Economics
WHO's message is that of public health. But tobacco control touches on broader sectors of society. The bottom line is that tobacco is not only bad for health, it is also bad for the economy at large.
Dr Gro Harlem Brundtland, Director-General Emeritus, World Health Organization
Few people now dispute that smoking is damaging human health on a global scale. However, many governments have avoided taking action to control smoking—such as higher taxes, comprehensive bans on advertising and promotion, or restrictions on smoking in public places—because of concerns that their interventions might have harmful economic consequences. The World Bank examined in a 1999 Report, Curbing the Epidemic, Governments and the Economics of Tobacco Control, the economic questions that policymakers must address when contemplating tobacco control. It demonstrates that the economic fears that have deterred policymakers from taking action are largely unfounded. Policies that reduce the demand for tobacco, such as a decision to increase tobacco taxes, would not cause long-term job losses in the vast majority of countries. Nor would higher tobacco taxes reduce tax revenues; rather, revenues would climb in the medium term. Such policies could, in sum, bring unprecedented health benefits without harming economies.
Effective economic interventions make a real difference to tobacco prevalence and consumption, and associated health outcomes. Most of the documented successes have occurred in developed countries where effective approaches have been implemented for several years. In more recent years, several developing countries have introduced similar measures. Early indications are that they too will be effective.
Economic Costs
Smoking imposes costs on nonsmokers. The costs to nonsmokers clearly include health damage as well as nuisance and irritation from exposure to environmental tobacco smoke. In addition, smokers may impose financial costs on others. The World Bank estimates that in high-income countries, smoking-related healthcare accounts for between 6 and 15 percent of all annual healthcare costs. In any given year, smokers' healthcare costs will on average exceed nonsmokers'.
The World Bank Report
Do smokers know their risks and bear their costs?
Agricultural Issues
Demand-side interventions such as increases in price, advertising and promotion bans, and smoking restrictions are effective at reducing tobacco attributable mortality and morbidity. While interventions to reduce demand for tobacco are likely to succeed, measures to reduce its supply are less promising. Crop substitution is often proposed as a means to reduce the tobacco supply, but there is scarcely any evidence that it reduces consumption, since the incentives to farmers to grow tobacco are currently much greater than for most other crops. While crop substitution is not an effective way to reduce consumption, it may be a useful strategy where needed to aid the poorest tobacco farmers in transition to other livelihoods, as part of a broader diversification program.
Campaign for Tobacco-Free Kids
Golden Leaf, Barren Harvest: The Costs of Tobacco Farming [PDF]
Deforestation
In many of the tobacco growing countries evidence indicates negative environmental impacts of tobacco agriculture, particularly when associated with deforestation required to increase farmland and cure tobacco plants. The Bellagio statement on tobacco and sustainable development concluded that, in the developing world, "tobacco poses a major challenge, not just to health, but also to . . . environmental sustainability."
Globalization
The globalization of tobacco marketing, trade, research and industry influence represents a major threat to public health worldwide. The industry has used a wide range of methods to buy influence and power and penetrate markets across the world. In contrast, until recently tobacco control lacked global leadership and strategic direction and had been severely underfunded. As part of moving towards a more sustainable form of globalization, a global enabling environment linked to local actions should focus on the following strategies: global information management; development of nationally and locally grounded action; global regulation, legal instruments, and foreign policy; and establishment of strong partnerships with purpose.
- Globalisation of tobacco industry influence and new global responses by Derek Yach and Douglas Bettcher, Tob Control 2000;9:206-216 ( Summer )
- Global trade and health: key linkages and future challenges (PDF) by Douglas W. Bettcher, Derek Yach, & G. Emmanuel Guindon, Bulletin of the World Health Organization,vol.78, no.4, 521-534.