Triple tobacco tax to save lives: researchers

Tripling cigarette taxes would prevent tens of millions of smoking-related deaths worldwide over the next few decades, and about 200 million premature deaths over the remainder of the century as a whole, a Canadian-led review concludes.

If current smoking trends hold, tobacco will kill about one billion people this century, Prabhat Jha, director of the Centre for Global Health Research at Toronto's St. Michael's Hospital and the University of Toronto writes in this week's edition of the New England Journal of Medicine.

In Canada, smoking remains the leading cause of preventable deaths. More than 40,000 Canadians die each year from lung cancer and other smoking-related diseases, according to the Public Health Agency of Canada.

Many are killed in middle age: Studies in the U.K. the U.S., Japan and India show that smokers are two to three times more likely to die between the ages of 30 and 69 than non-smokers, according to Jha and his co-author, Sir Richard Peto of the University of Oxford.

"Some of those killed in middle age might have died soon anyway, but others might have lived on for decades," they write.

On average, smoking costs people a full decade of life, Jha said.

But his own research published this past year shows that smokers who quit before age 40 avoid 90 per cent of that excess risk, "meaning you get back nine of the 10 years you would have lost if you had continued to smoke."

Even those who quit at age 50 gain back six years of life expectancy.

"The risks are big, and the benefits of quitting are huge," Jha said.

"This prompted us to ask, what would it take to really knock down consumption?"

Doubling the inflation-adjusted price of cigarettes should cut consumption by about a third worldwide, Jha and Peto conclude.

In low- and middle-income countries, that would mean tripling inflation-adjusted specific excise taxes on tobacco — tax hikes that would double the street price of cigarettes in many countries, and more than double prices for cheaper brands.

In Canada, the federal excise tax on a carton of cigarettes is $17, according to background material released with the study.

Federal and provincial sales taxes bring the total cost of a carton to between $46 and $87.

But Jha said there hasn't been a significant increase in the federal tobacco tax since then Finance Minister Paul Martin raised taxes in the early 2000s.

France and South Africa halved consumption in less than 15 years by tripling cigarette prices.

In Canada, smoking rates have flatlined after years of steady decline.

Statistics show that five million Canadians were smokers in 2011, as many as there were in 2008.

"Our evidence suggests that, even in Canada, a big increase in the federal excise tax could get about one million smokers to quit and save about 5,000 lives a year," Jha said.

The biggest barrier is tobacco's "enormous profitability," he said. Worldwide profits for the tobacco industry reached $50 billion U.S. in 2012, or about $10,000 for every smoking-related death, Jha said.

But he and his co-author argue that the extra revenue per pack would offset the effect of tax increases on consumption, and that raising excise taxes to double prices "would raise about another $100 billion (in U.S. dollars) per year in tobacco revenues, in addition to the approximately $300 billion that the WHO (World Health Organization) estimates governments already collect on tobacco."

But the biggest argument is the "hundreds of millions of tobacco-related deaths if current smoking patterns persist."

source: www.montrealgazette.com