Tobacco Control Community Unites to Protect Youth: World No Tobacco Day 2024

On World No Tobacco Day 2024, we are joining the tobacco control community and sounding warning bells about the concerning trends in youth smoking around the world. Surveys from around the world show that youth tobacco prevalence is either increasing or staying the same in nearly half of countries where recent data are available (learn more in the Tobacco Atlas Youth chapter). These findings underscore the need to strengthen efforts to deter youth from initiating use.

Research from our think tank partners in low- and middle-income countries, produced as part of the Think Tanks Project over the last 6 years, delve further into the effects of tobacco use and price and non-price tobacco control policies on youth. In addition to the direct harm caused by tobacco use, youth are also affected indirectly when those around them smoke.

Parental smoking threatens the development of children even before birth and continues over their life course. In Indonesia, higher spending on cigarettes was associated with a greater likelihood of premature and extremely premature births, as well as stunting of children. Specifically, a 7% increase in expenditure in households would increase the risk of stunting by 25.6%. Similarly, in Pakistan, children exposed to maternal, paternal, or parental smoking were all more likely to be stunted. These health effects follow children for the rest of their life with significant negative consequences.

In households, tobacco spending also crowds out beneficial and necessary goods and services, such as food, education, or health care (read about the evidence from Indonesia, Mexico, Montenegro, Pakistan, Serbia, and Viet Nam). The crowding out effect is especially prominent in vulnerable low-income households who have smaller budgets. This spending, in addition to tobacco-related health costs, can push households below the poverty or deep poverty lines. In Albania, the number of children living in poverty grew by more than 10,000 as a result of spending on tobacco, and in Viet Nam, it increased by more than 117,000. In the long-term, these spending patterns threaten the development and earning potential of youth.

The production of cigarettes also harms youth due to the labor required to farm tobacco.  Tobacco farmers often use large amounts of unpaid family labor for tobacco, including children (read about evidence from Kenya and Indonesia). In North Macedonia, youth are 2.3x more likely to harvest tobacco than any other crop. These children are often losing the opportunity to receive an education when they are in the field which undermines their opportunities to lead a more prosperous life than their parents. Tobacco farmers tend to have lower household resources, increasing the likelihood that children grow up in poverty. Farming tobacco also reduces the available land for beneficial crops, including food which potentially contributes to food shortages.

Tobacco excise taxes, on the other hand, represent an opportunity for policy makers to protect youth. Raising the price of cigarettes through excise tax increases delays and even prevents smoking initiation because youth tend to be more price-sensitive than other groups (read about evidence in Albania, Bosnia and Herzegovina, Kosovo, Montenegro, North Macedonia, and three countries in Latin America). Furthermore, peer and parental influence is very significant when it comes to youth smoking. When prices increase, overall cigarette consumption decreases including of these role models and others close to them. Excise tax revenues can also be earmarked for education, mass media campaigns, and other efforts to deter youth smoking. Unfortunately, cigarette tax policies in a majority of countries remain underutilized and do not align with evidence-based best practices (learn more in the 3rd edition of the Cigarette Tax Scorecard).

We hope that this World No Tobacco Day prompts action and highlights the urgency to implement both price- and non-price tobacco control measures to protect the most vulnerable members of the population: youth.