Higher cigarette prices would save millions of people from extreme poverty and poor health around the world

April 11/2018

Increasing cigarette prices would add to years of life lived, and cut billions of dollars in treatment costs for families globally

By: Ana Gajic, St. Michael’s Hospital

Higher cigarette prices would save millions of people from extreme poverty and poor health around the world, while also cutting health treatment costs for families across the globe, suggests a comprehensive study published today in The BMJ.

Cigarette butts in ashtray

Cigarette butt photo by Jayaprakash R via Flickr

The analysis, led by Professor Prabhat Jha and Patricio V. Marquez, concludes that those with lower incomes would benefit the most from higher cigarette prices. Examining 500 million male smokers in 13 countries, they found that a 50 per cent price increase in cigarettes would result in 67 million men quitting smoking, with the biggest benefit in low-income men.

The higher price would also lead to 15.5 million men avoiding catastrophic health spending in the seven countries studied without universal health coverage. This would result in 8.8 million men avoiding extreme poverty, half of whom are in the bottom income group.

Professor Prabhat Jha

Professor Prabhat Jha

“Our study debunks the current narrative that higher cigarette prices would negatively impact the poorest among us,” said Dr. Jha, a professor of Epidemiology and Dalla Lana Chair in Disease Control at DLSPH.

“This analysis shows the opposite – a higher price would encourage cessation, lead to better health, and save money much more strongly for the poor than the rich,”

Cessation would result in 449 million years of life gained, the study showed. Higher tobacco costs would also benefit households globally, with about $157-billion USD averted to treat the four main tobacco-attributable diseases examined: chronic obstructive pulmonary disease, stroke, heart disease and cancer.

Despite more awareness of the risks, Jha said, if we don’t deflect the current trends, smoking will be responsible for one billion deaths in the 21st century. Most of these will be in low and middle-income countries. Previous research by Jha, who is also director of the Centre for Global Health Research of St. Michael’s Hospital, has shown that raising taxes on tobacco is the single most effective intervention to lower smoking rates and to deter future smokers.

Building on his earlier research, Jha and the team undertook this new analysis to understand the true impact of higher cigarette prices around the world. They conducted an assessment across 13 middle-income countries with diverse socioeconomic characteristics, tobacco use and health care coverage. Focusing on male smokers – who make up 90 per cent of smokers in the selected countries – the researchers used mathematical models to quantify the effect of a 50 per cent increase in prices.

“The findings of our new analysis will have a far-reaching impact,” said Marquez, lead health specialist at The World Bank. “Not only does increasing tobacco taxation reduce smoking and its health consequences, but the study’s findings are also relevant to the United Nations sustainable development goals to reduce poverty and improve health.”

This study will add to a growing body of knowledge that higher cigarette pricing, though not yet universally adopted, has significant health benefits. Small steps taken by governments can lead to unprecedented health gains and poverty reduction, Jha said.

This study was supported by the Fogarty International Center of the US National Institutes of Health; the Dalla Lana School of Public Health, University of Toronto; Canadian Institute of Health Research; the Bill & Melinda Gates Foundation; Bloomberg Philanthropies, and the International Development Research Centre.