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Call To Action

The damage inflicted by tobacco use holds back the human potential of entire societies. Ending the tobacco epidemic will realize gains above and beyond improved public health.

Percentage of median household income needed to buy 10 of the cheapest brand of cigarettes per day, 2012

Tobacco control is a fundamental investment in human capital – an investment that leads to growth. Every dollar spent by governments and international donors on tobacco control yields enormous dividends, as non-smokers and former smokers live not only longer, but also more productive lives. Tobacco control measures are relatively inexpensive to implement and, when in place, help to move entire nations from poverty toward prosperity.

Disparity in tobacco deaths

Percentage of smoking-related deaths in mixed-race (mixed black and white ancestry, generally with lower socioeconomic status) and white men (ages 35-74 years) in South Africa: 1999–2007

Tobacco-related deaths are more common in people with lower socioeconomic status. In South Africa, mixed race men tend to be of lower socioeconomic status than white men.

Child Labor

Working in tobacco fields affects school attendance and retention rates

Suza in Kasungu district and Katalima in Dowa district of Malawi: 2008

63% of children of tobacco-growing families were involved in child labor.

10–14% of children from tobacco-growing families are out of school because of working in tobacco fields.

16% of parents said their children were out of school because of an inability to pay educational fees and buy uniforms and shoes.

Lack of education drives individuals further into poverty.

In Burkina Faso in 1998, a Rothman’s representative said, “the average life expectancy here is 40 years, infant mortality is high, the health problems which some say are caused by cigarettes just won’t be a problem here.”

“We reserve …[the] right [to smoke] for the poor, the young, the black and the stupid.” –R.J. Reynolds Tobacco Company executive, 1993

“…when child and maternal mortality are falling universally around the world, the threat of a rise in tobacco is heading in the wrong direction…The developing world is about to enter a phase of rapid growth in tobacco at a time when it can least afford it” –Keith Hansen, The World Bank Group, 2012

Resources

Sources

Hansen K. Remarks by Mr. Keith Hansen, Director of Human Development for Latin America and Caribbean – The World Bank Group: The Tobacco Atlas DC Launch. D.C., USA: The National Press Club; 2012.

“The yawning poverty gap in smoking exacerbates existing, and unconscionable, health disparities. Endgame strategies, therefore, must pay particular attention to the least advantaged, focusing on the equitable distribution of benefits. What justice requires is that the poor do not feel the blowback of the last blasts in the war against Big Tobacco” –Keith Hansen, The World Bank Group, 2012

Tobacco impoverishes countries

Productivity loss and healthcare cost burdens undermine economic development in many countries.

TANZANIA

$40M OF $50M REVENUE
Tanzania earns $50 million per year from tobacco but spends $40 million for tobacco- related cancers alone.

UNITED STATES

$6000 EXCESS COST PER SMOKER
US smokers cost their employers an excess of $6000 a year per smoker due to lower on-the-job productivity, higher absences, and excess healthcare costs.

BRAZIL

100M REALS
The cost to Brazil due to tobacco is approximately 100 million reals per thousand smokers in lost productivity.

Vicious cycle

Disadvantage increases smoking likelihood, and smoking increases likelihood of disadvantaged circumstances

“In 2004-2005, tobacco consumption [impoverished] roughly 15 million people in India.”

—Rijo M John et al, Tobacco Control, 2011

“The market competes on addiction—the most addictive products win out. With research, they [firms], like the cigarette companies, may find out which of their ingredients is most effective in increasing sales/addiction. […]they are loath to give up these profit opportunities, no matter the costs to society.” Joseph E. Stiglitz, Recipient of the Nobel Memorial Prize in Economic Sciences, 2008

A U.S. study found that nearly three quarters of children aged 7-17 who were laboring in tobacco fields in the USA experienced symptoms of green tobacco sickness.

This is ironic as it is illegal for children under 18 to purchase cigarettes, yet they can be employed in tobacco fields and experience illness from their labors.

Opportunity-cost of cigarettes

Slices of bread and servings of rice that could be bought for the price of an average pack of cigarettes; 2013

Purchasing the necessities in life is made more difficult with each extra pack of cigarettes purchased. This matters most for people in low socioeconomic status groups, who make the greatest financial trade-offs to continue smoking.

Resources

Methods

Figures on opportunity costs to purchase cigarettes from 89 countries are available in the Source Data file.

Sources

Economist Intelligence Unit. Worldwide Cost of Living Survey. The Economist; 2013. Proprietary Subscription-Based Data.

The Whole Grains Council. What Counts as a Serving?. 2013 [cited 2014 May 9].

Economic Costs

Direct and Indirect Tobacco-Attributable Costs as a Percentage of Gross Domestic Product

COUNTRY
YEAR
TOTAL COSTS AS A PERCENTAGE OF GDP
DIRECT COSTS AS A PERCENTAGE OF GDP
INDIRECT COSTS AS A PERCENTAGE OF GDP

CHINA
2008
0.64%
0.14%
0.50%

KOREA
2008
0.33%
0.09%
0.24%

US
2009-2012 avg.
2.00%
0.92%
1.08%

SWEDEN
2007
0.35%
0.10%
0.25%

Direct costs are the costs of treating tobacco-related disease borne by the healthcare systems. The main component of indirect costs is lost workplace productivity.

Cost Effectiveness: “With […] cost-effectiveness rivalled only by basic childhood immunisations, few public investments provide greater dividends” –World Health Organization, 1997

Financial strain

Percentage of smokers who spent money on cigarettes instead of household essentials

Smokers spend money on cigarettes instead of on household essentials such as food and education. This could exacerbate the poor’s disadvantaged circumstances and standard of living.

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