Governments Can Lower Smoking Rates--If They Want to

Smoking is one of the biggest health risks in the world. It greatly increases your risk of dying at a younger age than non-smokers, and before you die it has a high chance of having created multiple (and often very expensive) health problems. I saw that with my own father-in-law, who started smoking as a teenager and then had a stroke at age 67 that kept him confined to a wheel-chair until his death at age 83 from complications with lung cancer. Now that the world has been able to move beyond the "fake news" stories that there was no link between smoking and lung cancer and other health problems, the question is why rates of smoking are as high as they are in some parts of the world? Three years ago, for example, I blogged about the fact that there are more smokers in China than there are people in the U.S. This does not bode well for China's ability to deal with its aging population. 

This week's Economist reports on a study just out in The Lancet showing that smoking rates are directly related to the willingness of a government to step in and do something.

The study examined the link between smoking prevalence and measures to curb it in 126 countries. The authors considered five measures: taxation to raise cigarette prices, smoke-free places, cessation programmes, warning labels on cigarette packs and bans on tobacco advertising. They took stock of the countries which, between 2007 and 2014, had introduced these measures at the level of stringency recommended by the World Health Organisation (WHO). It advises, for example, that taxes comprise at least 75% of the retail price of the most popular brands of cigarettes, and that countries ban all forms of advertising, including billboards, promotional discounts and sponsorship of events by tobacco companies. 

Countries that introduced more measures had greater declines in smoking between 2005 and 2015. In a country that introduced three such measures, for example, the number of smokers shrunk on average by about a fifth. 

These data suggest that it is not necessary to leave it up to individuals to change behavior on their own. Government policies do make a difference.