Tobacco Control in Bulgaria

Document Sample
Tobacco Control in Bulgaria Powered By Docstoc
					Tobacco Control in Bulgaria

    World Bank presentation
       Burden of Tobacco Deaths Shifting
         World: Annual Tobacco deaths (in millions)

                    2000                              2030

Developed                 2                            ~3
Developing               ~2                            ~7
World Total               4                           ~10

   1 in 2 of long-term smokers killed by their addiction
   1/2 of deaths in middle age (35-69)
           Billion pieces




       5
             10
                   15
                            20
1960

1964

1968

1972

1976

1980

1984

1988

1992
                                 Cigarette Sales in Bulgaria 1960-1999




1996
                               Smoking Prevalence by Sex in Bulgaria, 1997


                  70
                  60
                  50
Prevalence rate




                  40                                                               male
                  30                                                               female

                  20
                  10
                  0
                       18-29   30-39   40-49     50-59    60-69    70-79     80+
 Which interventions are effective?
       Measures to reduce demand
• Higher cigarette taxes
• Non-price measures: consumer information,
  research, cigarette advertising and
  promotion bans, warning labels and
  restrictions on public smoking
• Increased access to nicotine replacement
  (NRT) and other cessation therapies
    Why increase tobacco taxes

• Good for public health
  – Improve health outcomes
     • Change smoking behavior
     • Youth and the poor are more sensitive
     • Increase budget share for other goods and services
• Good for economy
  – Generate revenues
  – Won’t necessarily reduce employment
  – Won’t necessarily increase smuggling
Tobacco Taxes- Important source of revenue!
               Cigarette Tax Revenue as % of Total Government Tax Revenues in Selected
                                         ECA Countries, 1999

                                                                                                                        11%
                                                                                                                10% 11%

                                                                                                    9%     9%
                                                                                          7%
                                                                                   6%
                                                                  5%        5%
                                                           4%
                                 3%      3%       3%
                   2%     3%
         1%
                                       s




                                                         a
                        ia




                                                                                                                ia
                                                                       ia

                                                                                 ch
                                                             sia




                                                                                                              ey
       ia




                                              ry




                                                                                        d

                                                                                               an
                               us




                                                                                                                 e
                                                                                                              ria
              a




                                    ru




                                                       i




                                                                                      an




                                                                                                             in
              ni




                                                                                                           an
                     tv




                                                    on




                                                                        t
     n




                                              a




                                                                                                           rk
                                                                               e




                                                                                                t
                                                                     oa
                             ar




                                                                                                          ga
                                                              s
                                    p
  ua




                                           ng




                                                                                             hs




                                                                                                          ra
            ve

                   La




                                                                            Cz


                                                                                      l




                                                                                                         m
                                                           Ru




                                                                                                        Tu
                                                     t
                                 Cy




                                                                                   Po
                             l




                                                                  Cr
                                                  Es




                                                                                                       l
                          Be




                                                                                                       Uk
  th




                                                                                          ak
          o




                                        Hu




                                                                                                    Bu

                                                                                                      Ro
       Sl
Li




                                                                                         z
                                                                                      Ka
          Studies on the employment effects of dramatically
             reduced or eliminated tobacco consumption


   Type of Country         Name and year              Net change as % of
                                                      employment in base year

   Net Exporters           US (1993)                        0%

                           UK (1990)                       0.5%
                           Zimbabwe (1980)               -12.4%

   Balanced Tobacco        South Africa (1995)             0.4%
   Economies

                           Scotland (1989)                 0.3%

   Net Importers           Bangladesh (1994)              18.7%


Source:Buck and others, 1995; Irvine and Sims, 1997; McNicoll and Boyle 1992,
van der Merwe and others, background paper; Warner and others 1996
                                    The level of tobacco taxes in Bulgaria
                                                            Central European Countries, 2000
                                  100
                                  90
% of total and excise tax rates




                                  80
                                                                                                                                                                          67
                                  70                                                                                                                          63
                                                                                                                             60          61         61
                                  60                                                         54        55          55
                                                                                   49                                                                                          50
                                  50                                                                                               42                    43
                                                                       39                         38                    40                     41
                                  40                                                    34                   37
                                                            31                                                                                                       32
                                  30                                          24
                                                  21
                                  20                              15
                                        88
                                  10                   5
                                   0
                                                                                             Romania




                                                                                                                                          Hungary
                                                                                                                   Estonia




                                                                                                                                                                          Crotia
                                                   Russia




                                                                       Lithuania




                                                                                                        Bulgaria




                                                                                                                                                    Poland
                                                                                   Latvia
                                        Moldova




                                                             Ukraine




                                                                                                                                                              Slovenia
                                                                                                                             CzechRep.
                                                      Total Tax Incidence                                                    Excise incidence
                                 Global (European) Evidence:
                           Total and Excise Tobacco Taxes as % of Retail Price 2000

                                       Excises                   Total
                 110
                 100
                                                              81 82
% share of RSP




                  90                             76 76 79 80
                  80              73 73 74 74 75
                        69 70 71                         65 66 62
                  70 55                               62
                             57 58 57 57 57 58 58 58
                  60      50
                  50
                  40
                  30
                  20
                  10
                   0




                 Po K
                   Fi ly
                  Au h.
                          en




                           rk
                            d
                             .
                 G in
                 Sw y




                          ria




                 De g.
                          nd
                            e




                            e
                          lg




                         ln
                         U
                       an




                       Ita
                       ec




                       nc




                     nm
                        a



                          t




                     r tu
                     Be
                    Ne
                     ed




                      nl
                      st




                    Ir e
                   Sp
                   re




                   Fr
                   m
                 er
           G




                  Total tobacco tax= Excise+VAT, Excise = (Specific+Ad Valorem)
   Li
     th




                  0.00
                         0.50
                                       1.00
                                              1.50
                                                     2.00
                                                            2.50
                                                                      3.00
       ua
          n
   Be ia
Ka la r
  za u s
    kh
        st
            an
     La
                                                                   US$/Pack




         tv
   Uk ia
       ra
          i
  Bu n e
      lg
         ar
              i
    Ru a
         s                      0.57
  Hu s ia
      ng
          a
   Es r y
       to
          ni
    Tu a
        rk
  Ro ey
     m
         an
    Po ia
        la
            n
    Cr d
       oa
            t
    Cy ia
        p
  Sl rus
    ov
        en
                                                                              Average Cigarette Prices/ Pack for ECA Countries, 1999




             ia
     Cz
         ec
              h
                                                                                                                                       Low cigarette prices in Bulgaria
Levs/Litre for milk, and Levs/500
                                           Prices of Cigarettes and Other Consumer
                                                Commodities in Bulgaria, 2000
   Levs/pack for cigarettes,



                                                    % higher than
                                       3.00         cigarette                                450%
        grams for others



                                       2.50         price                             363%
                                       2.00                               230% 232%
                                       1.50
                                       1.00                 50% 60% 61%
                                                   0% 16%
                                       0.50
                                       0.00
                                                 e




                                               rk
                                                o



                                      Ba ilk


                                              en


                                               al
                                      Ch na


                                                 r
                                              ce
                                      To s




                                            tte
                                              pl
                                             at
                                             te




                                           Ve
                                          Po
                                           M


                                         ick
                                          Ri




                                          na
                                         Ap
                                          m
                                          et




                                        Bu
                                       ar
                                       g
                                    Ci
       Tobacco expenditure as % of gross
     income and wages&salaries in Bulgaria
                    1997
6%
                                4.9%
5%

4%                                     3.6%
                                              3.1%
3%

       1.8%
2%            1.6%
                     1.1%
1%

0%
     as % of gross income   as% of w ages & salaries

     Low        Middle        High
                 Deaths in developing regions
                                             CMP
                    Injuries                 18%
                       11%
                                                        Injuries
  NCD                                                    13%
                                     NCD
 47%                     CMP         69%
                         42%


             1990                            2020
                                            By 2020 developing countries will
                                            have a disease profile similar to that
                                            in 1990 in developed countries

                                            Deaths in developed regions
CMP - communicable, maternal                                                    Injuries
and perinatal diseases                                             NCD            7%
                                                   Injuries
                                                     8%            89%
NCD - non communicable         NCD                                                 CMP
diseases                       86%                                                 4%
                                                   CMP
                                                    6%



  Source: Murray and Lopez, 1996           1990                          2020
The impact of the tobacco epidemic on
    health is alarming and rising.

                            Percentage of Smoking Attributable Deaths in Middle Age
                                  Men (35-69) by Selected Causes in Bulgaria,
                                                   1975-1995
% of smoking deaths




                      100

                      80             90                      92                 93               93

                                                                  76                   76               77
                      60                   72

                      40                              46                   47               48
                               41
                      20

                       0
                                    1975                   1985                 1990             1995

                                                All Cancer             Lung cancer          COPD
                                        Male Lung Cancer Mortality in
                                          Selected ECA Countries
                                 150
                                                                                                       Bulgaria
                                 130
Age standardized rate/100,000




                                                                                                       Former
                                 110                                                                   Czechoslovakia

                                                                                                       Hungary
                                  90

                                  70                                                                   Poland


                                  50                                                                   Romania


                                  30                                                                   Former
                                                                                                       Yugoslavia
                                  10
                                        1973

                                               1978

                                                      1983

                                                             1988

                                                                    1993

                                                                           1998

                                                                                  2003

                                                                                         2008

                                                                                                2013
                                Source: International Agency for Research on Cancer
                                 Bulgaria Lung Cancer-Males
                           400
                           350
Annual Mortality/100,000




                                                                                  40-44
                           300
                                                                                  45-49
                           250                                                    50-54
                           200                                                    55-59
                                                                                  60-64
                           150                                                    65-69
                           100                                                    70-74
                                                                                  75-79
                           50
                            0
                                 1973 1978 1983 1988 1993 1998 2003 2008 2013

                            Source: International Agency for Research on Cancer
      Key World Bank Advice to
  Governments to Control Tobacco Use
• Price and taxation increases
• Ban all advertising and promotion (indirect and
  direct)
• Restrict smoking in public and work places
• Disseminate information on health risks that is
  understood
• Fund analytic research on causes, consequences
  and costs of tobacco use
• Support tobacco or health units

				
DOCUMENT INFO
Shared By:
Categories:
Stats:
views:133
posted:3/28/2008
language:English
pages:18