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Tobacco: Health and Economics

Tobacco: Health and Economics. Dr. Joy de Beyer World Bank International Meeting on Economic, Social and Health Issues in Tobacco Control Kobe, Japan, December 3-4, 2001. Health and Economics. At first: focus on Health Impact of tobacco use on health

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Tobacco: Health and Economics

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  1. Tobacco: Health and Economics Dr. Joy de Beyer World Bank International Meeting on Economic, Social and Health Issues in Tobacco Control Kobe, Japan, December 3-4, 2001

  2. Health and Economics • At first: focus on Health • Impact of tobacco use on health • what works, what doesn’t to protect health • then: Health OR Economics? (“Yes, but”) • Many stakeholders • Health versus economic and social issues ? • today: Health AND Economics • Policy-relevant global, regional and country-level evidence-based research

  3. Focus on HealthEffective measures to protect health • Higher cigarette taxes/prices • Non-price measures: Information, research, strong warning labels, bans on tobacco advertising and promotion, bans on smoking in public places incl.workplaces • Helping smokers quit: cessation support

  4. Price Elasticity EvidenceAs real price decreases, consumption increasesEvidence from South Africa

  5. Comprehensive advertising bans reduce cigarette consumptionConsumption trends in countries with strong bans compared with countries with no bans (102 countries) Source: Saffer, 2000

  6. Bans on smoking in public places(transport, hospitals, schools, restaurants, workplaces) • Protect against “passive smoking” • info on 2nd hand smoke effects can raise public support • Workplace bans promote quitting, reduce smoking intensity (some), and are cost-saving to employers • What about smoke-free homes ?

  7. Help smokers who want to quitCessation support • Advice from health professionals is key • Quit lines, community & family support also work • NRTs double the success of quit attempts Governments may make NRTS more affordable and accessible by: • Licensing, OTC sales, allowing advertising • more studies on cost-effectiveness (especially in LDCs) • Considering NRT subsidies for poorest smokers

  8. Focus on HealthThings that don’t improve health Most “supply side” actions do not reduce tobacco use / improve health • Prohibition • Youth access restrictions • Trade restrictions • Crop substitution Control of smuggling is the only exception and is the key supply-side measure

  9. Health OR Economics? (“Yes, but”) Health versus economic and social issues? Tobacco kills, but tobacco also: • generates tax revenues • provides jobs, incomes and large profits • may attract foreign private investment • generates export earnings in some countries • gives smokers pleasure

  10. Health OR Economics? fears about harm to economies • Policy makers (and others) worry that tobacco control will harm the economy: • Reduce government revenues • Generate unemployment • Reduce farmers’ livelihoods • Increase smuggling • Cause hardship to smokers and hesitate to adopt and implement strong, comprehensive tobacco measures

  11. Health AND EconomicsFacts and evidence Policy-relevant global, regional and country-level evidence-based research Do strong tobacco control measures: • Reduce tax revenues ?No Revenues rise as a result of higher taxes. • Increase smuggling? Not exactly Role of organized smuggling, corruption • Cause net job/income losses ? Not necessarily, but needs more research • Hurt poor people ? Some, benefit some

  12. As Cigarette Tax Rises Revenue IncreasesTax per pack and cigarette tax revenues in Norway, 1990-1998

  13. Health AND EconomicsKey Stakeholders in Policy Dialogue • Ministries • Health: Health care costs • Agriculture: tobacco farmers and their livelihood • Trade: Tobacco export earnings • Labor: jobs related to tobacco • Finance and Customs: Tax revenues (profit, excise, income, investment, trade) and smuggling • Central, provincial/regional & local govts • Tobacco industry

  14. Today: Health AND EconomicsMost frequently raised issues in policy dialogue • Supply side issues • Farmers and their livelihoods • Smuggling • Crop substitution • Trade issues (WTO, import duties etc.)

  15. Health and economicsfor Successful Tobacco Control • Partnership is the KEY • Join comparative advantages for effective policy dialogue • Address concerns of key decision makers • Policy relevant research, and • Disseminate research evidence

  16. Changing Cigarette Consumption

  17. Conclusion 1. Change in tobacco demand is slow. rising incomes population growth nicotine addiction consumer choice advertising and promotionall increase or maintain tobacco use. The global tobacco market will not “wither away”. 2. Economies change constantly. People made vulnerable may need help to adjust as demand switches to other goods & services.

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