Higher taxes on tobacco could reduce consumption in South Asia by at least one-third and avoid 35-45 million premature deaths, as per an analysis published in The British Medical Journal on Tuesday.
South Asia, with a population of 1.1 billion adults, has about 170 million adult smokers — mostly male and mostly from India. The region has very low rates of cessation.
The analysis, led by Dr Prabhat Jha, calls on South Asian countries to implement the World Health Organisation’s global tobacco 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 high-income countries, 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 Dr Jha’s research.
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.
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.
Co-author Prakash Gupta, from the Healis-Sekhsaria Institute of Public Health in Mumbai, India added: “This analysis is important in consideration of GST, all tobacco products especially bidis should be fixed at highest level of tax under GST with no segmentation”.