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We can beat the tobacco epidemic

Dr Oleg Chestnov, WHO Assistant Director-General, Noncommunicable Diseases and Mental Health, and Dr Tim Evans, Senior Director, Health, Nutrition and Population Global Practice, The World Bank Group

Joint commentary
7 July 2015

2015 marks a decade since the WHO Framework Convention on Tobacco Control (WHO FCTC) entered into force, and in that time impressive global gains have been made in the battle against the tobacco use epidemic.

Dr Oleg Chestnov, WHO Assistant Director-General, Noncommunicable Diseases and Mental Health.
Dr Oleg Chestnov, WHO Assistant Director-General, Noncommunicable Diseases and Mental Health.

Spurred by this landmark Convention, most countries across the world have launched comprehensive tobacco control programmes. But, much more must be done to prevent ill health, disability, and the projected 1 billion deaths from tobacco-related diseases this century.

This deadly epidemic has the potential to undermine economic and social development worldwide, and is what drives WHO’s support to countries in the war against tobacco. One strategy that has taken national tobacco control efforts to the next level is the MPOWER package of measures, which was established in 2008. It identifies 6 key WHO FCTC policies – 1 for each letter of the MPOWER acronym – to stamp out the tobacco epidemic, namely to:

  • Monitor tobacco use and prevention policies
  • Protect people from tobacco smoke
  • Offer help to quit tobacco use
  • Warn people about the dangers of tobacco
  • Enforce bans on tobacco advertising, promotion and sponsorship
  • Raise taxes on tobacco.
Dr Tim Evans, Senior Director, Health, Nutrition and Population Global Practice, The World Bank Group.
Dr Tim Evans, Senior Director, Health, Nutrition and Population Global Practice, The World Bank Group.

WHO, in its fifth and latest "Report on the global tobacco epidemic, 2015", makes a strong case for action to implement MPOWER. The report shows how strong tobacco control policies, can reduce tobacco use and monitor progress in reducing the impact of the tobacco epidemic. It also details country efforts to meet tobacco control targets, and what more they can do.

The evidence of progress is impressive. Today, due to decisive action taken by many countries, almost one in every two people on the planet are covered by at least one MPOWER measure applied at the highest level. This number of countries has more than doubled since 2007 and consequently millions of lives have been saved.

However, the latest "WHO Report on the global tobacco epidemic" points to the fact that most countries are not using one of the cheapest, most effective measure to curb death and suffering from tobacco – taxation of tobacco products.

Higher taxes make tobacco less affordable, helping tobacco users quit and keeping non-users– especially young people, women, and the poor – from ever starting. Despite the proven effectiveness of raising taxes, it is the least implemented MPOWER measure. As shown in a recent study for WHO, only 33 countries levy sufficiently high taxes on tobacco, comprising at least 75% of the retail price of cigarettes. This equates to just one in 10 people on the planet.

Raising tobacco taxes costs little to implement and leads to a windfall of benefits. More importantly, the burden of noncommunicable diseases (NCDs) will be much lower, and public health improved. There will also be less need for expensive care from tobacco-related illness.

And, raising taxes can help a country mobilize additional revenue to fund vital health programmes and other essential public services that benefit us all. Indeed, tobacco taxation is an untapped source of domestic financing that will also be important for the successful implementation of the post-2015 Sustainable Development Goals (SDGs).

The tobacco industry and other vested interests argue that tax increases on tobacco products fuels the illicit trade of such deadly items. Accumulated international experience, however, shows this argument is flawed. In high-income countries, where higher taxes have increased tobacco prices, illicit trade still is less common when compared to low-income countries with low tobacco taxes. Indeed, the United Kingdom, Hungary, Chile, Brazil and Spain, for example, have increased tobacco taxes while curbing illicit trade.

Many countries have achieved best practice implementation of multiple MPOWER measures. But it’s clear more must be done. All countries are obliged – and able – to protect and contribute to their people’s wellbeing. Fully implementing the WHO FCTC, including all MPOWER measures, can help countries achieve better health outcomes, and contribute to sustainable economic and social development.

Both WHO and The World Bank Group remain committed to support, as a moral and development imperative, the global tobacco control measures outlined in this report, particularly those related to the tobacco tax agenda. We are convinced that, working together, in support of countries, we will be able to contribute to reverse the epidemic of tobacco use and prevent the human tragedy of tobacco-related illness and death, and save countless lives each year.