A new global study reveals that higher cigarette taxes could dramatically reduce child deaths, especially in low and middle-income countries (LMICs), where children are most vulnerable to the health consequences of smoking.
Researchers from Sweden’s Karolinska Institutet, along with international collaborators, published their findings in The Lancet Public Health, highlighting how fiscal policy can be a life-saving public health tool.
According to the World Health Organization (WHO), tobacco taxes should account for at least 75% of the retail price of cigarettes. However, most countries fall short of this benchmark.
If the 94 LMICs studied had implemented this recommended level of taxation, over 280,000 child deaths under the age of five could have been prevented in just one year.
The researchers analyzed data from WHO, the World Bank, and the UN Inter-agency Group for Child Mortality Estimation from 2008 to 2020. They examined how different types of cigarette taxes—such as excise duties, ad valorem taxes, import duties, and VAT—affected child mortality across income groups.
The study found that higher cigarette taxes benefited all socioeconomic groups but had the most significant impact among the poorest families. Excise taxes, in particular, showed the strongest link to improved child survival.
These taxes help reduce parental smoking, lower exposure to secondhand smoke, and free up household income for essential needs like food and healthcare.
“Smoking-related diseases and deaths among children remain alarmingly high in LMICs,” said Olivia Bannon, a lead researcher on the study. “Increasing cigarette taxes is a proven, cost-effective strategy to protect child health, especially in disadvantaged populations.”
Despite strong evidence, researchers warn that the tobacco industry continues to resist policy changes. “Our study provides clear evidence for policymakers to resist industry pressure and act in favor of public health,” emphasized Dr. Márta Radó, principal investigator.
The research was supported by Sweden’s Forte, the Riksbankens Jubileumsfond, and the EU Horizon 2020 Programme, and conducted in collaboration with institutions in the Netherlands, Canada, and the UK.
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