12 April 2018:
As many as 67 million smokers around the world would kick the habit if the price of a packet of cigarettes was increased by 50 per cent, new research has found.
The study, published in the British Medical Journal, found that increasing cigarette prices through taxation would benefit the poorest in each country the most.
Researchers built a model to predict how a 50 per cent hike could affect the health and finances of 490 million male smokers in 13 middle income countries – including India, Brazil and China – as, globally, men are far more likely than women to take up the habit.
Similar studies have previously focused on high income countries, prompting researchers for this study to look at less wealthy nations.
Analysts discovered raising the cost of a cigarette pack by 50 per cent would lead to 67 million men quitting, with nearly eight times more smokers stubbing out cigarettes in the poorest fifth of the population, compared to the richest fifth.
Encouraging smokers in the 13 countries looked at in the study to quit the habit could save 450 million years of life and avert $157 billion in medical costs, the researchers found.
The World Health Organization (WHO)estimates that 100 million people fall into poverty every year because they have to pay for health care. This includes “catastrophic expenditure” amounting to more than 10 per cent of a person’s annual salary. Much of this cost is for treatment of chronic conditions such as cancer.
Prahbat Jha, one of the authors of the study and professor at University of Toronto’s School of Public Health, said that increased tobacco taxes are more beneficial to poorer smokers who are more likely to give up smoking when prices go up.
“The poor are more responsive to prices than those on higher incomes,” said Professor Jha. “The poor spend more of their income on tobacco.”
He added that the poor also tend to suffer more from tobacco-related diseases such as heart disease and lung cancer as they are less able to afford health care, particularly in countries without free health coverage.
The study reflects the findings of a recent major study in the Lancet which found that so-called “sin taxes” on products such as fizzy drinks, fast food and tobacco are more likely to alter the spending habits of less well-off consumers.
Although the study was limited to 13 countries, Prof. Jha believes that the implications of more widespread tobacco taxes could be huge.
He added: “Twenty million people worldwide could avoid falling below the poverty line due to a price increase. Governments have a powerful and underused tool to fight poverty.”
Experts predict that smoking will be responsible for about one billion deaths this century.
“In low and middle income countries people quit not to avoid disease, but because of disease,” said Prof. Jha.
This is in stark contrast to high income countries where – at age 50 – there are roughly twice the number of ex-smokers as smokers, he added.
The WHO recommends countries introduce a minimum 70 per cent tax on tobacco, but few countries currently implement this. European countries currently have the highest levels of tax on tobacco. Smokers in the UK pay 16.5 per cent of the retail price – plus a flat rate of £4.34 on each 20-pack of cigarettes.
Prof. Jha and many experts and policymakers, including the WHO, believe tobacco taxation is the single most effective way to encourage smokers to quit and stop young people from taking it up in the first place.
“There’s ample evidence that prices are what people respond to,” he said. “Higher prices work even in addicted smokers.”
The study found that for taxes to be effective, they must be applied to all products to prevent companies from pushing short, cheap cigarettes or other forms of tobacco.
A recent survey in the United Arab Emirates, which introduced a cigarette tax in October last year, found that some smokers were turning to medwakh – a traditional super-strength pipe-smoked tobacco – in the face of rising cigarette prices.
Commenting on the study, Dr Robert Branston of the Centre for Governance and Regulation and the Tobacco Control Research Group at the University of Bath, reiterated the need for a tax on all forms of tobacco.
“Increases in cigarette prices should be accompanied by increases in taxation of all tobacco products,” he said.
Dr Branston co-authored a research study last year that found that tobacco companies were turning to new tactics to keep smokers hooked, such as reducing pack sizes and absorbing the cost of tax increases on cheaper lines to keep prices down for consumers.
“The tobacco industry has a history of trying to influence or undermine government policy for their benefit, and their efforts in this regard in low and middle income countries are increasingly being exposed,” said Dr Branston.