The tobacco epidemic is one of the biggest public health threats the world has ever faced, killing more than 8 million people each year through direct use and exposure to secondhand smoke. Tobacco is the second leading risk factor for death and contributes to the development of many noncommunicable diseases, including cancer, cardiovascular disease, and lung disease. Additionally, smoking increases risk associated with infectious diseases, such as COVID-19. According to WHO, smokers face a 40-50% higher risk of developing severe disease or death due to COVID-19 compared to non-smokers.
Many of the deaths attributable to tobacco use are considered premature, happening before people turn 70. About 80 percent of the world’s 1.3 billion smokers live in low- and middle-income countries (LMICs). Worldwide, healthcare expenditures to treat diseases caused by tobacco totaled nearly 6 percent of global health expenditures in 2012. Further, tobacco use can reduce productivity by permanently or temporarily removing individuals from the workforce due to poor health or premature death. The effects of tobacco use are most severe for lower income populations, for whom these health and economic losses related to medical expenses and workforce dropout can be devastating. Additionally, spending on tobacco can contribute to poverty by diverting income to purchase tobacco products rather than to fulfill other household needs.
To combat the tobacco epidemic, the World Health Organization (WHO) initiated the development of the Framework Convention on Tobacco Control (FCTC), which was adopted in February 2005. The FCTC is the first global public health treaty and aims to tackle causes of the tobacco epidemic and to address the social, economic, and environmental impacts. Currently, there are 182 Parties to the WHO FCTC, covering more than 90 percent of the world population.
While there have been remarkable achievements following the adoption of the FCTC, many countries are still working to implement tobacco control. The FCTC 2030 project is meant to strengthen tobacco control in LMICs by supporting governments to accelerate the implementation of FCTC measures in line with the 2030 Agenda for Sustainable Development. RTI has worked with the United Nations Development Programme (UNDP) and the Convention Secretariat of the WHO FCTC to prepare the case for investing in tobacco control in 36 countries that were selected to receive direct support under the FCTC 2030 project.
Our analyses have demonstrated that these tobacco control policies result in significant health and economic benefits, and have a positive return on the investment required to implement them. In the four countries featured in this story, investment in six tobacco control interventions is estimated to result in a return of between $40 and $178 to the economy for every $1 spent. The investment cases provide a broad range of policymakers with evidence needed for decision-making and demonstrate that tobacco control can be a win-win for social and economic development.