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Tobacco Control Research to Prevent Cancer

Researchers in our Economic and Health Policy Research program continue their innovative research on the economic and policy aspects of tobacco control. In particular, the team has developed world-leading expertise on: the illicit trade of tobacco products; the effects of international trade and investment agreements on tobacco control; tobacco taxation; tobacco’s impacts on poverty and development, which includes the economics of tobacco farming; and the dynamics around the affordability of tobacco products. The team also participates actively in global capacity-building efforts in these and related areas.

Illicit Trade: One of the most ubiquitous arguments that the tobacco industry uses to undermine public health efforts is the notion that tobacco control policies, and particularly increased excise taxation, cause growth in the illicit trade growth of cigarettes, which prompts governmental concern about tax revenue and even product safety. Remarkably, governments frequently use research on illicit trade from the tobacco industry to inform policy. To address this situation, the EHPR is working with partners worldwide to generate better research, including using more innovative and accurate methods, to improve our understanding of these challenges and better inform policymakers.

Trade and Investment Policies: EHPR’s research on international trade and investment policies closely examines not only how opponents of tobacco control are utilizing key institutional features of international economic agreements (e.g. the World Trade Organization) to undermine tobacco control, but also how these same agreements might serve to engender public health efforts. EHPR Vice President Jeffrey Drope, Ph.D., is leading the Society’s research in this area through a multi-year collaborative project funded by the National Institutes of Health (NIDA, NCI and FIC) and the Johns Hopkins Bloomberg School of Public Health. Please see the reports below.

Tobacco Taxation: The EHPR team continues its cutting edge work on tobacco prices and taxes. Through the years, our researchers have generated many articles about how to implement effective tobacco excise tax reforms.

Poverty and Development: Tobacco use is growing in low- and-middle income countries. It is more prevalent among the poor who can least afford it both in terms of the household expenditures allocated to tobacco consumption and the health care costs born due to tobacco-caused illnesses. The research agenda of EHPR emphasizes poverty and development issues of tobacco use and control. Nigar Nargis, Ph.D., has studied the poverty and development impact of tobacco use as a global phenomenon. Currently, she is devoting her research to the impact of tobacco control, particularly tobacco taxation on the poor and other socially disadvantaged populations. Jeffrey Drope, Ph.D., is leading a project in major tobacco-growing countries that examines the impacts of tobacco farming on poverty and development.

Affordability: In recent years, EHPR researchers have produced pioneering research about the affordability of tobacco products, helping to re-shape the public health community’s conceptualization of the nexus of price, tax, and consumption. This work is now integrated thoroughly and explicitly into the World Health Organization’s formal recommendations on tobacco excise taxation. Previously, health economists focused primarily on prices’ effects on consumption, and particularly the dynamic that higher cigarette prices lead to lower consumption. Observing that many governments were increasing taxes on cigarettes, but consumption was not decreasing, often even when prices were also rising, our researchers began to question the simplicity of this narrow focus. Two of the missing pieces turned out to be income and inflation changes. In other words, the tax and price increases were not “keeping up,” so cigarettes were often still becoming more affordable to consumers. These findings have made addressing affordability the core goal of tobacco taxation efforts. The EHPR team continues this work, particularly now in collaboration with our close colleagues at the University of Waterloo’s International Tobacco Control Project (ITC) and the University of Illinois – Chicago.

Capacity-building: The EHPR program investigators actively participate in educating and informing governments, international organizations, and civil society organizations about the economics of tobacco and NCDs more broadly. For example:

  • Nigar Nargis, Ph.D., continues to play an active role helping governments to implement tobacco taxation reforms. Most recently, she has worked with The Gambia and Bangladesh.
  • Michal Stoklosa, M.A., continues to be actively involved in formally educating representatives of the European Union’s 27 members on tobacco taxation and illicit trade and recently testified before the European Commission.
  • Jeffrey Drope, Ph.D, has twice been a delegate at the WHO FCTC Conference of Parties representing ACS, and recently co-hosted workshops on trade and investment policy in Brazil with the colleagues at Brazil’s National Public Health School and in the Philippines with long-time partner organization, Action for Economic Reforms.

Recent Tobacco Control Publications

Tobacco Atlas Fifth Edition logo

The Tobacco Atlas

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.

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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.

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The Economics of Tobacco Farming in Zambia

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.

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Cigarette Taxation in Kenya at the Crossroads: Evidence and Policy Implications

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.

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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.

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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.