The health and economic benefits of tobacco control outweigh the lost tax revenues, the authors of a medical journal commentary say.
In Thursday's online issue of The Lancet, Prof. Stanton Glantz and Mariaelena Gonzalez of the University of California, San Francisco, argue that tobacco controls such as eliminating exposure to second-hand smoke don't take decades to show benefits as is often assumed.
Rather, studies since 2000 show important benefits of reducing smoking mount quickly. The risk of heart attack drops immediately on quitting and returns to that of someone who has never smoked after about five years. California's large-scale tobacco control program started to reduce heart disease death rates after one year, the authors said.
Soviet-era pill to help smokers quit
A related study in Thursday's New England Journal of Medicine suggested that a pill developed in Bulgaria during the Soviet era may help smokers butt out cheaply and safely.
The drug, cytisine, is now used just in Eastern Europe.
Smokers usually take the pill for three or four weeks. Generic versions cost as little as $5 to $17 US a month, compared with about $100 US for an eight-week supply of nicotine patches.
The drug is derived from laburnum seeds, which contain a natural nicotine substitute.
The study involved 740 smokers in Poland. For 25 days, half were given cytisine and half received dummy pills. Neither they nor their doctors knew which treatment they were getting.
After one year, 2.4 per cent of those on dummy pills had stopped smoking versus 8.4 per cent of the people on cytosine.
The study did not compare cytisine to other smoking-cessation treatments, but experts said the results were on par with those of many alternatives
Source: The Associated Press
They pointed to how implementing smoke-free laws has been generally been followed by rapid decreases in hospital admissions for heart attacks in the U.S., Italy, Scotland, Canada, Ireland, France, England and Argentina.
Eliminating exposure to second-hand smoke may also help improve respiratory function. A Canadian study published last year in the Canadian Medical Association Journal also noted that respiratory admissions decreased by 33 per cent in the two years after a smoke-free restaurant law was introduced.
Lost tax revenue is sometimes used to argue against tobacco control. The authors said the evidence doesn't support that claim.
"The California tobacco control program cost $14 billion during its first 15 years, and saved $86 billion in direct health-care costs, a 6.1 times return on investment," Glantz and Gonzalez wrote.
In the same time, the 36 billion packs of cigarettes not smoked during the first 15 years reduced tobacco tax revenues by only $31 billion, they said.
In wealthy countries, spending on tobacco products accounted for a substantial proportion of low-income household budgets, which could otherwise be spent on basic needs such as food, education and health care.
For low-income countries, a study in Bangladesh suggested that if people reallocated 69 per cent of their usual tobacco expenditure on food, 105 million fewer Bangladeshis would be malnourished and the daily rate of child deaths from malnutrition would be halved.
The authors called on leaders to commit to funding to a global program to reduce tobacco in the short term to curb health-care costs and "improve standards of living and human capital levels immediately, with increasing benefits over time."
The work was funded by the U.S. National Cancer Institute and University of California Tobacco-Related Disease Research Program.