Countries should raise taxes on tobacco, says WHO

BMJ 2015; 351 doi: (Published 06 July 2015) Cite this as: BMJ 2015;351:h3691
  1. Anne Gulland
  1. 1London

Countries are urged to impose higher taxes on tobacco products, after a World Health Organization report found that only 10% of the world’s population lived in countries where tax accounted for 75% or more of the price of a packet of cigarettes.1

Thirty three countries impose taxes that account for more than three quarters of the price of a packet of cigarettes, one of the measures recommended in WHO’s Framework Convention on Tobacco Control. Raising taxes is the least implemented measure in WHO’s six point action plan on curbing tobacco use, with just 11 countries raising taxes to the recommended level between 2008 and 2014.

Countries levying high taxes include Jordan (where tax accounts for 83.3% of the cost of a packet of cigarettes), Bosnia and Herzegovina (82.3%), the United Kingdom (82.2%), Finland (81.5%), and Chile (80.8%). Low tax countries include Tuvalu (2.7%), Afghanistan (2.8%), and Iran (4.8%).

The most expensive country in the world to be a smoker is Australia, where the cheapest packet of 20 cigarettes costs $US13.66 (£8.78; €12.38), followed by Norway ($12.72) and Ireland ($10.64). The cheapest country in the world is Tunisia, where a pack of 20 cigarettes costs $0.23, followed by Ethiopia, where it costs $0.25.

The proportion of adults who smoke has fallen only slightly in recent years, from 23% in 2007 to 21% in 2013. The proportion of smokers was higher in rich countries (28%) than in middle (22%) and lower income countries (17%) in 2013.

WHO’s report emphasised that raising taxes was an effective way to reduce the prevalence of smoking, with research from high income countries showing that a 10% price rise reduced consumption by between 2.5% and 5%. Data from low and middle income countries showed that the effect of price increases was more variable, with a 10% hike in the cost of tobacco leading to a 2-8% reduction in consumption.

Implementing tax increases was relatively inexpensive, WHO said, and was the least costly of all the tobacco control measures. A recent WHO study estimated that implementing and administering tax increases cost $0.05 per person per year in low and middle income countries.2

Margaret Chan, WHO’s director general, said that raising tobacco taxes was one of the best “win-win policy options available for health.”

She said, “Raising taxes on tobacco products is one of the most effective—and cost effective—ways to reduce consumption of products that kill.”

Other gains in tobacco control since 2012 include the five countries (Chile, Jamaica, Madagascar, Russia, and Suriname) that implemented laws banning smoking in indoor public places and workplaces and the 12 countries (including Bangladesh, Jamaica, Turkmenistan, and Vietnam) that introduced large graphic warnings on the dangers of smoking on cigarette packets.


Cite this as: BMJ 2015;351:h3691


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