Tripling tobacco taxes worldwide would avoid 200 million tobacco deaths, study finds

Tripling taxes on cigarettes around the world would reduce the number of smokers by one-third and prevent 200 million premature deaths from lung cancer and other diseases this century, according to a review published today in the New England Journal of Medicine.

Such a large tax increase would double the street price of cigarettes in some countries and narrow the price gap between the cheapest and most expensive cigarettes, which would encourage people to stop rather than switch to a cheaper brand and help young people not to start.

This would be especially effective in low- and middle-income countries, where the cheapest cigarettes are relatively affordable and where continue to rise, said Dr. Prabhat Jha, director of the Centre for Global Health Research of St. Michael's Hospital and a professor in the Dalla Lana School of Public Health at the University of Toronto. But it would also be effective in rich countries, he said, noting that France halved cigarette consumption between 1990 and 2005 by raising taxes well above inflation.

"Death and taxes are inevitable, but they don't need to be in that order," Dr. Jha said. "A higher tax on tobacco is the single most effective intervention to lower smoking rates and to deter future smokers."

Countries around the world agreed at the United Nations General Assembly and the World Health Organization's 2013 Assembly to decrease the prevalence of smoking by about one-third by 2025 to reduce from cancer and other chronic diseases by 25 per cent.

Tobacco causes about 200,000 deaths a year of people under 70 in Canada and the United States (120,000 men and 80,000 women). Doubling cigarette prices would prevent about 70,000 of those deaths and provide new revenue that governments could spend on health care. Dr. Jha said that even while higher would reduce consumption, they would still generate an additional $100 billion U.S. a year for a total of $400 billion.

"Worldwide, around a half-billion children and adults under the age of 35 are already – or soon will be – smokers and on current patterns few will quit," said Professor Sir Richard Peto of the University of Oxford, the co-author.

"So there's an urgent need for governments to find ways to stop people starting and to help smokers give up. This 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 premature deaths from smoking and yet, at the same time, increasing government income. All governments can take action by regularly raising tobacco taxes above inflation, and using occasional steep tax hikes starting with their 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."

Controlling tobacco marketing is also key to helping people quit smoking. An independent review in the United Kingdom concluded that plain packaging would reduce the appeal of cigarettes, a switch that is expected before the next election. Australia changed to plain packaging in 2011, a measure New Zealand plans to follow.

Dr. Jha and Sir Richard noted that the 21st-century hazards of smoking have been reliably documented only in the past year, when several researchers published papers showing that men and women who started smoking when they were young and continued throughout adulthood had two or three times the mortality rate of non-smokers. An average of 10 years of life is lost from smoking. Many of those killed are still in middle age, meaning on average they lose about 20 years of life expectancy.

Both Dr. Jha and Sir Richard published papers last year showing that people who quit smoking when they are young can regain almost all of the decade of life they might otherwise have lost.

Smoking around the world: Facts and Figures

  • Worldwide, about 1.3 billion people smoke, mostly in low- and middle-income countries.
  • Two-thirds of all smokers live, in descending order, in China, India, the European Union, Indonesia, the United States, Russia, Japan, Brazil, Bangladesh and Pakistan.
  • China consumes more than 2 trillion cigarettes a year, out of a world total of about 6 trillion.
  • Smoking causes about 12-25 per cent of all deaths in middle-age men in China, India, Bangladesh and South Africa, and these proportions are set to rise as successive generations in which few people smoked are being replaced by generations in which many people have smoked throughout their adult lives
  • Numerous studies find that a 50 per cent higher inflation-adjusted price for cigarettes reduces consumption by about 20 per cent with stronger effects in the young and in the poor.
  • In most high-income countries, about 50-60 per cent of the retail price of a pack of cigarettes is the excise tax (based on the quantity or weight of tobacco, and which is difficult for the tobacco industry to manipulate). By contrast, this proportion is only 35-40 per cent in most low- and middle-income countries.
  • About $300 billion dollars is raised from tobacco tax worldwide. Tripling the tax would double the price of a package of cigarettes and reduce consumption by one third, yet still yield another $100 billion US in revenue
  • A low excise tax is the main reason cigarettes are cheaper in many low- and middle-income countries than in high-income countries.
  • The federal excise tax on a carton of cigarettes in Canada is $17. Federal and provincial sales taxes bring the total cost of carton from between $46 and $87
  • About 10 per cent of all manufactured worldwide are smuggled. Smart taxation strategies and efforts to clamp down on criminals who smuggle reduce smuggling. Even in the presence of smuggling, higher taxes reduce consumption and raise more revenue.
  • Non-price interventions such as complete bans on tobacco advertising and promotion, plain packaging (already used in Australia) or pictorial warning labels, smoke-free laws and support for cessation help reduce smoking, and raise support for higher taxes.

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Returners
1 / 5 (4) Jan 01, 2014
Sadly, the U.S. is going the wrong way, as more states cave in and legalize "recreational" marijuana.

From what I've seen, the most legitimate uses of "Medical" marijuana don't even involve smoking the stuff, but rather making medicines from extracts. Smoking yet another addictive substance is probably going to contribute to some other disease.

Anyway, we all know a typical problem of the addict, in that when they have the craving, they will forego other forms of entertainment, and even other more legitimate needs of themselves and family, to get what they need. Ultimately, this means many people will end up just cutting back somewhere else, and buying the cigarettes anyway.

I suppose one should congratulate the intentions here, but we have a very long way to go to get rid of these idiotic practices like smoking, and I doubt I'll live to see it done away with either.

I can only hope for a future where humans at least stop killing themselves, never mind one another.
Whydening Gyre
5 / 5 (3) Jan 01, 2014
All that money collected should be applied to "rebituation" programs for the smokers.
But it won't...
Huns
3.7 / 5 (3) Jan 01, 2014
Sadly, the U.S. is going the wrong way, as more states cave in and legalize "recreational" marijuana.

Alcohol kills brain cells, reduces inhibitions that can lead to aggressive behavior, and the LD50 (how much it takes to kill you, on average) is about 8x what it takes to get drunk. (I used to know a college kid who killed himself with alcohol intoxication, so that one stands out for me.) Over time, it will destroy your liver, shrink your brain, and do all sorts of nasty things to your body. It has a tendency to make you think you can do things you can't.

Marijuana does not kill brain cells, inhibits aggressive behavior, and the LD50 is over a thousand times what it takes to get high. Over time, if smoked, it will mess up your lungs and possibly give you lung cancer, but it can be vaporized or prepared in food and drink and thus doesn't need to be smoked at all. It has a tendency to discourage dangerous behavior, the opposite of what alcohol does.

If we have to pick one? Weed.
Skepticus_Rex
4 / 5 (4) Jan 01, 2014
All that will result is that the black markets will get richer.
Huns
3.7 / 5 (3) Jan 01, 2014
All that will result is that the black markets will get richer.
And we will get a little more used to taking orders from old men in suits that don't care whether we live or die, so much as they want to make a good impression for the next election cycle.
Whydening Gyre
not rated yet Jan 01, 2014
All that money collected should be applied to "rebituation" programs for the smokers.
But it won't...

I meant reHAbituation..

as to the old men in suits working for reelection - they're the ones that run the black markets...
dogbert
4.2 / 5 (5) Jan 01, 2014
This is a very detailed propaganda piece, full of unsupported assertions.

Consider the lack of humanity in an article which seeks ever increasing taxes on the addicted? Obviously, if they could just quit, they would already have done that. The purpose of the taxes is to punish them, impoverish them and enrich the governments who persecute them.

In the U.S., billions of dollars were extracted from the tobacco companies earmarked for medical care of smokers. These dollars were distributed to the various states which promptly used those funds for a variety of projects which have nothing to do with medical care or addiction.

Increased taxes, smoking bans and other so called incentives are simply punishment inflicted on those who are trapped by their addiction.

Hatred never drives a productive plan of action.
Whydening Gyre
5 / 5 (2) Jan 01, 2014
Dogbert. Maybe a little over the top, but Nicely done.

My own addiction to the product was begun back in the early 70's in the service.
Drill sergeant - "Take break. Smoke 'em if ya got 'em. Don't got 'em? Don't take a break..."
Guess what?
alfie_null
4 / 5 (1) Jan 02, 2014
Obviously, if they could just quit, they would already have done that. The purpose of the taxes is to punish them, impoverish them and enrich the governments who persecute them.

Not obvious at all (as is usually the case when someone feels the need to use the word). You have a poor understanding of the nature of addiction.

Anyways, you're conflating two distinct issues: improving overall health by reducing tobacco consumption, and how the government spends its revenue.
tadchem
5 / 5 (3) Jan 02, 2014
Increased tobacco taxes had little to do with the recent reduction of smoking in the US. Blame the proliferation of 'smoke-free zones' that made it inconvenient for smokers to continue smoking. Increased tobacco taxes will merely increase government revenues, disproportionately affecting the poor. The US 'tobacco settlement', intended to fund health care but nearly universally redirected to local programs of interest to politicians, demonstrated how irresponsible governments will be with any additional revenues.
Egleton
1 / 5 (1) Jan 02, 2014
The revenge of the American natives.
I cannot give money to my own daughter because she will just pass it on to the tobacco companies that killed my father.
l forgive all shareholders of tobacco companies.
Edit: So why is Ayahuaska illegal? Is it because it cures addictions?
Returners
1 / 5 (2) Jan 02, 2014
Dogbert:

Considering most modern cigarette addicts started smoking decades after it was already known to cause cancer, decades after they already had the surgeon General's warning on the things, they SHOULD be punished. They are the ones who keep buying the things, harming themselves and their neighbors, and they KNEW IT before they ever smoked their first cigarette.

Huns:

See my other post, regarding the fact that Marijuana in fact does make some users more aggressive. Since you can't know how it will affect you, or what amount is the "breaking point" until you actually take it, then doing so is in fact "irresponsible".
bearly
4 / 5 (1) Jan 02, 2014
Propaganda by government designed to steal more money from the people in the guise of "helping" them. Greed, just greed.
dogbert
3.3 / 5 (3) Jan 02, 2014
Returners,

Presuming you are correct in your assessment the current long term smokers knew smoking was harmful when they started smoking, why do you assert that they should be "punished"?

Should everyone who does something you think is harmful be punished?

Should over weight people be punished because they weigh too much?

Should type II diabetics be punished for eating too many carbohydrates?

Should people with skin cancer be punished for being in the sun without protection?

Should we punish everyone who engages in risky behavior?

Do you ever ride in a car? Should you be punished for that?
Scroofinator
4.5 / 5 (2) Jan 03, 2014
So instead of instituting a true prohibition of tobacco, they want to create a financial prohibition? I see another black market coming...
Shootist
2.5 / 5 (2) Jan 04, 2014
Using Gestapo and KGB techniques and a society can reduce the crime rate to near zero.

I suppose someone is bound to see that as a good thing.
goracle
3 / 5 (2) Jan 05, 2014
Using Gestapo and KGB techniques and a society can reduce the crime rate to near zero.

I suppose someone is bound to see that as a good thing.

Using scare words (Gestapo, KGB) in rhetoric can reduce the credibility of comments to zero. It's obvious that you consider it a good thing.
Also, I invoke Godwin's Law. http://en.wikiped...in's_law
antialias_physorg
5 / 5 (1) Jan 06, 2014
While I'm all for reducing the number of people who smoke this is probably the wrong way to go about it.
Smokers aren't addicted to nicotine specifically, but they are addicted to being addicted. Take nicotine away and they'll find something else (and as addicting substances go that 'something else' will likely not be any less harmful).

There's a psychological problem, here, that needs to be addressed - and you can't do that by going through someone's wallet.

Should everyone who does something you think is harmful be punished?

This case is a bit different. The aim here is to stop people from hurting themselves. Most people are very bad at estimating potential dangers/costs (especially if they are far off in the future. That's also why most people are pretty bad at realizing what they are doing when they go into debt, BTW.)
aroc91
5 / 5 (1) Jan 06, 2014

See my other post, regarding the fact that Marijuana in fact does make some users more aggressive. Since you can't know how it will affect you, or what amount is the "breaking point" until you actually take it, then doing so is in fact "irresponsible".


Spoken like a true str8-edger. Breaking point? Is that the point at which you smoke too much and just snap, attacking the first person you see, or the far more likely point at which you eat whatever's in front of you and go to bed?