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The World Health Organization’s Report on the Global Tobacco Epidemic published today suggests that if low- and middle-income countries tripled excise taxes on tobacco, rates of use would drop by about 40 percent. It proposes that this is ‘the most plausible way’ to cut tobacco use in order to reduce non-communicable disease (NCD) deaths by 30 percent by 2030. In other words, tobacco taxes offer a direct route to achieving the United Nations’ ambitious Sustainable Development Goal [SDG] 3.4.

At present, one in ten deaths worldwide is caused by tobacco use. It is the greatest risk factor for NCDs, which account for over 39 million deaths each year. Strategic tobacco tax policies can help turn this situation around.

Tobacco taxes can also boost funds for health. Several countries already have successful systems for achieving this – directing increased revenues from higher tobacco taxes to fund universal health care or public health programmes.

In the context of global commitment to the SDGs, one would imagine that the new WHO Report would show the majority of countries seizing the opportunities these strategies offer – to reduce disease and premature death on the one hand while simultaneously increasing funding for health care on the other.

In reality, however, in 2016 just 32 countries had a tobacco tax policy that met WHO recommendations for best-practice. And this number has dropped since 2014. Although tobacco tax is proven to be the most effective policy for reducing tobacco use it is the least well implemented.

So why is this? The public health community has identified several reasons.

Tobacco control has largely remained within the remit of health ministries; but of course health ministers do not set tax rates. Ministers of finance may not necessarily know about, or subscribe to, tobacco control policies - historically, the tobacco industry’s closest government ties have been with the finance ministry. Greater collaboration and unity of purpose across ministries is urgently needed.

It has also been said that the sums involved in a strategic tobacco tax policy are too negligible to bother with. But this view is blinkered. In addition to the ever needed financial income from a tobacco tax policy, the economic gains resulting from these measures include increased productivity, protecting and promoting the health of the workforce, as well as lifting the burden on health services.

But perhaps the main reason for the lack of such policies is simply that tax is rarely interesting. And by its very nature, tax is rarely welcomed by the voter. But if we don’t call for action, governments will not move on this.

Tax might not be compelling, but the huge wins it can achieve for public health absolutely are – children protected from second-hand smoke in the home as parents quit; young people priced out of experimenting with cigarettes; education and homes for families. This is, in part, what achieving SDG 3 looks like. And it is achievable.

Tobacco kills more than seven million people each year, and causes untold distress for the tens of millions of loved ones they leave behind. Meanwhile the tobacco industry is in effect, picking the pocket of the tax payers who fund health and social care. Increase taxes on tobacco, and the balance begins to be redressed.

The saying claims that nothing is certain except for death and taxes. Both are inevitable. But through effective taxation we can work to prevent the particular horror of death caused by tobacco.



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The Tobacco Control Department is based at The Union Europe Office, Edinburgh, registered charity no. SC039880
ⓒ Copyright 2015 The Union