Earlier this month, we attended the 17th World Conference on Tobacco or Health , held in Cape Town, South Africa--the first time on the African continent. While we celebrated the effort made by the global community to implement the Framework Convention on Tobacco Control (FCTC) over the past decade, it was sobering to realize that a greatly intensified and sustained effort is required in the future. Business as usual will not suffice.
This blog first appeared on Joint Learning Network for Universal Health Coverage
Adam Smith, the 18th century social philosopher and political economist, renowned as the father of modern economics, observed in his seminal work “The Wealth of Nations” that “sugar, rum, and tobacco are commodities which are nowhere necessaries of life, [but] which are ... objects of almost universal consumption, and which are therefore extremely proper subjects of taxation.”
Few people today doubt that smoking is bad. But many, including seasoned policy makers, do not realize just how bad it is. Bad for people, bad for economies, and bad for poverty reduction. In fact, tobacco use not only kills millions of people each year but places a staggering poverty and economic burden on low-income families and less-developed countries that is deepening inequalities between and within countries.
For some people in low- and middle-income countries, opening a bank account, taking out a loan, obtaining a driver’s license, or sending their children to school is out of reach because they don’t have official documents that prove their legal identity. Why do some people lack birth certificates, marriage certificates, family members’ death certificates, and other documentation?
Tobacco use poses an unparalleled health and economic burden worldwide. A new study found that the diseases caused by smoking account for US$ 422 billion in health care expenditures annually, representing almost 6% of global spending on health. Smoking causes close to 6 million deaths per year - more than the deaths from HIV/AIDs, TB and Malaria combined. And the total economic cost of smoking after including productivity losses from death and disability amounts to more than US$ 1.4 trillion per year- equivalent in magnitude to 1.8% of the world’s annual GDP.
Since the World Health Organization (WHO) adopted the Framework Convention on Tobacco Control (FCTC) a decade ago, over 180 countries have signed the treaty. Progress has been made in expanding the coverage of effective interventions--more than half of the world’s countries, with 40% of the world’s population have implemented at least one tobacco control measure, and despite increasing global population, smoking prevalence has decreased slightly worldwide from 23% of adults in 2007 to 21% of adults in 2013. How can greater reductions in smoking be achieved in the next decade and contribute to reaching the health and social targets of the UN Sustainable Development Goals (SDGs) by 2030? We review some key issues in the epidemiology and economics of global tobacco control.