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 in the New England Journal of
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 smoking rather
than switch to a cheaper brand and help young people not to start.
cigarette taxes change drinking behaviour
This would be especially effective in low- and middle-income
countries, where the cheapest cigarettes are relatively affordable and where
smoking rates 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
Countries around the world agreed at the United Nations
General Assembly and the World Health Organisation's 2013 Assembly to decrease
the prevalence of smoking by about one-third by 2025 to reduce premature deaths
from cancer and other chronic diseases by 25%.
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.
Read more about death from smoking:
deaths triple over decade
• Smoking deaths in China could triple by 2030
Dr Jha said that even while higher tobacco taxes would
reduce consumption, they would still generate an additional $100 billion 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,
"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
“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."
ways to quit smoking
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 through 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.
Smokers in South
With support from the South African Medical Research
Council, the analysis of nearly half a million death records found the highest
tobacco related mortality was in the coloured population group. In this group
smoking causes one in four of all deaths in middle-aged men and one in six of
all deaths in middle-aged women.
At ages 35-64 the
excess risk of death among smokers was greater in the coloured than in the
• Men 14-2% vs. 7-6%
• Women 11-0% vs. 7-7%
The proportion of coloured vs. white people who had smoked
at these ages was also much higher:
• Men 68% vs. 47%
• Women 46% vs. 28%
These findings imply that the death rate from smoking is
more than twice as great in the coloured as in the white population.
The black African population already accounts for more than
half of all deaths from smoking in South Africa, due to its larger size.
At present, the death rate from smoking is not yet as high
in the black African population as in the white or coloured population, but the
researchers warn that this is likely to change if the large numbers of young
black African adults who now smoke continue to do so.
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