Tobacco Control in Bulgaria

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Tobacco Control in Bulgaria

• World Bank presentation

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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)

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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

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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
• Wont necessarily reduce employment
• Wont necessarily increase smuggling

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Tobacco Taxes- Important source of revenue!
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Studies on the employment effects of dramatically
reduced or eliminated tobacco consumption
SourceBuck and others, 1995 Irvine and Sims,
1997 McNicoll and Boyle 1992,
van der Merwe and others, background paper
Warner and others 1996
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The level of tobacco taxes in Bulgaria
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Global (European) Evidence Total and Excise
Tobacco Taxes as of Retail Price 2000
Total tobacco tax ExciseVAT, Excise
(SpecificAd Valorem)
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Low cigarette prices in Bulgaria
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Deaths in developing regions
CMP
Injuries
18
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Injuries
13
NCD
NCD
CMP
69
47
42
1990
2020
By 2020 developing countries will have a disease
profile similar to that in 1990 in developed
countries
Deaths in developed regions
Injuries
NCD
7
Injuries
89
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NCD
CMP
4
86
CMP
6
1990
2020
Source Murray and Lopez, 1996
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The impact of the tobacco epidemic on health is
alarming and rising.
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Male Lung Cancer Mortality in Selected ECA
Countries
Age standardized rate/100,000
Source International Agency for Research on
Cancer
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Bulgaria Lung Cancer-Males
Source International Agency for Research on
Cancer
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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