Intended for healthcare professionals

Clinical Review

The economics of global tobacco control

BMJ 2000; 321 doi: (Published 05 August 2000) Cite this as: BMJ 2000;321:358
  1. Prabhat Jha (, senior scientista,
  2. Frank J Chaloupka, professor of economicsb
  1. a Economics Advisory Service, World Health Organization, 20 Avenue Appia, CH-1211 Geneva 27, Switzerland
  2. b University of Illinois at Chicago, USA
  1. Correspondence to: P Jha
  • Accepted 5 July 2000

Few people now dispute that smoking is damaging human health on a global scale.1 However, many governments have avoided taking action to control smoking—such as higher taxes—because of concerns that their interventions might have harmful economic consequences, such as permanent job losses.

In 1997 the World Bank, in partnership with the World Health Organization, began a global study on the economics of tobacco control. A team of over 40 economists, epidemiologists, and tobacco control experts critically examined the current state of knowledge about tobacco control. The aim was to provide a sound and comprehensive evidence base for the design of effective tobacco control policies in any country, with an emphasis on the needs of the low income and middle income countries, where most smokers live. A synopsis of this work, including interim results, was published in 1999.2 Final results, including 19 chapters and a statistical appendix, are now available.3 This article presents the key findings from this study.

Summary points

Tax increases are the single most effective intervention to reduce demand for tobacco (tax increases that raise the real price of cigarettes by 10% would reduce smoking by about 4% in high income countries and by about 8% in low income or middle income countries)

Tax comprises about two thirds of retail price of cigarettes in most high income countries but is less than half of the total price on average in lower income countries

Improvements in the quality and extent of information, comprehensive bans on tobacco advertising and promotion, prominent warning labels, restrictions on smoking in public places, and increased access to nicotine replacement treatments are effective in reducing smoking

Reducing the supply of tobacco is not effective in reducing tobacco consumption

Comprehensive tobacco control policies are unlikely to harm economies


Each chapter of the study relied on …

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