Taxes on alcohol, tobacco, and soft drinks are fair and produce health gains, review finds
BMJ 2018; 361 doi: https://doi.org/10.1136/bmj.k1524 (Published 05 April 2018) Cite this as: BMJ 2018;361:k1524All rapid responses
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The research news section about “non-communicable diseases and economics” concluded with a citation “Taxes on unhealthy products can produce major health gains, and the evidence shows these can be implemented fairly, without disproportionately harming the poorest in society”(1) but did not analyse why there was no implementation or at best only flawed implementation (eg. no adjustment for inflation).
First, the conclusion is not news. As long ago as 1776, in “The Wealth of Nations”, Adam Smith stated: "Sugar, rum, and tobacco are commodities which are nowhere necessaries of life, which have become objects of almost universal consumption, and which are therefore extremely proper subjects of taxation." For several decades there has been accumulating evidence of the major effectiveness of such policies on citizens’ health.
Second, the report overlooked economics.
a) Tobacco is a great tool to stimulate the economy. It provides high revenues from taxes plus savings in healthcare spending, retirement pension and long-term nursing care: indeed, smokers die 10 years earlier than non-smokers.(2) Preventing premature death is costly: average healthcare spending up to the age of 60 is twice as high as the spending up to 40.
b) Wine is the second French export after the airspace industry and a wealthy internal market is the cornerstone for exports. Accordingly, France lobbied against the act about minimum alcohol pricing in Scotland claiming it “would be disastrous on the balance of European trade”.(3) The new French President hired as special advisor for agriculture the CEO of "Vins et Société", the wine professional organisation.(4) French citizens are most happy with this: since 1998, a small group of “wise” persons has been questioning candidates for the presidency about their public policies (tobacco, alcohol, nutrition, road safety and drug marketing) and publishing their evaluation. In 2017, French citizens elected the one ranking just before the last.(5) France will remain at the top among the chimneys (smoking prevalence one third) and the barrels (12 g of alcohol per adult per year) of rich countries. The trade and the pension scheme deficits preclude public health policies for tobacco and alcohol control.
Comprehensive public health policies are simple and effective. However, major adverse effects cannot be overlooked: public health policies are damaging to the wealth of the nation. That is why they are not, and will not be, implemented.
1 Mayor S. Taxes on alcohol, tobacco, and soft drinks are fair and produce health gains, review finds. BMJ 2018;361:k1524.
2 Braillon A. Smoking-attributable medical expenditures: Time biases and smokers' social role. Prev Med 2015;81:294.
3 http://www.bbc.com/news/uk-scotland-scotland-politics-22188373
4 http://www.decanter.com/wine-news/president-macron-wine-adviser-bourolle...
5 http://www.securite-sanitaire.org/reponses2017/LeMonde11avril.pdf
Competing interests: No competing interests
Re: Taxes on alcohol, tobacco, and soft drinks are fair and produce health gains, review finds
I support Dr Braillon. Indeed, a search through the archives will show that I have advocated aerial spraying of herbicides to kill off tobacco crops. I have also advocated tbe emptying out of alcohol bottles held in the bars of the Commons into the mouth of Old Father Thames.
Those who have read history might recall that the British traders once forced opium down the throats of the Chinese. We mounted the Opium Wars. Of course we won.
We are proud of our grape harvests and our fizzy which is said to match ....Champagne.
Let us turn our alcohol into automobile fuel.
Competing interests: No competing interests