Published on Investing in Health

World No Tobacco Day 2024: Preventing tobacco addiction in children and youth

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 Teenage boys smoking Asian boy is holding lighted cigarrette and starting to smoke with his friend in private area of school and house to avoid punishment from teachers or parents. Copyright: Shutterstock

The theme for this year’s World No Tobacco Day, "Protecting Children from Tobacco Industry Interference," underscores the critical need to prevent future generations from falling prey to the harmful impact of tobacco use.

About 8 million people die each year from tobacco-related diseases, accounting for 13 percent of deaths worldwide. The industry's strategic targeting of youth through marketing tactics such as appealing packaging, flavors, and advertising is designed to entice new, younger users. These practices, part of the “economics of deception and manipulation” as described in the acclaimed book by Nobel Prize in Economics laureates, George Akerlof and Robert J. Shiller, undermine public health efforts and pose a significant threat to the well-being of young people, who are more susceptible to addiction and the long-term ill health consequences of tobacco use.

The significance of protecting youth for human capital development

Protecting children from tobacco use is vital for supporting human capital development. By safeguarding young people from the influence of tobacco, we ensure that they are less likely to develop tobacco-attributable-diseases that hinder their educational attainment and professional achievements. Healthy, tobacco-free youth are more likely to perform better academically, which translates into a more skilled and capable workforce in the future. This fosters innovation, economic growth, and societal progress, as individuals can fully realize their lifetime potential without the ill health burden of tobacco use.

These efforts also contribute to reducing healthcare costs associated with treating tobacco-attributable diseases, such as cancer, cardiovascular diseases, and respiratory illnesses. This not only improves individual quality of life but also reduces the strain on healthcare systems. 

Tobacco taxation is a highly effective measure to control tobacco use

One effective strategy in protecting children from tobacco industry interference is the implementation of higher taxes on tobacco products to increase their prices and lower their affordability. Research has consistently shown that young people are more price-sensitive than adults, meaning that higher tobacco prices can significantly reduce their likelihood of purchasing these products.

In addition to fiscal measures, regulatory policies can also play an important role in protecting children and adolescents from relentless advertising and promotion by the tobacco industry. Comprehensive bans on tobacco advertising, promotion, and sponsorship, as well as plain packaging laws, can reduce the social acceptability of tobacco use. By creating environments where tobacco use is less visible and less glamorized, we can deter youth from starting to use tobacco in the first place.

Despite the potential of tobacco taxes, they remain an underused policy

Taxing tobacco is a highly effective but underused policy to control tobacco use. The 2024 Tobacconomics Cigarette Tax Scorecard reveals that governments worldwide have made insufficient progress in leveraging tobacco taxation to combat tobacco use as one of the leading causes of preventable death. Despite the potential of tobacco taxes to both save lives and increase government revenues, most countries have not effectively utilized this policy tool. The Scorecard finds that the global average cigarette tax score dropped down to 1.99 out of 5.00 points in 2022 following a modest increase from 1.89 in 2014 to 2.25 in 2020. Overall scores improved in only 31 countries from 2020 to 2022, while scores worsened in 76 countries and stayed the same in 55 countries. Only 68 countries of the 170 for which data are available scored 2.50 or higher.  As a result, cigarettes are affordable in most countries and becoming more affordable in too many.

Advancing the tobacco taxation agenda

A World Bank Group assessment of country experiences suggested that to move forward with tobacco taxation, leaders need to adopt bold and decisive strategies. One critical step is to implement substantial tax rate increases early in the process, prioritizing health gains over fiscal benefits. Successful tax strategies should focus on reducing tobacco product affordability.  Combining large initial tax hikes with recurrent increases can help ensure that prices are adjusted not only for inflation, but rise faster than real income growth, thus curbing consumption.

Effective communication is also crucial in managing public expectations. Governments must convey that tax hikes are not one-off events but part of a sustained effort to keep tobacco prices increasing to motivate current smokers to quit and deter young people from starting. Simplifying tax rates and basing them on quantity rather than price can prevent tobacco users from switching to cheaper brands. Additionally, "soft earmarking" of tax revenues—linking increased taxes to increased health spending—can garner grassroots support for tax hikes. Regional collaboration can also enhance the impact of these measures, as seen in the European Union, by minimizing cross-border smuggling and fostering shared goals among countries.

There is no time to waste

The COVID-19 pandemic exposed the potential devastating impact of unattended public health, social, and environmental risks and their spillover effects in a fast-changing, crowded, and interconnected world. That sobering experience clearly illustrated the high price societies pay for inaction in dealing with global challenges, old and new. Tobacco use is a decades-old pandemic that needs to end once and for all, across the world, as an imperative to sustainable development. 

 

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Patricio V. Marquez

Former World Bank Group (WBG) Lead Public Health Specialist

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