Smoking-induced morbidity and mortality is truly a global phenomenon right across the world regardless of region, race, ethnicity, gender, age group, socioeconomic class, etc.
Smoking affiliated diseases range from cardiovascular and metabolic diseases, pulmonary diseases, lung cancers, oral cancers and many more. Cigarette and tobacco smoking which is an addictive social lifestyle practice is truly a global dilemma in terms of healthcare burden and associated costs.
Despite being a signatory to the Framework Convention on Tobacco Control (FCTC) and a Tobacco Free Pacific, Papua New Guinea is one of the ten countries with the highest rates of tobacco use in the world. According to the 2015 WHO Report on the Global Tobacco Epidemic, 55.4% of adult males and 40.3% of adult females smoked tobacco, whilst at the same time 52.1% of all adult males smoke cigarettes and 43.8% of adult females smoked cigarettes in Papua New Guinea. This is indeed an alarming statistics that needs proper attention from the government authorities in light of its consequences on diseases burden as a result of widespread tobacco and cigarette use in all classes of the communities.
It is well established in medical literature that smoking affects nearly every bodily organ and organ systems in the body and greatly impacts on the individual’s overall health. Smoking is a leading cause of cancer and deaths from cancer. It causes cancers of the lung, throat, oesophagus, mouth, larynx, kidney, bladder, liver, pancreas, stomach, cervix, colon, and rectum, as well as acute myeloid leukaemia. Smoking causes heart diseases, stroke, aortic aneurysm, chronic obstructive pulmonary disease, diabetes, osteoporosis, rheumatoid arthritis, age-related macular degeneration, tuberculosis, and other airway infections. In addition smoking causes inflammation and impairs immune function.
According to the report by The Tobacco Atlas, more than 4,600 people are killed by tobacco related disease every year in Papua New Guinea alone, whilst at the same time 191,000 children and more than 1,658,000 adults continue to use tobacco each day. This startling report from Tobacco Atlas further reveals that 57 deaths in men (8.8%) and 32 deaths in women (5.6%) are caused by tobacco related diseases every week in Papua New Guinea, necessitating the need from policymakers to take drastic measures. Complacency in the face of the tobacco epidemic will ensure the tobacco industry continues dictate over the health of Papua New Guineans year after year.
Tobacco consumption in PNG imposes a significant burden to households, thereby disproportionally affecting poor households. The PNG Government has announced in its 2015 National Budget a change to the indexation arrangements applying to tobacco excise so that it is increased by 10% annually for the next 5 years. Whilst this may help raise tobacco tax by 70% of the retail price, it is still being not enough to deter the addictive power of cigarettes and tobaccos. This current rate of progress in tobacco control is not effective enough, and a lot needs to be done to end the tobacco epidemic. Unacceptably high levels of smoking-induced illness and death, and the associated costs, will persist for decades without change in the approach to slowing or even ending the epidemic.
A new shift in paradigm is needed for this epidemic of the 21st century. The smoking epidemic has shown that the curative-based model is insufficient to reduce the use of tobacco and cigarette and that this will only be achieved by prevention and public health measures such as drastically increase tax on tobacco and cigarette products.
Tobacco taxation is an essential component of a comprehensive tobacco control strategy. Tobacco tax passed onto consumers in the form of higher cigarette prices has been recognized as one of the most effective population-based strategies for decreasing smoking and its adverse health effects. According to published literatures, on average, a price increase of 10% on a pack of cigarettes would reduce demand for cigarettes by about 4% for the general adult population in high income countries such as the United States.
Tobacco taxation increase must be accompanied by other antismoking counter measures to deter cigarette and tobacco consumption. The magnitude of health risks and the associated economic factors can only lead to one conclusion: that there needs to be hard-hitting, well-funded campaigns in all regions at all levels to avert initiation, decrease consumption, and assist with cessation, and protect non-smokers.
In addition, Tobacco taxes can further benefits smokers who quit, reduce the overall consumption of tobacco, and put smoking cessation on the radar of those who continue to smoke. Furthermore, increased taxes also have a positive impact on non-smokers by reducing their exposure to passive smoking.
The associated burden on public healthcare and the economic costs both in terms of household spending and government spending in healthcare far outweigh any economic benefits that tobacco and cigarette lobbyists may advocate.
It has been shown that interventions that raise the unit price of tobacco products through increased taxes generate substantial healthcare cost savings and can generate additional gains from improved productivity in the workplace. Rising tobacco and cigarette tax has been proven to be highly effective in reducing smoking, and therefore cigarette tax increase has become preferred policy for tobacco control in many countries.
Given the alarming figures above, it is high time that the PNG Government pragmatically looks at tackling this disease burden head on by introducing touch countermeasures together with a drastic tax hike on all cigarette and tobacco products. The government’s recent free universal healthcare policy is costing the government a huge chunk of the government budget. This can be alleviated if the government tackles the root cause of the disease burden which is tobacco and cigarette products. Overtime, this will save the government in healthcare costs budget, lower tobacco related deaths and disease as well as improved livelihood and productivity from a healthy population.
Rose Andrew, 2015-2017 PNG’s Fulbright Scholar, Master of Public Health (MPH), Montclair State University, New Jersey, United States. Motivated by Health Policy & Politics course project on Tobacco Tax Policy in USA, 2016 Spring Semester, Course Professor & Advisor: Dr Lisa Lieberman.