TEPAV’s webinar on "The Economics of Curbing and Cessation of Smoking in Turkey" was held on October 21, 2021
Findings from TEPAV’s extensive research report examining
the dimensions of supply, demand, health, and public policy dynamics related to
tobacco consumption in Turkey were discussed. The speakers also emphasized
where further research is required in devising more effective control policies.
Making the opening remarks, TEPAV Executive Director Şenay
Akyıldız reminded the audience of the harms of tobacco use on human health and
stated that according to the World Health Organization (WHO), approximately 8
million people die each year due to diseases related to tobacco use. Although
the effects of tobacco use on health is clearly demonstrated by research, 1.3
billion people in the world continue to consume tobacco products, of which 80%
live in low- and middle-income countries. In addition to its impact on health,
Akyıldız also underlined that tobacco use has a serious economic burden, which
includes both its cost on the health system and the loss of productivity due to
tobacco-related diseases and deaths. Moreover, while Turkey was one of the
first countries to sign and ratify the WHO Framework Convention on Tobacco
Control (WHO FCTC), enacting strict rules and legal regulations, the expected
decrease in the tobacco use rate in Turkey did not take place. This situation
reveals why it is critical to investigate tobacco control policies in Turkey
and to establish a strong understanding of the current situation in Turkey and
around the world. As such, the research being conducted by the TEPAV Tobacco
Control Policy Research Team is to meet this need, and that the comprehensive
report will contribute to Turkey's tobacco control policy goals.
Sharing the findings of the report, TEPAV Sustainability
Governance Program Director Sibel Güven noted the importance of contributing to
the development of effective tobacco control policies in Turkey. Güven stated
that this research was carried out to scrutinize the roles of stakeholders such
as producers, users, and the public sector on the axis of supply, demand, and
public policies. Emphasizing that the majority of preventable deaths are due to
tobacco use, Güven added that the number of tobacco-related premature deaths in
2050 is globally estimated to exceed 127,000 individuals annually. Furthermore,
data from 2002 to 2017 reveals that the burden of active and passive tobacco
use on Turkey's health system is rather high.
Highlighting that the health aspect of the consumption of
tobacco products in Turkey came to the fore in the 1990s, Güven reminded that
Turkey was the first country to carry out all of the WHO’s MPOWER policy
package measures to its highest levels. WHO’s tobacco policy package is meant
to Monitor tobacco consumption, Protect individuals from smoking, Offer
services for quitting, Warn of risks, Enforce bans, and Raise taxes (MPOWER).
Güven emphasized that tobacco use rates in Turkey are higher in all age groups
compared to peer countries, this includes an increase of consumption for
adolescents aged 15-17 over the years, the alarming increase of consumption of
students aged 13-15, that the daily tobacco use rate for women increases faster
than that of men, and that the tobacco use rate increases in tandem with an
increase in the level of education. Indicating the asymmetrical and incomplete
information on the health effects and economic consequences of tobacco use,
Güven stressed the need to develop more focused policies for subgroups
witnessing increased consumption levels.
Asena Caner, who leads the TEPAV Tobacco Control Policy
Research Team, made a detailed statement classifying MPOWER measures as
price-oriented and non-price oriented measures. Citing the current
implementation of the policy of reducing tobacco use in Turkey by increasing
taxes on tobacco products as a price-oriented measure, Caner pointed out that
the tax burden on tobacco products in Turkey is above the world average. The
total tax burden on cigarettes in European Union countries is on average 80.3%,
however, this rate for Turkey in 2020 for average and above average priced
cigarettes were 84.8% and 92.1% for below average priced cigarettes.
Additionally, tobacco tax revenues obtained in Turkey in 2018 amounted to 41.8%
of total public health expenditures with most health expenditures (roughly 77%)
being covered by the public sector. Stating that the effect of taxation on the
demand for tobacco products depends on the composition of ad valorem and
specific taxes in the total tax burden, as well as important parameters such as
income, price, and cross-price elasticity of demand, Caner emphasized that more
detailed studies are a must in studying the demand effects of tobacco taxation.
Explaining the details of non-price-oriented measures, Caner
emphasized having a holistic approach in designing economic policies taking
into account the supply side of the market. For the policies to be effective in
demand reduction, the focus should be on supplementing population-wide policies
with policies that target certain demographic groups such as women,
adolescents, students, teachers, and doctors. Additionally, to improve the
implementation processes of tobacco control policies, it is necessary to
monitor the entire implementation process by clarifying the institutions
responsible for ensuring regulatory compliance as well as following through
with the enacted punishments and penalties.