Tobacco Addiction

Excerpt

Cigarette smoking and other forms of tobacco use impose a large and growing global public health burden. Worldwide, tobacco use is estimated to kill about 5 million people annually, accounting for 1 in every 5 male deaths and 1 in 20 female deaths of those over age 30. On current smoking patterns, annual tobacco deaths will rise to 10 million by 2030. The 21st century is likely to see 1 billion tobacco deaths, most of them in low-income countries. In contrast, the 20th century saw 100 million tobacco deaths, most of them in Western countries and the former socialist economies.

Hundreds of millions of premature tobacco deaths could be avoided if effective interventions were widely applied in low- and middle-income countries. Numerous studies from high-income countries and a growing number from low- and middle-income countries provide robust evidence that tobacco tax increases, timely dissemination of information about the health risks of smoking, restrictions on smoking in public and workplaces, comprehensive bans on advertising and promotion, and increased access to cessation therapies are effective in reducing tobacco use and its consequences. Cessation by the 1.1 billion current smokers is central to meaningful reductions in tobacco deaths over the next five decades. New analyses presented here find that higher tobacco taxes could prevent 3 million tobacco deaths by 2030 among smokers alive today. Reduced uptake of smoking by children would yield benefits chiefly after 2050. Price and non-price interventions are, for the most part, highly cost-effective.

This chapter begins with an overview of smoking trends and tobacco's health consequences, followed by a discussion of the economic rationale for government intervention, with a focus on the uniquely addictive properties of nicotine. A review of the effectiveness of tobacco-control policies in reducing tobacco initiation and in increasing cessation follows. A cost-effectiveness analysis of these interventions is provided. Finally, the constraints to implementing tobacco-control policies are discussed.