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Tobacco doesn’t have to kill 1 billion people this century

Adam Cohn

It is well known that tobacco is a killer.

The problem that was once concentrated among the rich countries has spread to low and middle-income countries. With more young people in these countries smoking cigarettes and growing populations, the number of global deaths caused by tobacco is going to increase.

Roughly 5 million people died from tobacco attributed deaths in 2010. That number will likely double in the coming decades, says Dr Prabhat Jha and Richard Peto in the New England Journal of Medicine. The good news is that millions of lives can be saved if action is taken in the next decade. Better yet, we already know how to keep people away from tobacco products.

Maintaining the status quo means tobacco will kill 1 billion people in the next century. Implementing known solutions today can avert 200 million of those deaths.

“Worldwide, a reduction of about a third could be achieved by doubling the inflation-adjusted price of cigarettes, which in many low- and middle-income countries could be achieved by tripling the specific excise tax on tobacco,” write the authors.

It’s that easy. Increase taxes. Fewer people will buy the cigarettes because of the high price and they will not be at risk of the litany of diseases that will kill them.

Top Causes of Death

As easy as it is, increasing the price of cigarettes is just about the only solution short of banning tobacco products entirely. With that understood, the authors say that public officials, journalists and health professionals should be well aware of the negative impacts associated with young adults starting to smoke.

Smoking is the third leading risk factor for death in the world, up from number 4 in 1990, according to the Institute for Health Metrics and Evaluation (above graphic). Global health leaders from the WHO to the Center for Disease Control list tobacco use reduction as a top-line way to save lives and healthcare costs. A WHO-led initiative called MPOWER seeks to advocate for solutions to reducing tobacco use, such as increased taxes and package labels, and confront the global tobacco industry.

Jha and Peto cite it as an important part of the anti-tobacco effort. Stopping youth from smoking is vital because of its addictive quality and the fact that smoking through adult years leads to a loss of roughly ten years for smokers. Fortunately, helping people quit can reverse a lot of the damage caused by smoking. Even a person who smoked until the age of 50 can expect to add another 6 years of life expectancy if s/he quits, cite the authors.

 Persons who began smoking in early adulthood but stopped before 40 years of age avoid more than 90% of the excess risk during their next few decades of life, as compared with those who continue to smoke.

Following the WHO recommendations to reduce tobacco use works. Uruguay implemented the majority of the provisions laid out by the WHO and saw more people quite smoking and fewer take it up. Argentina, on the other hand, followed only a few of the provisions and experienced more modest gains. The authors say that it is important to make quick improvements against tobacco-use because they “can have a substantial and rapid effect on consumption.”

By Max Fisher
Annual per capita cigarette consumption rates. Gray countries have no data available.
Max Fisher / Washington Post

Still, it is the price that will keep people away and force some smokers to quit. Doubling the price of a pack of cigarettes leads to a one-third reduction in smoking, in high-, middle- and low-income countries alike. The taxes hit the poor and least educated the hardest, thus reducing their smoking rates. Further, it is an effective way to keep youth from picking up the habit of smoking.

France and South Africa, for example, were able to halve cigarette consumption twice as fast as the US and the UK by implementing large tax increases on cigarettes. The authors add that money raised by the increased taxes can be used to fund more tobacco-cessation programs, thus further reducing use.

The impact of reaching the WHO goal of decreasing smoking prevalence one-third by 2025 is an estimated 200 million fewer tobacco-related deaths this century. Armed with the knowledge of the impact of smoking and what policies can save lives, will countries implement the necessary policy changes?


About Author

Tom Murphy

Tom Murphy is a New Hampshire-based reporter for Humanosphere. Before joining Humanosphere, Tom founded and edited the aid blog A View From the Cave. His work has appeared in Foreign Policy, the Huffington Post, the Guardian, GlobalPost and Christian Science Monitor. He tweets at @viewfromthecave. Contact him at tmurphy[at]