Higher taxes on tobacco could reduce smoking rates in South Asia by at least one-third and avoid 35-45 million premature deaths, according to a recent study. South Asia, with a population of 1.1 billion adults, has about 170 million adult smokers – mostly male and mostly from India – and very low rates of cessati7. Higher tobacco taxes can help South Asia kick the button. The analysis, led by Prabhat Jha, calls on South Asian countries to implement the World Health Organization`s global tobacco control treaty and its requirements for high tobacco taxes, smoke-free public spaces, warning labels, comprehensive advertising bans and support for smoking cessation services. Jha said the price of cigarettes, bidis (a small traditional Indian cigarette) and chewing tobacco is lower in South Asia than in high-income countries in the West because the excise taxes are so low. He said the main reason for this is opposition from the tobacco industry because of the considerable profit margins. Annual increases in tobacco taxes are below the rate of inflation and income growth, so cigarettes remain affordable. Variations in the tax rates, usually based on the length of cigarettes, lead to price differences and enable smokers to change to cheaper brands or shorter cigarettes. In addition, the sale of single cigarettes is common in South Asia, which reduces the effectiveness of tax increases. Jha said South Asian countries should also strengthen the most effective non-price interventions to control smoking, including a complete ban on tobacco advertising, use of large pictorial warnings or plain packaging on tobacco products, and a complete ban on smoking in public places. The use of plain packaging or prominent pictorial warning labels is particularly relevant given the high levels of illiteracy among tobacco users in the region. Jha also noted that smoking cessation programmes are uncommon in South Asia. Most people who quit do so without physician advice, nicotine replacement therapy or electronic cigarettes.

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