A pair of leading tobacco control experts are urging countries to significantly boost tobacco excise taxes, saying it is the best way to reach the global goal of cutting the prevalence of smoking by one-third by 2025.
The experts say a steep rise in tobacco excise taxes would double the cost of cigarettes on the street in developing countries where prices are currently low and the numbers of smokers are climbing rapidly.
They say this type of approach has resulted in substantial reductions in the portion of the population that smokes in countries that have used it, including Canada and France.
'Higher taxes are the single best way to get people to quit smoking. Quitting seriously would avoid something like 200 million premature deaths this century' - Dr. Prabhat Jha, University of Toronto
The arguments are laid out in a review article by Dr. Prabhat Jha, a public health professor at the University of Toronto, and Sir Richard Peto, a professor of medical statistics and epidemiology at Oxford University.
The article is published in this week's New England Journal of Medicine.
They say that if current smoking patterns continue unabated, about one billion people will die from tobacco-related causes this century, most of them in low- and middle-income countries.
Doubling the cost of cigarettes would prompt some current smokers to quit and prevent others from starting, leading to a major drop in tobacco deaths.
"There are no magic bullets in public health. But tobacco taxes are as close to a silver bullet as you can think of," Jha, who is also with Toronto's St. Michael's Hospital, said in an interview from New Delhi.
"Higher taxes are the single best way to get people to quit smoking. Quitting seriously would avoid something like 200 million premature deaths this century."
Most smokers in developing world
The 2013 World Health Assembly — the annual general meeting of the World Health Organization — issued the challenge to governments to reduce smoking among their populations by 2025.
"Without large price increases, a reduction in smoking by a third would be difficult to achieve," Jha and Peto argue.
Jha says that as incomes rise in countries like India, smoking is growing in popularity. He and Peto say that about 1.3 billion people — or one out of every seven people on the globe — smoke. Most of those smokers are in developing countries, where quitting is not common.
"The reason smoking is going up in poor countries is because cigarettes are cheap. Particularly when incomes have grown, people are able to buy cigarettes at a lower price relative to their incomes."
And in many developing countries, cigarette prices vary a great deal, with the most expensive cigarettes priced 10 times or more higher than the lowest priced brands. That's a deliberate policy of the tobacco industry, he says, designed to keep some brands within the budgets of lower income smokers.
Raising excise taxes on tobacco would start to close that gap, Jha says.