Intended for healthcare professionals


The benefits of taxing cigarettes in middle income countries

BMJ 2018; 361 doi: (Published 11 April 2018) Cite this as: BMJ 2018;361:k1433
  1. Gordon C McCord, assistant professor1,
  2. Thomas E Novotny, professor emeritus2
  1. 1School of Global Policy and Strategy, University of California, San Diego, La Jolla, CA 92093, USA
  2. 2Graduate School of Public Health, San Diego State University, San Diego, CA, USA
  1. Correspondence to: G C McCord gmccord{at}

People on low incomes have the most to gain

In a linked article, published on the heels of the 17th World Conference on Tobacco or Health,1 Jha and colleagues in the Global Tobacco Economics Consortium (doi:10.1136/bmj.k1162) provide a detailed analysis of the effects of a substantial (50%) increase in the tobacco excise tax in 13 middle income countries.2 In their model of half a billion male smokers, estimates of the responsiveness of demand to cigarette tax increases suggest they will result in substantial smoking cessation (particularly among people on low incomes), reduce tobacco attributable years of life lost, and decrease the risks of catastrophic medical costs in these countries. Many economists, including former US treasury secretary Lawrence Summers, argue that taxes could be more effectively applied to slow the global epidemic of non-communicable diseases, especially in low and middle income countries. Not only do such fiscal policies reduce tobacco consumption, they also denormalise tobacco use and can support funding for public health programmes.3

Here, we review some economic arguments for cigarette taxation. These are useful to justify these …

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