Public health measures aimed at reducing tobacco use have saved countless lives in recent decades. But there are still around 1.2 billion tobacco users globally, and tobacco-related diseases kill about 7 million people annually, according to the World Health Organization.
In Australia, high taxes on cigarettes and other tobacco control policies have achieved sharp declines in deaths from lung cancer and other smoking-related diseases since 2000, but progress has stalled in recent years.
Some experts have argued that the high price of cigarettes has pushed consumers to look for cheaper alternatives, fuelling an illicit market that now accounts for half of the cigarettes consumed in Australia. They have called for a pause or reduction in taxes to help bring the illicit trade in cigarettes under control.
Responding to this suggestion, Professors Prabhat Jha and Sarah Lewington from Oxford Population Health, and Professor Emily Banks, from the National Centre for Epidemiology and Population Health at Australian National University point out that high duties on cigarettes have been the single most effective intervention for reducing smoking rates, even where lower-priced illicit cigarettes are available.
In a commentary article published in Addiction, they point to evidence that the tobacco industry uses smuggling to try to retain market share of its brands and exaggerates the size and impact of illicit sales to convince governments to lower taxes. A ‘misguided decision’ to cut taxes in Canada resulted in 30 to 40 billion more cigarettes being consumed which could contribute to approximately 30 to 40,000 excess deaths.
Jha, Lewington and Banks argue that saving further lives in Australia will require using other measures to counter illicit sales while maintaining high taxes on cigarettes and helping current smokers to quit.
Among 2.3 million adults in Australia who currently smoke, figures from several studies suggest that at least half of those who started in early adulthood will be killed by their addiction. But quitting by age 40 or earlier avoids 90% of tobacco-related health risks.
Speaking to the Daily Mail recently, Jha described giving up smoking as ‘ridiculously effective’.
‘Studies have shown that if you’re a long-term quitter – having not smoked for 10 years or more – you get back almost all of that lost life that you wouldn’t have if you’d continued. And it takes just three years for half of those gains to accumulate.’
Jha, Lewington and Banks conclude that ‘no single intervention is a panacea’. ‘To further save lives, combinations of price and non-price interventions, including expanded cessation support, are needed.’
Mortality trends in Australia were derived from the Richard Doll Consortium Mortality Trends tool.