Interpreting results, impacts and implications from WHO FCTC tobacco control investment cases in 21 low-income and middle-income countries

Abstract

BackgroundTobacco control investment cases analyse the health and socioeconomic costs of tobacco use and the benefits that can be achieved from implementing measures outlined in the WHO Framework Convention on Tobacco Control (WHO FCTC). They are intended to provide policy-makers and other stakeholders with country-level evidence that is relevant, useful and responsive to national priorities and policy context.MethodsThis paper synthesises findings from investment cases conducted in Armenia, Cabo Verde, Cambodia, Chad, Colombia, Costa Rica, El Salvador, Eswatini, Georgia, Ghana, Jordan, Laos, Madagascar, Myanmar, Nepal, Samoa, Sierra Leone, Sri Lanka, Suriname, Tunisia and Zambia. We examine annual socioeconomic costs associated with tobacco use, focusing on smoking-related healthcare expenditures, the value of lives lost due to tobacco-related mortality and workplace productivity losses due to smoking. We explore potential benefits associated with WHO FCTC tobacco demand-reduction measures.ResultsTobacco use results in average annual socioeconomic losses of US$95 million, US$610 million and US$1.6 billion among the low-income (n=3), lower-middle-income (n=12) and upper-middle-income countries (n=6) included in this analysis, respectively. These losses are equal to 1.1%, 1.8% and 2.9% of average annual national gross domestic product, respectively. Implementation and enforcement of WHO FCTC tobacco demand-reduction measures would lead to reduced tobacco use, fewer tobacco-related deaths and reduced socioeconomic losses.ConclusionsWHO FCTC tobacco control measures would provide a positive return on investment in every country analysed.

Evolving methodology of national tobacco control investment cases

“…Small et al in this collection describes the evidence to date on how WHO FCTC investment cases have been used and the policy results that might be attributable to them across multiple countries, and Mann et al report results for 21 countries. 4 30 …”

“…Results from the analysis are reported in Mann et al in 2021 US$. 4 Below, we discuss the data and methods we used from 2017 to 2022, describing instances where our approach or data source(s) changed to align with evolving evidence or best practices. More detailed methods and explanation of the underlying data may be viewed in the online supplemental file 1 and country-specific data used in investment cases may be found in annexes of individual country investment cases that are available online.…”

“…Mann et al provides a full accounting of these results and places them in the context of country demographic, economic and health conditions. 4 …”

Advancing progress on tobacco control in low-income and middle-income countries through economic analysis

“… 14 Mann et al compile results of the modelling across 21 countries and discuss patterns and insights derived from the studies. 15 Finally, Spencer et al explore the equity implications of potential tobacco tax increases in 19 countries, demonstrating how tobacco control is linked to addressing poverty and inequalities. 16 Taken together, the papers provide a view of the FCTC 2030 project’s contribution to examining and strengthening responses to the health, social and economic aspects of tobacco.…”

Tobacco control in low-income and middle-income countries: findings from WHO FCTC investment cases

“…Mann et al 10 provide a summary of results and a synthesis of findings from 21 tobacco investment cases in LMICs that employed the common investment case methodology described in Nugent et al . 9 Tobacco consumption was found to result in average annual losses of US$95 million, US$610 million and US$1.6 billion in the low-income, lower-middle-income and upper-middle-income countries that were studied, respectively.…”