all young women become smokers, and, particularly in developing countries, relatively few quit. If they keep smoking, about half will be killed by it, but if they stop before 40, they’ll reduce their risk of dying from tobacco by 90 per cent.”

He added: “The international tobacco industry makes about £30bn ($50bn) in profits each year – that’s a profit of approximately £6,000 ($10,000) per death from smoking.”

Governments have agreed to prioritise reducing premature deaths from cancer and other chronic diseases in the United Nations General Assembly and in the WHO’s 2013 World Health Assembly. Smoking is the largest cause of premature death from chronic disease, and governments agreed a global target of reducing smoking by a third by 2025.

Tripling tobacco taxes would decrease worldwide consumption by about a third, but despite this it would also increase government revenues from tobacco by a third, from £180bn (US$300bn) a year now to £240bn (US$400bn) a year – income which could be spent on better healthcare.

In the European Union, tobacco now causes 300,000 deaths a year under the age of 70 (250,000 men, 50,000 women). An EU-wide doubling of cigarette prices would prevent 100,000 deaths a year in the under 70s.

Co-author Professor Prabhat Jha, University of Toronto, said: “Controlling tobacco marketing is also key to helping people give up smoking.”

In the UK an independent review concluded that standardised plain packaging would reduce the appeal of cigarettes. The UK could be ready to switch to standardised plain cigarette packaging before the next election. Australia changed to standardised plain packaging in 2012 – a measure New Zealand plans to copy.

Dr Harpal Kumar, Cancer Research UK’s chief executive, said: “Worldwide, around half a billion children and adults under the age of 35 are already – or soon will be – smokers, and many will be hooked on tobacco for life. So there’s an urgent need for Governments to find ways to stop people starting and to help smokers give up. This immensely important study demonstrates that tobacco taxes are a hugely powerful lever, and potentially a triple win – reducing the numbers of people who smoke and who die from their addiction, reducing the health care burden and costs associated with smoking and yet, at the same time, increasing Government income. We urge all Governments, not least the UK Government, to take action by regularly raising tobacco taxes above inflation, and using occasional steep tax hikes starting with the next budget.

“Young adult smokers will lose about a decade of life if they continue to smoke – they’ve so much to gain by stopping.”

For more information
Tripling tobacco taxes to prevent 200 million premature deaths

New England Journal of Medicine
Global Effects of Smoking, of Quitting, and of Taxing Tobacco

Sixty percent of 12th graders do not view regular marijuana use as harmful

Marco Dal Negro

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