Fast population growth, increased advertising by the tobacco industry, and growing tobacco consumption among young people in Africa, all contribute to a projected mass burden of tobacco-related disease. The World Health Organization (WHO) Dear that one in five African adolescents uses tobacco. WHO also predicted a duplication tobacco-related deaths in low- and middle-income countries between 2002 and 2030.
Many efforts are being made to prevent these unnecessary deaths. One of them is the establishment of the Africa Conference on Tobacco Control and Development (October 26-28, 2021). The goal of the conference is to connect researchers, legislators, advocates, students, and members of the public interested in tobacco control on the continent. It is a platform to share information on some of the tobacco control work done in Africa, reflect on lessons learned, and identify what needs attention.
Our own contribution to the conference is work on the economic impacts of tobacco use on the continent and beyond.
Many African countries have indicated that they want to adopt tobacco control policies. Of the 54 countries in Africa, 51 have ratified the WHO Framework Convention on Tobacco Control – Malawi, South Sudan and Eritrea have not. By ratifying the convention, countries commit to adopt effective, evidence-based measures to curb tobacco use.
One of the key interventions is the ban on smoking in public spaces. WHO suggests that, globally, among 1 million and 1.2 million deaths annually are related to exposure to second-hand smoke. Thirteen African countries have smoke-free bans, joining more than 50 countries around the world.
Sixteen African countries demand that cigarette manufacturers print graphic health warnings on cigarette packages. The studies have shown that images of hazards, such as diseased lungs, reduce the appeal of the package and the appeal of smoking.
In 2018, the Protocol to Eliminate Illicit Trade in Tobacco Products entered into force. Countries that ratify the protocol agree to adopt a variety of measures, such as the use of track and trace systems to prevent and counter illicit trade. Currently, 27 African countries have ratified the protocol, the highest proportion of any continent. Several countries have already implemented some of the measures suggested in the protocol.
Increasing excise duties is the most effective measure to reduce smoking. Studies from around the world show that excise duties that effectively raise the price of tobacco products almost always result in a decrease in smoking. The structure of the excise tax is important. In general, a specific tax (an amount of tax per cigarette, regardless of value) is better than an ad valorem tax (a percentage of the value of the product). Simpler tax systems are better than complex ones.
Despite the progress made in many countries, many challenges lie ahead. One is the slow adoption of recommended tobacco tax policies.
Most African countries have excise tax systems that are Generally considered as suboptimal. This is because tax systems are often ad valorem, tiered, or both. These factors reduce the influence of excise duties on the price of cigarettes. Therefore, it is not surprising that cigarettes are relatively cheap in most African countries. In fact, the excise duty, expressed as a percentage of the average retail price, is lower in Africa than in any other continent in the world. On average, this figure stands at 28.6% in Africa, 35.4% in South America and 37.3% in Asia.
In fact, excise duty systems in some countries have regressed. A classic example is Kenya. In the 1990s and early 2000s, Kenya had one of the most complex tax systems in Africa. This complexity allowed the tobacco industry to benefit at the expense of the fiscal and public health. Campaigns led by tobacco control advocates culminated in the implementation of the specific uniform excise duty recommended by the WHO in 2015. However, this achievement was short-lived. In 2019, under pressure from the tobacco industry, the Kenyan government reintroduced a two-tier system. The two-tier system allows tobacco companies to differentiate their products enough to maximize profits on high-end brands, while keeping low-end brands cheap enough that large numbers of people continue to smoke.
South Africa’s tax system has also regressed. Between 1994 and 2009, South Africa’s tobacco control efforts, based on sharp increases in the excise tax, were praised globally. Strict administrative controls by the South African Revenue Service prevented illicit trade from increasing. Since 2010, there has been a rapid increase in illicit trade, although increases in excise duties in the last decade have been negligible. Since 2015, illicit trade in South Africa has increased substantially and now represents at least 35% of the total market. The main reason for this increase is the decreased ability of the South African Revenue Service to ensure tax compliance among tobacco manufacturers. The tobacco industry has been at the forefront of undermining the tax authority. Efforts to implement a track and trace system have been unsuccessful.
The ethical practices of the tobacco industry have been questioned for decades. Recently, the BBC program Panorama presented a documentary on the tobacco industry. The documentary was the culmination of years of research conducted by investigative journalists and researchers from the University of Bath. That details the ways in which British American Tobacco (BAT) acted unethically in various African countries maintain its high profits, block or weaken tobacco control legislation and maintain its dominance of the market.
This is not the first time that British American Tobacco has been accused of these practices and, sadly, it is unlikely to be the last.
Corné van Walbeek, Professor in the Faculty of Economics and Principal Investigator of the Tobacco Control Economics Project, University of Cape Town and Zunda Chisha, Research Officer, Research Unit on the Economics of Excise Goods, University from Cape Town