About the Economic & Health Policy Research Program
Analyzing the economics and politics of cancer risk factors
The Economic and Health Policy Research (EHPR) program seeks to address cancer worldwide by conducting research on the economic and policy aspects of risk factors to cancer, including in the areas of tobacco, nutrition, physical activity and harmful alcohol use. We also examine issues around the economics of health equity, including access to care. Within these broader goals, we aim to:
- Provide insights into how market forces and governmental policies affect unhealthy behaviors and consequent health outcomes (and vice versa).
- Increase capacity of colleagues in low- and middle-income countries in relevant data collection, analysis, and the dissemination of policy-relevant research results.
- Promote collaboration and coordination among researchers, advocacy organizations, policy makers, and funders engaged in similar research programs and policy initiatives.
Our program’s historical focus has been on tobacco control, but in recent years, we have made significant efforts to expand to nutrition, physical activity, and harmful alcohol use. Our team of economic and policy analysts, headed by Jeffrey Drope, Ph.D., examines and reports on the most pressing modifiable cancer risk factors globally: tobacco use, nutrition, physical activity, and harmful alcohol use.
Tobacco control remains one of the core components of the EHPR’s broader scientific inquiry. In particular, our investigators have generated cutting-edge research on tobacco prices, taxes, affordability, and illicit trade, and the consequences of international trade and investment policies on tobacco control policies. Recently, our team has led one of the main research initiatives to understand the economics of tobacco farming, including how it remains a barrier to global tobacco control efforts. Read more about our work in tobacco control.
Nutrition has emerged as major global cancer challenge. Analyzing the economics of nutrition is a particular area of focus for the EHPR. Recently, our team has completed research into the relationship between participation in the Supplemental Nutrition Assistance Program (SNAP) and dietary quality that reveals SNAP participants are more likely to consume a lower quality diet than income-eligible participants, emphasizing the need to support interventions encouraging a healthful diet among SNAP participants. We have also recently completed research at the nexus of nutrition and access to care within the Affordable Care Act.
Physical activity – and inactivity – and its impact on cancer is a rapidly evolving area of research. Kerem Shuval, Ph.D., leads the program’s physical activity research, recently collaborating with the Cooper Center to produce the first-ever analysis to look at the role of fitness in the relationship between sedentary time and increased obesity and metabolic risk. Notably, the inclusion of fitness in these models appears to mitigate most of the previously observed negative effects of prolonged sedentary time, suggesting that fitness should continue to be emphasized to reduce morbidity and mortality risk.
Our Team and Recent Publications
Browse a list of our team members and learn more about them.
The most comprehensive, informative, and accessible resource on the pressing issues in the evolving tobacco epidemic. The fifth edition of the book and companion website, produced by the American Cancer Society and the World Lung Foundation and released March 2015, detail tobacco’s role in non-communicable diseases, gender inequality, environmental devastation, and the rapidly growing use of e-cigarettes and water pipes.
The Economics of Tobacco Farming in Kenya
Researchers from the American Cancer Society, the International Institute for Legislative Affairs, McGill University and the University of Ottawa collaborated on a 2016 study about the economics of smallholder tobacco farming in Kenya. Based on a survey of 585 smallholder tobacco farmers in the 3 main tobacco-growing regions in Kenya, this report provides evidence countering tobacco industry claims that tobacco farming is a prosperous economic livelihood for most farmers. Most tobacco farmers make only a small profit and many even lose money each year. Tobacco farming, therefore, should not be a part of a successful Kenyan economic development strategy.
To help tobacco farmers find better livelihoods, the government and partners need to:
- Develop markets – especially improved supply chains – for other viable products
- Help farmers to access credit
- Increase efforts of agricultural extension services to maximize the cultivation of other crops.
A grant from the United States National Institutes of Health (National Institute on Drug Abuse, Fogarty International Center and National Cancer Institute, (Prime Award No. 5R01DA035158-04) allowed the researchers to undertake this study.
Farm-level Economics of Tobacco Production in Malawi
Researchers from the American Cancer Society, Malawi's Centre for Agricultural Research and Development (CARD) and McGill University collaborated on a 2016 study about the economics of smallholder tobacco farming in Malawi, the world’s most tobacco-dependent economy. The alleged damage to economic livelihoods of tobacco growers is widely used as an excuse to slow or stop tobacco control efforts, but actual information about the quality of these livelihoods is scarce. Using a nationally-representative economic survey of nearly 700 farmers, this research finds that tobacco farming is not a lucrative livelihood for most farmers and it is the perception of easier market and credit access that typically keeps farmers in the sector.
A grant from the United States National Institutes of Health (National Institute on Drug Abuse, Fogarty International Center and National Cancer Institute, Prime Award No. 5R01DA035158-04) allowed the researchers to undertake this study.
The Trend in Affordability of Tobacco Products in Bangladesh 2009-2015: Evidence From ITC Bangladesh Surveys
The affordability of tobacco products is widely recognized as an index for evaluating the efficacy of tobacco taxation in low- and middle- income countries. Typically, lower prices translate to increased consumption. A collaborative study led by the EHPR’s Dr. Nigar Nargis concludes that the current price and tax policy in Bangladesh falls short of the objective of effective tobacco control through taxation, as is evident from the increasing affordability of tobacco products there.
Tobacco Control Governance in Sub-Saharan Africa: Implementing Article 5.2(a) of the World Health Organization Framework Convention on Tobacco Control
This recent report sponsored by the United Nations Development Programme and the Secretariat of the WHO Framework on Tobacco Control, and led by EHPR’s Dr. Jeff Drope, examines how good governance and particularly multisectoral cooperation within governments is a key factor in successful tobacco control efforts. The report provides a list of recommendations for facilitating better cooperation within countries.
This preliminary report, a co-production of the University of Zambia School of Medicine and the American Cancer Society’s EHPR, examines the livelihoods of smallholder tobacco farmers in Zambia. Though governments and the tobacco industry argue that we should not pursue tobacco control because it will hurt the livelihoods of these farmers, this report demonstrates unequivocally that most tobacco farmers make a very poor living and would be better off pursuing other healthier economic endeavors.
Working with our colleagues at the International Tobacco Control Project at the University of Waterloo, our team – led by Dr. Nigar Nargis – helped to produce a timely report on tobacco taxation that was used to help convince legislators and other important actors in Kenya to support the recent major tobacco excise tax reform.
The Political Economy of Tobacco Control in Brazil
Together with colleagues from Brazil’s National Public Health School, University of California-San Francisco and McGill University, we examine how Brazil has developed some of the most effective tobacco control policies in the world, and highlight some of the most pressing challenges they continue to face to implement public health policies. A Portuguese language version of this report is available upon request.
The Political Economy of Tobacco Control in the Philippines
With our colleagues at Action for Economic Reforms and McGill University, we explore the challenges that the Philippines has faced to develop their tobacco control policies, with a particular emphasis on their recent landmark tobacco excise tax reform, which has become an example for countries around the world.