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New paper in Lancet: Effective tobacco control is key to rapid progress in reducing NCDs

New paper in Lancet:

Effective tobacco control is key to rapid progress in reducing NCDs

Submitted by sglantz on Wed, 2011-09-28 17:51

Hard evidence shows that implementing policies to cut tobacco use immediately improves health and reduces health care spending, say authors in this week’s issue of The Lancet. The researchers’ myth-busting Viewpoint argues that tobacco control does not, as is often assumed, take decades to show a benefit, nor does the economic benefit from tobacco revenue outweigh the healthcare savings.

Tobacco is responsible for about a sixth of the non-communicable diseases  – such as cancer – that kill 60% of the world’s people. Last week, a high-level UN meeting convened to discuss how to prevent such diseases and adopted a wide-ranging “political declaration”. This declaration recognised the importance of non-communicable diseases and the significant role of tobacco in causing them. It also pledged member states to work to reduce these diseases. While the benefits of cutting out tobacco use are now well-known, legislation and policies curtailing its use are still too weak and not widespread enough, say Prof Stanton Glantz and Mariaelena Gonzalez, at the University of California, San Francisco, USA. The reasons for this are the short-term revenue from tobacco taxes and the myth that the benefits of cutting tobacco use takes decades to materialise.

The mounting evidence in favour of drastically lowering tobacco use cannot be ignored, say the authors. For instance, after quitting smoking for just 1 year, the risk of heart attack falls by half, and after 5 years nearly returns to that of someone who has never smoked. In Arizona, USA, hospital admissions for asthma dropped by 22% after a year of strong smoke-free legislation (that included bans on smoking in workplaces, restaurants, and bars). In Scotland, there was a 13% annual decrease in childhood asthma admissions after the introduction of a smoke-free law.

Lost tax revenue is often used as a reason for being lenient with tobacco restrictions. Yet the numbers do not support this. “The California tobacco control programme cost US$1*4 billion during its first 15 years, and saved $86 billion in direct health-care costs, a 61 times return on investment,” say the authors. Meanwhile, the 3*6 billion packs of cigarettes not smoked during the first 15 years of the state’s programme reduced tobacco tax revenues by only $3*1 billion, a small fraction of the $86 billion in health-care savings.

The money not spent on tobacco still feeds the economy, but in different ways. “In middle-income countries, tobacco use lowers the household standard of living and human capital levels because money to purchase tobacco comes at the expense of other crucial necessities,” the authors add. A study in Bangladesh, for instance, showed that if people reallocated 69% of their usual tobacco expenditure on tobacco on food, 10*5 million fewer Bangladeshis would be malnourished.

World leaders must now “prioritise health over trade,” the authors conclude.

Download PDF : Glantz-NCD-Lancet

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