By Dr Poonam Khetrapal Singh, WHO Regional Director for South-East Asia
Improved tax measures, stronger law enforcement and enhanced cessation efforts are urgently needed in the WHO South-East Asia Region to protect people against the ill-effects of tobacco which continues to be a major public health issue.
Tobacco kills approximately 6 million people annually, 20% of them live in the Region which accounts for 25% of the world’s smokers and almost 90% of smokeless tobacco users. Recent estimates show that there are about 246 million smokers and 290 million smokeless tobacco users in the Region.
Increasing tobacco taxes is the most cost-effective measure of tobacco control, it is a win-win approach for government revenues and the health of the population. Governments need to tax all tobacco products in a manner that people do not opt out of one expensive product to a less expensive one. Taxing all tobacco products comparably is a must to reduce incentives for substitution. Currently governments are levying much less tax on smokeless tobacco and regulations do not cover all aspects of smokeless tobacco use. Smokeless tobacco is the main cause of oral cancer in the Region.
Tax structure needs to be made simpler to be more effective. At the moment most countries have a complex and tiered tax structure that is not only difficult to administer but also creates loopholes that undermine both the health and revenue impacts of tobacco excise taxes.
Also, while revising and setting tobacco taxes, we must always ensure that the taxes are large enough to offset any increase in incomes and purchasing power.
Equally important is the strong administration of tobacco taxes and crack down on illicit trade of tobacco to reap the public health benefit of tobacco tax increase.
One of the biggest area for improvement high-quality and accessible tobacco cessation programs.
Many countries in the Region have been making substantial progress in implementing tobacco control and prevention measures. Bangladesh is among the seven countries in the world that have raised taxes that represent over 75% of the retail price of a pack of cigarettes. Close on the heels are Sri Lanka and Thailand, with 70%.
The WHO Report on the Global Tobacco Epidemic released today shows that between 2012 and 2014, Bangladesh, India and Maldives have made progress in increasing taxes on cigarettes. Bangladesh and Indonesia have implemented pictorial health warnings. Nepal has made progress in implementing bans on advertisement, promotion and sponsorships of tobacco products, while Myanmar has expanded smoke free places. Thailand has successfully protected warning label requirements (85% of the two largest surfaces of cigarette packs and cartons). India’s comprehensive tobacco control program has expanded to cover the entire nation.
Countries in the Region need to strengthen their initiatives against tobacco that continues to cause premature deaths while adding to the increasing epidemic of non-communicable diseases (NCDs) such as chronic lung disease, heart ailments and cancer.