Tobacco Control Celebrates Thirty Years

Tobacco Control released its 30th anniversary issue this month, marking three decades of important research conducted across the globe to expose the dangers of the tobacco industry and provide evidence-based policy interventions. As editor-in-chief Dr. Ruth Malone notes in her editorial, this milestone calls for celebration of the policies and practices that have changed as a result of the impressive body of research published and the lives saved as a result. It is also, however, grounds for mourning as three decades later the tobacco epidemic persists and millions of lives continue to be lost to tobacco addiction and its secondhand effects.

The new issue highlights the achievements, enduring challenges, and goals in the tobacco control arena, emphasizing the need for renewed commitment to implementing and strengthening tobacco control policy. As found in a study by Dai et al., 1.18 billion people regularly smoke tobacco globally, and more than 7 million people died as a result in 2020. Further, while smoking prevalence has fallen by “more than 40% in some high-income countries . . . there has been little decline in smoking in most low- and middle-income countries.” In surveying the evolution of the tobacco epidemic, industry, and policy landscape, the 30th anniversary Tobacco Control makes it clear that bolder measures are needed to counter industry expansion efforts, particularly in low- and middle-income countries.

We’re proud that the new issue features two articles from our Tobacconomics team discussing several key policy reforms necessary to meet this need. The first, co-authored by Dr. Jeff Drope, Erika Siu and Dr. Frank Chaloupka, titled “Perseverance is innovation: the journey to successful tobacco tax reform,” underscores the need for further tobacco taxation reform, as this remains “the most effective intervention and the least implemented.” The article emphasizes four key components central to maximizing the likelihood of success in these reforms: political will, compelling evidence, technical capacity and civil society activism. Reinforcing the need for renewed efforts in low- and middle-income countries, the authors note that these markets typically have the lowest tobacco tax rates, and also tend to lack at least one of these four components, reinforcing the challenge of implementing more effective policies. With “less than 15% of the world population living in countries meeting WHO’s minimum benchmark that tax share of price be at least 75%,” the article stresses the need for stakeholders to strengthen these four key components to prevent the tobacco industry from continuing to undermine effective tobacco tax implementation, especially in low- and middle-income countries.

Dr. Drope also coauthors a second article in the issue, which discusses the common narrative that tobacco farming is a path to economic prosperity in many low- and middle-income countries. The tobacco industry plays a key role in perpetuating this narrative, which greatly influences policymakers and undermines efforts to improve tobacco control in these countries, particularly tobacco taxation. The article importantly notes that tobacco cultivation brings significant social, environmental, and economic harms to farming families and their communities in addition to the public health harms that result from sustaining tobacco use. To strengthen implementation of effective tobacco tax policy reforms and the four components that drive their success, tobacco control proponents will need to address the false narratives behind tobacco farming.

As we celebrate this 30-year milestone with the Tobacco Control community, we want to join our colleagues in this arena in continuing to pursue what we know works to prevent the tragic disease and death caused by tobacco use, particularly improved tobacco taxation. To reach loftier goals in tobacco taxation— and most other tobacco control interventions— in low- and middle-income countries, we must correct misconceptions around tobacco cultivation and understand the need to strengthen political will, generate compelling evidence, improve technical capacity, and engender civil society activism across these varied environments. When we integrate these understandings, we will achieve more success at changing key policies and saving more lives.