by Jihye Suk and Hanati Hailati
Smokers are great supporters of positive psychological effects of smoking. However, according to the CDC, smoking causes diseases such as lung cancer, diabetes, and erectile dysfunction on males. Smoking not only harms people with various diseases, but it will also cause 8 million deaths annually in 2030 if current trend continues [1]. What we need to focus on here is that the 8 million people are mostly from developing countries or from low-educated population. The correlation between education level and smoking in India, as Dr. So indicated in class, supports this presumption. Moreover, as he emphasized, while tobacco consumption in developed countries decreases by 0.2%, it is increasing by about 3.4% in developing countries each year.
Tobacco industry is getting smarter and more powerful based on their wealth. In contrast, our countermeasures are still stymied by the barrier of individual freedom issue. If it is truly personal choice, why does research show that developing country populations are more likely to choose smoking? Why even among developed countries, disadvantaged population is the group of main smokers?
Today, commonly utilized smoking cessation strategies are as follows: cigarette taxes, comprehensive bans on tobacco advertising and promotion, prominent warning labels, restrictions on smoking in public places, and increased access to nicotine replacement treatments.
As one of the readings by Dr. So noted, the economics of global tobacco control, written by Prabhat Jha and Frank J. Chaloupka, the threat posed by smoking to global health is extraordinary, but so is the potential for preventing millions of smoking related deaths with highly effective policies [2]. This article also states that tax increases are the single most effective intervention to reduce demand for tobacco [2]. WHO also notes that the most potent and cost-effective option for governments everywhere is the simple elevation of tobacco prices by use of consumption taxes [3]. Tobacco includes excise taxes, value added taxes (VAT) or general sales taxes and import duties.
According to the "WHO Report on the global tobacco epidemic 2015," 33 countries levy cigarette taxes that represent more than 75% of the retail price of a packet of cigarettes, but many countries have extremely low tax rates, and some countries even have no special tax on tobacco products at all [4]. Take China as an example. China has the largest smoking population in the world and bears the largest disease burden from smoking as the chart shows below. A research model in China suggests that raising cigarettes taxes so that they account for 75% of retail prices- up from 40% of the share of price in 2010- would prevent nearly 3.5 million deaths that would otherwise be caused by cigarette smoking [4]. However, levying cigarette taxes still faces lots of challenges. Recently the City of Beijing, one of top three populated city in China, just started its strictest bans on smoking in public places since this October.
Dr. So finished his lecture with suggesting our new challenge at the emerging of e-cigarette. The latest released presentation [5] by CDC indicates very few clinical trials are conducted to evaluate the impact of e-cigarette. Cultivating adolescent as a future smoker seemed to be e-cigarette industry’s main aim, but it is not yet regulated in many countries.
Source: Institute for Health Metrics and Evaluation
[1] World
Health Organization. (2011). WHO Report on the Global Tobacco Epidemic, 2011.
Geneva: World Health Organization, 2011. [accessed 2015 Nov 5]
[2] Jha, P., & Chaloupka, F. J. (2000). The Economics of
Global Tobacco Control. BMJ: British
Medical Journal, 321(7257), 358.
[3] World
Health Organization. (2010). WHO Technical Manual on Tobacco Tax
Administration. Geneva:
World Health Organization, 2010.
[accessed 2015 Nov 5]
[4] World
Health Organization. (2015). WHO Report on the Global Tobacco Epidemic, 2015. Geneva: World Health Organization,
2015. [accessed 2015 Nov 5]
[5] CDC. E-cigarettes: An Emerging Public Health Challenge
(10.20.2015.) by Brian King, PhD,
MPH, Jonathan M. Samet, MD, MS, John Wiesman, DrPH, MPH, Matthew L. Myers,
President of Campaign
for Tobacco-Free Kids.
