Study: Tobacco taxes and the WHO Framework Convention save millions of lives

A study published in Nature shows that the ratification of the WHO Framework Convention on Tobacco Control (FCTC) This has resulted in an accelerated decline in smoking. Countries that simultaneously implemented active tobacco tax policies saw twice as many declines in tobacco consumption. Researchers highlight the importance of the FCTC, and in particular its tax tool, in saving tens of millions of lives.

The study focused on observing the evolution of tobacco consumption in 171 countries over the ten years following their ratification of the Framework Convention. In particular, the authors focused on two population categories: those under 25, to examine the evolution of their smoking prevalence, and those aged 45-59, to determine the evolution of their smoking cessation rate.[1].

Ratification of the WHO Framework Convention accelerates the decline in tobacco use

The results show that, internationally, smoking prevalence among those under 25 years of age decreased by an additional 0.8% per year, compared to the expected change had the FCTC not been ratified. The effect of ratification of the treaty appears to be magnified in low-income countries, which saw prevalence decrease by 4% per year, compared to the pre-FCTC period. Similarly, the quit rate among those aged 45-59 increased by 0.1% per year after ratification. However, this quit rate is highest in high-income countries.

A reduction in smoking prevalence twice as strong thanks to taxation

The authors also identified 23 countries classified as "high-tax," meaning those whose ratification of the FCTC was accompanied by a ten-point increase in the share of taxation on tobacco sales prices. Smoking prevalence in these countries declined at an annual rate of 2.1% among those under 25, a reduction on average twice as strong as that observed in countries with low taxation on tobacco products. Among 45-59 year-olds, the smoking cessation rate was 0.5% per year in high-tax countries, compared to -0.1% in low-tax countries.

Cumulative effects after ten years of ratification of the WHO FCTC

A decade after ratification of the WHO Framework Convention on Tobacco Control, countries experienced an additional 7.5% decrease in smoking prevalence among those under 25 years of age, compared with what would have been expected if the FCTC had not been ratified. The cumulative global increase in the quit rate among those aged 45-59 was 1.8%. This differential is greater among high-income countries and those with high tobacco taxes.

A significant reduction in the human consequences of smoking

By comparing these prevalence figures to the actual number of smokers, the study shows that ratification of the Framework Convention has resulted, over a decade, in a decrease of 24 million smokers among the population studied, aged under 25. At the same time, the authors of the study point out that the Framework Convention has led to two million additional smoking cessations among 45-59 year-olds. Ultimately, taking into account the decrease in smoking prevalence among young people and the increase in cessation, ratification of the FCTC could save an additional 12 million lives from premature mortality within the population covered by this study. With high-tax countries limited to 23, the researchers estimate that if all the states studied had implemented strong tax policies alongside ratifying the FCTC, 44 million young people under 25 would have been smoke-free.

Keywords: FCTC, WHO, taxes

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[1] Paraje, G., Flores Muñoz, M., Wu, DC et al. Reductions in smoking due to ratification of the Framework Convention for Tobacco Control in 171 countries. Nat Med (2024). https://doi.org/10.1038/s41591-024-02806-0