Smoking: Licence to die?

Smoking kills up to half of its users. This is the grim reality that slaps you in the face when you read the tobacco fact sheet of the World Heath Organization (WHO). A staggering amount of scientific evidence accumulated over the past 50 years shows that smoking causes several types of cancer, cardio-vascular and respiratory diseases. Nevertheless, smoking kills over 5 million people every year and the death toll continues to rise, especially in low and middle-income countries.

To tackle this global tobacco epidemic, the WHO established the Framework Convention on Tobacco Control in 2005. More than 170 countries have joined this treaty and agreed to put into practice a set of public health policies to protect people from second-hand smoking, to combat tobacco illegal trade and to encourage smokers to quit.

Brazil is one of the pioneer countries in implementing such policies for tobacco control. In 1990, Brazil introduced the first rises in cigarette taxes, which doubled cigarette prices in just ten years. This and other subsequent anti-smoking policies such as smoking bans on public spaces and tobacco marketing restrictions for instance, led to a remarkable drop in smoking rates from 35% in 1989 to nearly half in 2008. But it wasn't known which policies were responsible for this steep decline in the number of smokers.

In a new study published in PLoS Medicine, David Levy from Georgetown University used a computational model to answer this question. Levy found that as much as half of the reduction in smoking rates was due to cigarette price increases alone, while smoking bans and marketing controls each accounted for a 14% drop, and other policies contributed slightly less. The raw numbers are even more impressive: the model estimates that anti-smoking policies saved over 400 thousand lives over the past 20 years in Brazil, and the prediction is that by 2050 almost 7 million more lives will be saved.

Brazil's success story tells us that anti-smoking measures can work even in low to middle-income countries, where smoking is more prevalent. However, Levy's model estimates that an additional 1.3 million deaths could be prevented by 2050 if stricter policies were introduced. So are tougher anti-smoking policies needed to eradicate smoking all together? The answer might be found on the other side of the globe.

Read more: Licence to die?