Duke Geneva Program, 15 July 20161 |

Tobacco Control and the

Framework Convention

Evan Blecher, PhD

Economist, Prevention of Noncommunicable

Diseases, World Health Organization, Geneva

Duke Geneva Program, 15 July 20162 |

Cigarette excise taxes, prices and consumption in South Africa:

Tax increases that result in price increases, reduce consumption

0

500

1,000

1,500

2,000

2,500

0

5

10

15

20

25

196

1

196

3

196

5

196

7

196

9

197

1

197

3

197

5

197

7

197

9

198

1

198

3

198

5

198

7

198

9

199

1

199

3

199

5

199

7

199

9

200

1

200

3

200

5

200

7

200

9

201

1

Mil

lio

ns o

f p

ac

ks

of

20

cig

are

tte

s

Pri

ce

pe

r p

ac

k o

f 2

0 c

iga

rett

es

(C

on

sta

nt

20

12

Ran

ds

)

Excise tax Net-of-excise-tax price Consumption

Duke Geneva Program, 15 July 20163 |

Smoking prevalence in South Africa:

There are 4 million fewer smokers than there would have been

0%

5%

10%

15%

20%

25%

30%

35%1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

2012

Per

cen

tage

of

adu

lt p

op

ula

tio

n

Duke Geneva Program, 15 July 20164 |

What drove changes in South Africa?

Answers from a “synthetic” South Africa

0

200

400

600

800

1,000

1,200

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004

Per

Cap

ita C

on

su

mp

tio

n o

f C

igare

ttes (

Sti

cks)

Actual/Treatment Synthetic

Duke Geneva Program, 15 July 20165 |

Industry understands importance of

tobacco taxes…

“With regard to taxation, it is clear that in the US, and in most

countries in which we operate, tax is becoming a major

threat to our existence.”

“Of all the concerns, there is one - taxation - that alarms us the

most. While marketing restrictions and public and passive

smoking (restrictions) do depress volume, in our experience

taxation depresses it much more severely. Our concern for

taxation is, therefore, central to our thinking....”

Philip Morris, “Smoking and Health Initiatives”, 1985

Duke Geneva Program, 15 July 20166 |

Cigarette excise taxes and excise tax revenue in South Africa:

tax increases also increase revenue

0

2

4

6

8

10

12

0

2

4

6

8

10

12

196

1

196

3

196

5

196

7

196

9

197

1

197

3

197

5

197

7

197

9

198

1

198

3

198

5

198

7

198

9

199

1

199

3

199

5

199

7

199

9

200

1

200

3

200

5

200

7

200

9

201

1

Ex

cis

e R

eve

nu

e,

Bil

lio

ns (

Co

nsta

nt

20

12

Ran

ds

)

Ex

cis

e t

ax

pe

r p

ac

k (

Co

nsta

nt

20

12

Ra

nd

s)

Excise tax Excise revenue

Duke Geneva Program, 15 July 20167 |

Affordability of cigarettes:

AAPC Relative Income Price, 1990-2006

Duke Geneva Program, 15 July 20168 |

Affordability of cigarettes:

AAPC Relative Income Price, 2006-2013

Duke Geneva Program, 15 July 20169 |

Affordability of beer:

AAPC Relative Income Price, 1990-2013

Duke Geneva Program, 15 July 201610 |

Affordability of sugar-sweetened beverages:

AAPC Relative Income Price, 1990-2013