A substantial increase in cigarette prices could help millions of people around the world avoid poor health and extreme poverty, according to research published by the BMJ. The findings show that people on low incomes have the most to gain. Researchers from the Global Tobacco Economics Consortium and the University of Toronto set out to predict the effect of a 50% increase in cigarette prices on health, poverty and financial protection in 13 middle income countries with a total of 500 million male smokers. The authors used a simple compartmental model, developed by the Disease Control Priorities Project and building on an earlier poverty and tobacco taxation analysis by the Asian Development Bank, to measure the impact of quitting, by age and income group, on life years gained, treatment costs averted, catastrophic medical costs and poverty avoided, and additional tax revenue. Prices were assumed to have been raised by increasing tobacco excise rates to reach the target price in each country. The investigators found that a 50% price increase would lead to about 450 million years of life being gained in the 13 countries as the result of quitting, half of them in China. Across all countries, men in the lowest income group (poorest 20% of the population) would gain seven times as many life years as men in the top income group (richest 20% of the population; 155 v 23 million life years). The average number of life years gained as the result of quitting by smokers in the lowest income group was five times that of those in the top group (1.46 v 0.23 life years). Of the $157 billion in averted treatment costs, the savings were almost five times as great in the lowest as in than the top income group ($46 billion v $10 billion). In seven countries without universal health coverage, about 15.5 million men would avoid catastrophic medical costs. As a result, 8.8 million men, half in the lowest income group, would avoid falling below the World Bank definition of extreme poverty. Overall, 31% of the life years saved and 29% of the averted disease costs and medical costs would be in the lowest income group, which would, however, contribute only 10% of the additional $122 billion in taxes collected.
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