Higher tobacco taxes needed to reduce smoking rates in South Asia, new analysis says

April 11, 2017, St. Michael's Hospital
Higher taxes on tobacco could reduce consumption in South Asia by at least one-third and avoid 35-45 million premature deaths, concludes an analysis published today in The British Medical Journal by Dr. Prabhat Jha, director of the Centre for Global Health Research of St. Michael's Hospital in Toronto. Credit: Courtesy of St. Michael's Hospital

Higher taxes on tobacco could reduce consumption in South Asia by at least one-third and avoid 35-45 million premature deaths, concludes an analysis published today in The British Medical Journal.

South Asia, with a population of 1.1 billion adults, has about 170 million adult smokers - mostly male and mostly from India - and very low rates of cessation.

The analysis, led by Dr. Prabhat Jha, calls on South Asian countries to implement the World Health Organization's global control treaty and its requirements for high tobacco taxes, smoke-free public spaces, warning labels, comprehensive advertising bans and support for smoking cessation services.

Previous research by Dr. Jha, director of the Centre for Global Health Research of St. Michael's Hospital in Toronto, has shown that raising the tax on tobacco is the single most effective intervention to lower smoking rates and to deter future smokers. Evidence from , including Canada and the United States, and emerging evidence from China, shows that cessation has an almost immediate impact. Smoking cuts at least 10 years off a person's lifespan, but people who quit smoking before they turn 40 regain almost all of those lost years, according to the research by Dr. Jha, a professor in the Dalla Lana School of Public Health at the University of Toronto.

Dr. Jha said the price of cigarettes, bidis (a small traditional Indian cigarette) and chewing tobacco is lower in South Asia than in high-income countries in the West because the excise taxes are so low. He said the main reason for this is opposition from the tobacco industry because of the considerable profit margins. Annual increases in tobacco taxes are below the rate of inflation and income growth, so cigarettes remain affordable. Variations in the tax rates, usually based on the length of cigarettes, lead to price differences and enable smokers to change to cheaper brands or shorter cigarettes. In addition, the sale of single cigarettes is common in South Asia, which reduces the effectiveness of tax increases.

Dr. Jha said South Asian countries should also strengthen the most effective non-price interventions to control smoking, including a complete ban on tobacco advertising, use of large pictorial warnings or plain packaging on tobacco products, and a complete ban on smoking in public places. The use of plain packaging or prominent pictorial warning labels is particularly relevant given the high levels of illiteracy among tobacco users in the region.

Dr. Jha also noted that smoking cessation programmes are uncommon in South Asia. Most people who quit do so without physician advice, nicotine replacement therapy or electronic cigarettes.

Dr. Jha said that for this analysis researchers looked at 140 million current and future smokers aged under 35 (about 33 million of whom are current smokers aged 25-34 and 107 million under 25 who have not yet started) and the 100 million current smokers over 35 (out of a total of 171 million smokers at ages 15 or more).

"Unless large numbers of them stop smoking, at least half of the 140 million young and future smokers would die because of smoking," he said. "At least half of these 70 million deaths would occur before age 70, losing decades of good life. Not starting smoking or complete cessation before age 40 would avoid nearly all of these deaths."

Dr. Jha said a tripling of the excise taxes, designed in particular to decrease substitution from more expensive to cheaper brands would likely reduce in South Asia by at least one-third. That would reduce the cohort of 140 million younger or future smokers under 35 years by about 50 million smokers, avoiding at least 25 million deaths. The benefits of a one-third reduction in the 100 million current over 35 years depend on their age of cessation. Conservatively, such a reduction might avoid about 10-20 million deaths, most of which would be before 2050.

Explore further: Study finds 36 percent increase in number of male smokers in India

Related Stories

Study finds 36 percent increase in number of male smokers in India

February 26, 2016
The number of men smoking tobacco in India rose by more than one-third to 108 million between 1998 and 2015, according to a new study published today in the journal BMJ Global Health.

Young people do not associate e-cigarettes with increased likelihood of smoking

March 8, 2017
New peer-reviewed research published today in Drugs Education Prevention and Policy shows that e-cigarettes are not increasing the likelihood of tobacco consumption and may in fact be contributing to negative perceptions ...

Reducing global tobacco use

April 20, 2015
Although global efforts to cut tobacco use have had some success, more can be done to reduce the number of deaths from smoking, according to a commentary published in CMAJ (Canadian Medical Association Journal).

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

January 1, 2014
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 ...

New report shows electronic cigarettes are beneficial to UK public health

April 27, 2016
Electronic cigarettes have the potential to contribute to reducing death and disability caused by Britain's biggest killer, say experts in The BMJ today.

Smoking down, number of lives saved up as more countries embrace tobacco control measures

December 12, 2016
Between 2008 and 2014, more than 53 million people in 88 countries stopped smoking due to tobacco control measures, which means that more than 22 million smoking-related deaths have been averted, say researchers at the Georgetown ...

Recommended for you

Engineered enzyme eliminates nicotine addiction in preclinical tests

October 17, 2018
Oct. 17, 2018—Scientists at Scripps Research have successfully tested a potential new smoking-cessation treatment in rodents.

Self-lubricating latex could boost condom use: study

October 17, 2018
A perpetually unctuous, self-lubricating latex developed by a team of scientists in Boston could boost the use of condoms, they reported Wednesday in the journal Royal Society Open Science.

How healthy will we be in 2040?

October 17, 2018
A new scientific study of forecasts and alternative scenarios for life expectancy and major causes of death in 2040 shows all countries are likely to experience at least a slight increase in lifespans. In contrast, one scenario ...

Study finds evidence of intergenerational transmission of trauma among ex-POWs from the Civil War

October 16, 2018
A trio of researchers affiliated with the National Bureau of Economic Research has found evidence that suggests men who were traumatized while POWs during the U.S. Civil War transmitted that trauma to their offspring—many ...

Father's nicotine use can cause cognitive problems in children and grandchildren

October 16, 2018
A father's exposure to nicotine may cause cognitive deficits in his children and even grandchildren, according to a study in mice publishing on October 16 in the open-access journal PLOS Biology by Pradeep Bhide of Florida ...

Many supplements contain unapproved, dangerous ingredients: study

October 13, 2018
(HealthDay)—U.S. health officials have issued more than 700 warnings during the last decade about the sale of dietary supplements that contain unapproved and potentially dangerous drug ingredients, new research reveals.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.