A sensible approach to taxation is essential to Europe’s tobacco control efforts
France recently delivered encouraging news for the fight against the tobacco habit that is responsible for some 700,000 deaths each year in Europe. According to figures released by the Droits des Non-Fumeurs association, cigarette sales in France fell by 6.5% year-on-year in 2021, in line with a trend that has seen total sales plummet by 25% over the past five years alone.
The announcement of the promising figures comes almost exactly one year after French President Emmanuel Macron launched a new 10-year strategy aimed at reducing cancer deaths from 150,000 annually to 100,000. According to the French approach, public funding for cancer research will rise by 20% as the government ramps up awareness campaigns, cancer screening programmes, and support for patients facing the long-term effects of cancer treatment. Anti-tobacco campaigns will play a pivotal role, since tobacco is the single biggest preventable risk factor for cancer in France.
At the helm of the rotating presidency of the Council of the European Union since January 1, France is hoping to align its national ten-year plan with the EU’s Beating Cancer Plan, uncovering synergies and strengthening cooperation on the issue. The Beating Cancer Plan is a key priority of the von der Leyen Commission, and will channel €4 billion of funding into actions addressing cancer, with an emphasis on prevention, early detection, diagnosis and treatment, and improved quality of life.
Once again, anti-smoking policies will play a pivotal role, with the draft Beating Cancer Plan pledging to rigorously enforce the EU tobacco control framework as well as update key European legislation such as the tobacco products directive. There is a growing fear, however, that vital harm reduction principles are not being integrated into these ambitious new plans.
Taxation a useful tool for controlling cigarette use
Both the national French anti-smoking strategy and the draft Beating Cancer Plan put special emphasis on tobacco taxation—the European Commission considers tobacco taxation “one of the most effective instruments to fight tobacco consumption, particularly in deterring young people from taking up smoking”. The logic is sound—according to a study in the International Journal of Environmental Research and Public Health (IJERPH), tobacco taxation in the form of higher cigarette prices is one of the most effective population-based strategies for decreasing smoking.
Tobacco companies are, of course, opposed to the idea. Industry executives have floated various theories to try and push back against increased taxes, arguing that the measure
puts a disproportionate burden on low-income smokers and claiming that heavily taxing the purchasing power of low-income smokers will not help them quit smoking.
But the facts don’t back this argument up. The IJERPH study found that on average, a price increase of 10% on a package of cigarettes reduces demand for cigarettes by roughly 4% for the general adult population in high-income countries. This certainly appears to be the case in France, where the cost of a package of cigarettes rose from €7 to more than €10 between 2017 and 2021. The total number of cigarettes sold fell from 44.3 billion to 35.8 billion over the same period – a 19% decrease which seems to underline the effectiveness of hiking tobacco taxes. What’s more, the IJERPH study found that this deterrent effect is even more pronounced for key groups, including young adults and people with low incomes.
The critical role of harm reduction
In order to maximise this deterrent effect, highly harmful tobacco products should be taxed differently to reduced-risk products such as e-cigarettes, in order to give consumers a financial incentive to switch to these safer products. A review by Public Health England has estimated that vaping is up to 95% safer than smoking, and the practice has been shown to help smokers abandon more harmful tobacco products without experiencing the anxiety, withdrawal symptoms, and weight gain of quitting cold turkey. It’s already reducing tobacco use, and there is an undeniable link between plummeting cigarette sales and the growing popularity of vaping.
Indeed, as Dr. Bertrand Dautzenberg, a French pulmonologist and anti-tobacco activist recently argued, the advent of the e-cigarette, which is used almost exclusively by ex-smokers, is also a driving force behind declining cigarette sales in France. E-cigarettes’ harm reduction potential has also been noted in the draft text adopted by the European Parliament’s Special Committee on Beating Cancer (BECA), with the BECA report highlighting that “electronic cigarettes could allow some smokers to progressively quit smoking.”
Keeping electronic cigarettes more financially attractive than combustible tobacco products is essential to preserving this harm reduction potential. A team of researchers funded by the US National Bureau of Economic Research, which is unaffiliated with the tobacco and vaping industries, found that for every vaping cartridge not purchased for price-related reasons, 6.2 additional packs of cigarettes are purchased instead. An evaluation of Minnesota’s hefty excise tax on e-cigarettes, meanwhile, calculated that a 10% rise in e-cigarette prices prompted a 13% rise in combustible cigarette consumption and found that some additional 32,400 adult smokers would have quit the habit if not for the tax. These findings, naturally, underline the pivotal importance of keeping taxation proportional to risk.
Indeed, as European policymakers overhaul the EU’s tobacco control framework in an effort to achieve a smoke-free generation by 2040, crafting the right tax policy that incentivises smokers to, ideally, quit the habit entirely and at a minimum switch to reduced-risk products will be essential. Sensible anti-tobacco policies will be more effective if harm reduction is taken into account, with decision-makers distinguishing between products that are known killers and those which could reduce health risks for smokers.