Public Health Impacts of Tobacco Taxation in Bangladesh

Tobacco consumption remains a significant public health concern in Bangladesh, with over 35% of adults using various tobacco products. The country faces a high burden of disease and premature deaths linked to tobacco use, resulting in substantial economic costs. Measures such as tobacco taxation and demand reduction strategies are proposed to mitigate these health hazards, including the impact on children exposed to secondhand smoke. Efforts are also directed towards supply reduction and promoting alternative activities to combat the tobacco epidemic.

• Bangladesh
• Public Health
• Tobacco Taxation
• Disease Burden
• Tobacco Control

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1. Tobacco Taxation and Impact on Public Health Rumana Huque, PhD University of Dhaka

2. Tobacco Use in Bangladesh One of the largest tobacco consuming countries in the world Over 35% adults consuming cigarettes, bidis, smokeless tobacco, or other tobacco products. 58% of all men and 29% of all women consume some form of tobacco, whether smoked or smokeless. 28% of women and 26% of men use smokeless tobacco. Nearly 7% of 13-15 year olds use tobacco products. R Huque: Budget 2021-22 2

3. Tobacco causes premature death It is a leading risk factor for disease and premature deaths. Premature! In 2018, tobacco use killed almost 126,000 people. The total economic cost of tobacco use is much higher than tobacco tax collection. 3 R Huque: Proposed Tobacco Tax Structure

4. Disease burden of SLT use Estimates based on GATS 2009 data suggests that 12,511 lives and 324,020 DALYs were lost in Bangladesh due to SLT related diseases. Estimates based on global disease burden 2017, suggests that at least 16,947 lives and 403,460 DALYs were lost across Bangladesh due to oral, pharyngeal, oesophageal cancers and ischemic heart diseases that can be attributed to SLT. R Huque: Budget 2021-22 4

5. Health hazards of SHS for children Sudden infant death syndrome Acute respiratory illnesses Chronic respiratory symptoms Asthma and exacerbation of asthma symptoms Repeated ear infection Neuro-behavioral deficits Neurodevelopmental deficits childhood cancer 5

6. Demand reduction Article 6: Price and tax measures Article 8: Protection from exposure to tobacco smoke Article 11: Packaging and labelling of tobacco products Article 12: Public awareness Article 13: Banning tobacco advertising, promotion and sponsorship Article 14: tobacco cessation 6 R Huque: Proposed Tobacco Tax Structure

7. Supply reduction Article 15: Illicit trade in tobacco products Article 16: Sales to and by minors Article 17: support for economically viable alternative activities 7 R Huque: Proposed Tobacco Tax Structure

8. Cigarette What has been changed? - There is No change in prices on Low and Medium tiers. 2020-21 2021-22 Retail price (BDT) 39 SD Retail price (BDT) SD Tier Low 57% 39 (No change) 63 (No change) 102 (5.2% increase) 135 (5.5% increase) 57% ( No change) 65% (No change) 65% (No change) - SD remains unchanged in all four tiers that will benefit tobacco industry while government will lose revenue. Medium 63 65% High 97 65% - Did not introduce tiered specific excise tax. Premium 128 65% 65% (No change) R Huque: Budget 2021-22 8

9. Biri 2020-21 2021-22 What has been changed? Category Retail SD Retail price (BDT) SD There is No change in prices and taxes on biri price (BDT) Filter BDT 19 per 20 sticks 40% BDT 19 per 20 sticks (unchanged) 40% (No change) Non-filter BDT 18 30% BDT 18 per 25 sticks (unchanged) 30% (No change) per 25 sticks R Huque: Budget 2021-22 9

10. Smokeless tobacco (SLT) What has been changed? 2020-21 2021-22 Category Retail SD Retail price (BDT) SD There is No change in prices and taxes on SLT price (BDT) Zarda BDT 40 per 10 gm 55% BDT 40 per 10 gm (No change) 55% (No change) Gul BDT 20 per 10 gm 55% BDT 20 per 10 gm (No change) 55% (No change) R Huque: Budget 2021-22 10

11. CURRENT Tax Structure 2020-2021 PROPOSED Tax Structure 2021-2022 SD Tier MRP Tier MRP SD (Ad Valorem-% of Retail Price) SD Share in Retail Price (Specific - BDT) Cigarette (10 stick) Low 39+ 57% Low 50+ 32.50 65% Med 63+ 65% Med 70+ 45.50 65% High 97+ 65% High 110+ 71.50 65% Prem 128+ 65% Prem 140+ 91.00 65% Biri (Without filter 25 stick and with filter 20 stick) Without Filter 18+ 30% Without Filter 25+ 11.25 45% With filter 19+ 40% With filter 20+ 9.00 45% Smokeless tobacco (10 gram) Zarda 40+ 55% Zarda 45+ 27.00 60% Gul 20+ 55% Gul 25+ 15.00 60% R Huque: Budget 2021-22 11

12. Expected economic and health impact 2020- 2021 2021-2022 (partner proposal) 2021-2022 (budget proposal) Average price change (inflation-adjusted) 20.4% -0.7% Cigarette sales (Crore packs) 640 540 620 Tax revenue (Crore BDT) 27,180 30,520 27,960 Industry revenue (Crore BDT) 5040 4350 4950 Cigarette smoking prevalence 15.1% 13.9% 14.8 Reduction in number of current smokers from 1 Crore 80 Lac (18 million) 1 Crore 40 Lac (1.4 million) 269 thousand Reduction in number of future smokers from 65 Lac (6.5 million) Number of lives saved 988 194 thousand thousand 974 191 thousand thousand R Huque: Budget 2021-22 12

13. PM Statements Tobacco is a hindrance to achieve SDGs FCTC implementation is a pre-condition

14. Tobacco Tax Structure and Administration Tax Administration Apply tax stamps, fiscal mark, banderole or other type of marking on other tobacco products Apply tax stamps, fiscal mark, banderole or other type of marking on cigarettes The unique identifier/ma rking contain data for tracking and tracing purposes Sales of duty (or excise) free cigarettes banned The marking contains a unique identifier Type of excise tax applied. Countries Bangladesh India Indonesia Myanmar Nepal Sri Lanka Thailand Timor-Leste Note: NA - Not Available Source: WHO Report on the Global Tobacco Epidemic, 2019, https://www.who.int/teams/health-promotion/tobacco-control/who- report-on-the-global-tobacco-epidemic-2019 Ad valorem excise Mixed excise Specific excise Specific excise Specific excise Specific excise Mixed excise Specific excise Yes No Yes Yes Yes No Yes No No Yes Yes Yes No NA No No No NA Yes No Yes Yes Yes NA Yes No No No No Yes No Yes No No R Huque: Budget 2021-22 14

15. Recommendation Impose specific tax Consider the recommended price and tax proposal of experts and tobacco control advocates Adopt a comprehensive tobacco tax policy R Huque: Budget 2021-22 15

16. Thank You R Huque: Budget 2021-22 16