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Raising Tobacco Taxes May Help to Lower Smoking Rates

Harold Mandel's picture
Smoking kills

Cigarette smoking remains a major killer worldwide in spite of the increased awareness of the health hazards associated with smoking. Even passive smoke from cigarettes has been shown to be dangerous for the well being of nonsmokers. Yet, there remains around us smokers of all ages just about everyplace we go. More aggressive initiatives are needed to fight the lucrative tobacco industry of illness and death.

Annual tobacco attributable deaths are projected to rise from about 5 million in 2010 to greater than 10 million a few decades, reports The New England Journal of Medicine. At the present time about 50 percent of young men and 10 percent of young women become smokers and relatively few stop. In the 20th century there were approximately 100 million deaths from tobacco, showing the enormous scope of this problem.

If current smoking patterns continue, tobacco will kill about 1 billion people this century, primarily in low- and middle-income countries. About 50 percent of these deaths will occur before 70 years of age. The tobacco industry has been flourishing as people continue to smoke at the expense of their lives, as I have reported on in a separate article for EmaxHealth.

Governments were asked to lower the prevalence of smoking by about a third by 2025 by the 2013 World Health Assembly. This would help prevent greater than 200 million deaths from tobacco during the remainder of the century. The cost of smoking has been found to be a primary determinant of smoking uptake and cessation. It is projected that a reduction of smokers by about a third could be achieved by doubling the inflation-adjusted price of cigarettes. It is felt that in the absence of substantial price increases, a reduction in smoking by a third would be very hard to achieve.

The problem of smoking is really incredibly serious, with tobacco being the biggest external cause of noncommunicable disease. Tobacco-attributable mortality increases slowly after smoking begins, while the effects of smoking cessation emerge more rapidly. However, the primary argument for reducing smoking centers around the hundreds of millions of tobacco associated deaths if current smoking patterns continue. Of interest has been the finding by the Lancet Commission on Investing in Health that a substantial increase in specific excise taxes on tobacco could be the single most important intervention against noncommunicable diseases.

Tripling tobacco taxes worldwide would really prevent 200 million tobacco deaths, according to St. Michael's Hospital. According to the review of the study published in the New England Journal of Medicine, tripling taxes on cigarettes worldwide would lower the number of smokers by one-third and prevent 200 million premature deaths due to lung cancer and other diseases this century.

The suggested tax increase would double the street price of cigarettes in some countries and narrow the price gap which exists between the cheapest and most expensive cigarettes. This could help encourage people to quit smoking instead of switching to a cheaper brand. Younger people would also not be as likely to start smoking. The suggestion appears rational in view of considerations that France halved cigarette consumption between 1990 and 2005 by increasing taxes well above inflation.

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Dr. Prabhat Jha, director of the Center for Global Health Research of St. Michael's Hospital, has said, "Death and taxes are inevitable, but they don't need to be in that order. A higher tax on tobacco is the single most effective intervention to lower smoking rates and to deter future smokers." At the United Nations General Assembly and the World Health Organization’s 2013 Assembly, countries worldwide agreed to lower the prevalence of smoking by approximately one-third by 2025 in order to lower premature deaths from cancer and other chronic diseases by 25 per cent.

Professor Sir Richard Peto of the University of Oxford and the co-author of this research paper has pointed out that worldwide there are about a half-billion children and adults who are under the age of 35 who are already, or soon will be, smokers. Current patterns indicate that few of these smokers will quit. It is therefore vitally important that governments find ways to stop people from beginning to smoke and help smokers give up. The study has indicated that tobacco taxes are a very powerful manner to help in doing so. Increased taxes on tobacco accomplish several things, including:

1: Reducing the numbers of people who smoke and who die from their addiction

2: Reducing premature deaths from smoking

3: Increasing government income

Governments worldwide are encouraged to take action by regularly raising tobacco taxes above inflation.

I have observed in shock how many people, young and old alike, have continued to smoke cigarettes in spite of the increased aggressive efforts at educating the public about the serious health hazards of smoking. Even with increased prices people are continuing to throw their money away on cigarettes, that is how addicting smoking can be. I have witnessed people lower their standards of living and drive junky dangerous cars instead of nice safe cars because of the expense of feeding their smoking addiction. And I have witnessed parents, sons and daughters, friends, teachers, students and others expose nonsmokers around them to the potentially lethal smoke from cigarette smoking.

It is an interesting suggestion, which is supported by the research discussed in the New England Journal of Medicine, that raising taxes should help in the fight against smoking. However, in view of the hard cold realities of the almost heroin like addiction potential of cigarettes, I frankly am skeptical that this alone will pave the way towards solving the problem. Although I support the suggestion of raising taxes on tobacco to help with this situation, I also encourage larger investments in aggressive anti-smoking marketing campaigns and treatment programs for smokers. The FDA has had the right idea dealing with graphic smoking warnings, I have reported in another article for EmaxHealth.

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