“An Ounce of Prevention Is Worth A Pound Of Cure”: Why Pay for Smoking Sicknesses, Let’s Prevent Them In The First Place

After last Monday’s class, I returned home to chat with my kids about things like the differences in global funding for HIV/AIDs, etc. vs. funding for NCDs (you can imagine how much fun it would be to grow up in my house!). I explained how class addressed the fact that diabetes, lung cancer, and heart attacks affect the rich and poor across all nations, yet only a relatively small amount of money goes to paying for these diseases. My 12-year old son responded, “yeah, but who wants to pay for someone’s lung cancer when everyone knows smoking is bad.”

While it is easy to agree with his sentiment, I was moved by Sandeep Kishore’s impassioned argument that paying for NCDs, with their many innocent victims, is a human rights issue. Even so, government entities and major private foundations have yet to express an interest in raising funding for NCDs. Indeed, the likelihood of international groundswell to establish another global fund during this current economic crisis simply does not appear to be realistic, even in view of the enormous costs of inaction.

So where does that leave us? Take my son’s smoking example. When I asked him if he thought there was anything that could be done about smoking, he didn’t miss a beat in suggesting that cigarette packs should cost $100 a pack so that no one could afford to buy them. We don’t need a 12-year old to tell us that strong government action, such as taxes, bans, and other measures, are an effective, low-cost way to reduce smoking and resultant smoking diseases.

In 2005, 173 countries signed on to the WHO Framework Convention on Tobacco Control (2005), which legally binds signatory countries to enact laws to curb tobacco use. In various Reports, the WHO has recognized that raising the price of tobacco through tax increases is the most effective way to reduce smoking (all the while raising funds that can go toward health programs). Similarly, comprehensive smoking bans have proven very effective in both reducing cigarette use and protecting non-smokers from second-hand smoke.

In fact, significant progress has been made. 31 countries have since enacted comprehensive bans to protect against second hand smoke (with many others enacting less restrictive bans). In 2004, Ireland was the first country to enact a national smoking ban in all public work places, and is looking to follow up with a new ban on smoking in cars. In England, it was recently reported that 400,000 people quit smoking in one year after a ban on smoking in public places went into effect. The developing world has also been part of the effort, with Uruguay the first to pass a restrictive ban on smoking in all workplaces, bars, and restaurants. As a sign of things to come, NYC just introduced a ban at outdoor public places, like beaches, parks and even Times Square. Nevertheless, much more needs to be done by the global community to pressure countries, especially developing countries, to enact increasingly restrictive measures to control tobacco use to reduce smoking-induced NCDs.

And what of non-tobacco-driven NCDs? Why not impose a sugar tax to slow horrific eating trends that have given rise to our diabetes crisis? Perhaps that is more government involvement than we can expect even in the face of our NCD crisis. If my son is any example, he has little to say about reducing sugar consumption (as he counts down the minutes until Halloween . . .).

 World Health Report On The Global Tobacco Epidemic, pp. 12, 42-44, 66-67 (2011); 
International Agency for Research on Cancer, IARC Handbooks of Cancer Prevention, Vol. 9, pp. 68-72 (2009); 
Laurance, J., The Independent, Smoking Ban Has Saved 40,000 Lives, June 30, 2008.


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