WHO event addressing public health priorities
Keywords: tobacco, nicotine, taxation, tobacco tax, Eastern Mediterranean
Citation: World Health Organization. High-level meeting of ministers of health and ministers of finance from the Eastern Mediterranean Region on taxation of tobacco and nicotine products. East Mediterr Health J. 2024;30(11):803–804. https://doi.org/10.26719/2024.30.11.803.
Copyright: © Authors 2024; Licensee: World Health Organization. EMHJ is an open access journal. All papers published in EMHJ are available under the Creative Commons Attribution Non-Commercial ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo).
In 2022, approximately 92.5 million adults (83 million men and 9.5 million women), or 19% of the population in the Eastern Mediterranean Region (EMR), were tobacco users (1). Alarmingly, 3 of the 6 countries, globally, in which tobacco prevalence is expected to increase are in the EMR (1). Reducing this high level of tobacco use requires urgent action on all fronts to strengthen tobacco control policies, most importantly by increasing tobacco and nicotine products taxes. Increasing taxes on tobacco products will make them less affordable, especially for adolescents and young adults, but inaction will put EMR at risk of higher health burdens and limit progress towards achieving the health-related Sustainable Development Goals.
In June 2023, the WHO Regional Office for the Eastern Mediterranean convened a high-level meeting of ministers of health and ministers of finance of EMR countries to discuss tobacco and nicotine products taxation, following recommendations of the High-Level Ministerial Group on the Control of Tobacco and Emerging Tobacco and Nicotine Products during the 2021 regional committee meeting. The June 2023 meeting discussed:
Commitments to implementing recommendations of the Framework Convention on Tobacco Control (FCTC) on the increase of tobacco taxes and improvements in the tax structure.
Status of tobacco products taxation in the EMR, including challenges and opportunities for improvement.
International and regional best practices in tobacco taxation as a basis for informing policy decisions.
Potential uses for revenue generated from tobacco and nicotine products taxes.
The way forward for the adoption of new taxation policies and for strengthening tobacco control strategies by EMR Member States.
Summary of discussions
EMR countries need to consider a comprehensive policy direction for the control of tobacco use, including raising tobacco taxes, which has been recognized globally as one of the most effective methods of curbing tobacco use, as evidenced by the SimSmoke model, the Interactive Smoking Projection and Target Setting Tool and the regional investment cases (2-7).
With guidance from the WHO FCTC Article 6, EMR countries have made notable progress in implementing tobacco taxation systems (8). However, tobacco and nicotine products remain affordable in the EMR. Only 3 countries in the region are implementing the WHO recommended effective taxation level of 75% with a regional average of 65.6% in 2022 (1).
Tobacco products taxation offers the dual benefits of increased revenue for government and the potential to increase health funding. One of the challenges to effective implementation of tobacco taxation is illicit trade and this can be addressed through inter-departmental collaborations, taxation of all tobacco products and implementation of anti-smuggling measures.
Initiatives to strengthen tobacco products taxation at country level include reassessment and revision of tobacco tax rates, conducting tax simulation on tobacco products and public health, implementing the track-and-trace system, effective implementation and enforcement of taxation policies, aligning taxes to inflation, increasing taxes on new and emerging tobacco products, raising awareness about the health and economic benefits of tobacco taxation, and continued evaluations and cross-border consultations to enhance taxation policies across the region.
Recommendations
Participants made the following recommendations:
For EMR countries
- Foster sustained collaborations between the health and finance ministries, with built-in capacity building, to ensure effectiveness of tobacco taxes.
- Explore opportunities to allocate tobacco tax revenues for healthcare and further tobacco control.
For WHO
- Encourage more countries to adopt the FCTC Protocol to Eliminate Illicit Trade in Tobacco Products.
- Facilitate regular meetings of countries to exchange knowledge and experiences on tobacco taxation.
- Continue to support in-depth analysis of tobacco and nicotine products taxation across the region.
References
- World Health Organization. WHO global report on trends in prevalence of tobacco use 2000-2030. Geneva: World Health Organization, 2024. https://www.who.int/publications/i/item/9789240088283.
- World Health Organization. The WHO tobacco tax simulation model WHO TaxSim. Geneva: World Health Organization, 2018. https://iris.who.int/bitstream/handle/10665/260177/WHO-NMH-PND-18.3-eng.pdf.
- UNDP Secretariat of the WHO Framework Convention on Tobacco Control. Investment case for tobacco control in Pakistan. Geneva: Geneva: United Nations Development Programme and World Health Organization, 2024. https://iris.who.int/bitstream/handle/10665/376725/9789240092662-eng.pdf.
- UNDP Secretariat of the WHO Framework Convention on Tobacco Control. Investment case for tobacco control in Lebanon. Geneva: United Nations Development Programme and World Health Organization, 2024. https://www.undp.org/lebanon/publications/investment-case-tobacco-control-lebanon.
- RTI International, Ministry of Health, United Nations Development Programme, Secretariat of the WHO Framework Convention on Tobacco Control World Health Organization. Investment Case for Tobacco Control Jordan. Geneva: United Nations Development Programme and World Health Organization, 2019. https://www.undp.org/sites/g/files/zskgke326/files/migration/jo/JordanTobaccoControlInvestmentCase.pdf.
- United Nations Development Programme, Secretariat of the WHO Framework Convention on Tobacco Control. Investment case for tobacco control in Egypt. Geneva: United Nations Development Programme and World Health Organization, 2024. https://www.who.int/publications/b/70854.
- Ministry of Health Tunisia, RTI International, United Nations Development Programme, Secretariat of the WHO Framework Convention on Tobacco Control, World Health Organization. The case for investing in WHO FCTC implementation in Tunisia. Geneva: United Nations Development Programme and World Health Organization, 2021. https://www.undp.org/sites/g/files/zskgke326/files/migration/tn/11f14594fe8f2c4e884e5b5c79627327898c8a90558ec59d53a83c6e05d263c2.pdf.
- World Health Organization. World Health Organization Framework Convention on Tobacco Control: Guidelines for implementation article 6. Geneva: World Health Organization, 2018. https://fctc.who.int/docs/librariesprovider12/technical-documents/who-fctc-article-6-guidelines.pdf?sfvrsn=3bee36c8_50&download=true#:~:text=Article%206%20of%20the%20WHO%20FCTC%20stipulates%20that%20the%20Parties,price%20accounted%20for%20by%20tax.