Tobacco Control Efforts and Research Initiatives in Romania
Significant efforts are being made in Romania to address the impact of tobacco on public health, with research projects focusing on tobacco taxation, prevention strategies, cessation programs, and economic implications. These initiatives involve collaboration between local universities, international mentors, and research teams to build capacity and enhance understanding of tobacco-related issues in the country.
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Source: facebook.com
Every day 115 Romanians die because of tobacco related diseases. This means 42000 people every year. 1 in 3 adolescents in Romania are using tobacco, 5 times more than in the USA. Source: Eurobarometer 2017, Societatea Rom n de Cardiologie, Societatea Rom n de Pneumologie iFunda iaRom n a Inimii (Romanian Society for Cardiology, Romanian Society for Pneumonology and Romanian Heart Foundation)
Tobacco taxation and its impact in Romania rp d Szab Partium Christian University, Oradea Workshop on Tobacco Economics in Southeastern Europe Belgrade, December 11, 2018
Tobacco taxation and its impact in Romania Content of the Presentation A Greater Research Project Economic Impacts of Tobacco in Romania Major findings The Anti Tobacco Law and Its Impacts Taxation
A research project: Building Tobacco Research Capacity for Romania Cooperation between Wake Forest School of Medicine and the University of Medicine and Pharmacy Tirgu Mures, Romania. Researchers from Romanian universities and other institutions (lead by Zolt n BR M) guided by mentoring teams from USA (lead by Kristie Long FOLEY) and Hungary (lead by P ter BAL ZS).
Building Tobacco Research Capacity for Romania - Projects Community-Based Prevention and Cessation of Tobacco Use Among Young Adolescents School-based Prevention & Cessation of Tobacco Use Among Adolescents Smoking habits of medical students at the UMPh Tg. Mures /Smoke Free University Project Adopting Systems-Level Changes to Promote Cessation Among Residents in Social Institutions Economic Impacts of Tobacco in Romania Air Quality Monitoring for SHS Exposure and Policy Advocacy Smoking and SHS Exposure among Pregnant Women & Children
Economic Impacts of Tobacco in Romania Research Team: rp d SZAB , Partium Christian University, Oradea Ede L Z R, Sapientia University Miercurea Ciuc Hunor BURI N , Sapientia University Miercurea Ciuc Mentors: Todd ROGERS, RTI International Frank J CHALOUPKA, University of Illinois at Chicago J zsef BODROGI, E tv s L r nd University, Budapest
Romania Country profile 19.9 million inhabitants (2014) 10932,3 GDP per capita (constant 2010 US$) 25840,8 GDP per capita, PPP (current international $) nearly 42000 deaths in 2016 from a disease caused by smoking - the costs of treating smoking-attributable diseases was over RON 1.2 billion in 2012, (approximately 5.4% of overall health care spending that year.)
Estimates of Adult Smoking Prevalence, Romania Eurobarometer 2017: Prevalence among 15 years and older: 28% 35% 30% 25% Prevalence 20% 15% Men: 38% Women: 19% 10% 5% Source: Romanian Society for Cardiology, Romanian Society for Pneumonology and Romanian Heart Foundation 0% 1989 1994 2002 2004 2007 2008a 2008b 2009a 2009b 2010 2011 2012 2014 Source: Szab , L z r E, Buri n H, Rogers T, Foley K, br m Z, Meghea C, Ciolompea T, Chaloupka FJ.: The Economics of Tobacco and Tobacco Taxation in Romania, University of Medicine and Pharmacy of T rgu Mure , Romania, 2016
Estimated prevalence 1981-2011 40% 35% 30% 25% Prevalence current former 20% 15% 10% 5% 0% 1981 1984 1987 1990 1993 1996 1999 2002 2005 2008 2011 Source: Szab , L z r E, Buri n H, Rogers T, Foley K, br m Z, Meghea C, Ciolompea T, Chaloupka FJ.: The Economics of Tobacco and Tobacco Taxation in Romania, University of Medicine and Pharmacy of T rgu Mure , Romania, 2016
Smoking Prevalence among 16 Year Old Students, 1999-2015 Eurobarometer 2017: Prevalence in the 15-24 age group: 30% 25% 20% 33% 15% Source: Romanian Society for Cardiology, Romanian Society for Pneumonology and Romanian Heart Foundation 10% 5% 0% 1999 2003 2007 2011 2015 Overall Boys Girls Source: Szab , L z r E, Buri n H, Rogers T, Foley K, br m Z, Meghea C, Ciolompea T, Chaloupka FJ.: The Economics of Tobacco and Tobacco Taxation in Romania, University of Medicine and Pharmacy of T rgu Mure , Romania, 2016
Cigarette Sales, 2001-2015 40,000 1,800 35,000 1,600 1,400 30,000 Sticks per Capita Million Sticks 1,200 25,000 1,000 20,000 800 15,000 600 10,000 400 5,000 200 0 0 2001 2004 2007 Total 2010 2013 Per Capita Source: Szab , L z r E, Buri n H, Rogers T, Foley K, br m Z, Meghea C, Ciolompea T, Chaloupka FJ.: The Economics of Tobacco and Tobacco Taxation in Romania, University of Medicine and Pharmacy of T rgu Mure , Romania, 2016
Cigar and Smoking Tobacco Sales, 2001-2015 7 90 80 6 70 Tonnes of Smoking Tobacco 5 60 Million Cigars 4 50 40 3 30 2 20 1 10 0 0 2001 2004 2007 2010 2013 Cigars Smoking Tobacco Source: Szab , L z r E, Buri n H, Rogers T, Foley K, br m Z, Meghea C, Ciolompea T, Chaloupka FJ.: The Economics of Tobacco and Tobacco Taxation in Romania, University of Medicine and Pharmacy of T rgu Mure , Romania, 2016
Agricultural Production of Tobacco Romania, 19902017 Total production (tons) 18,000 16,000 Area cultivated (hectares) 16,000 14,000 14,000 Drops: From 16805 to 801 hectares From 14168 to 1219 tons 12,000 12,000 10,000 Area cultivated Total production 10,000 No job losses! 8,000 8,000 6,000 6,000 4,000 4,000 2,000 2,000 0 0 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 Source: National Institute for Statistics, 2018
Total Exports and Imports of Tobacco, Romania 1991-2017 (millions of EUR) 1,000 900 800 700 600 500 , 400 300 200 100 0 199119921993199419951996199719981999200020012002200320042005200620072008200920102011201220132014201520162017 Exports Imports Source: National Institute for Statistics, 2018
Tobacco Control Policy in Romania Romania signed the WHO s Framework Convention on Tobacco Control (FCTC) in June 2004, and ratified it in January 2006. Tobacco product advertising on radio and television has been prohibited since 2002 Romania has required graphic health warning labels on cigarette packages since 2008 Law number 15 of 2016 entirely prohibits smoking in all enclosed public spaces, in all enclosed work spaces, in vehicles of public transport, and in all enclosed or open playgrounds. Smoking is also prohibited in health, educational and child protection institutions.
Tobacco Taxes in Romania Upon acceding the EU, in 2007 Romania became subject to the EU's tobacco tax directive (Council Directive 2002/10/EC). Requirements: a specific tax on cigarettes between 5% and 55% of the total tax (including the value added tax) the total excise tax to account for at least 57% of the tax-inclusive retail price of cigarettes (TIRSP) in the most popular price category (MPPC) the total excise tax to be at least 64 per 1000 cigarettes ( 1.28 per pack of 20 cigarettes). Romania and other EU accession countries had until the end of 2009 to come into compliance with these standards.
Tobacco Taxes in Romania Council Directive 2011/64/EU included several important changes: the specific tax to account for between 7.5% and 76.5% of the total tax the minimum excise tax share was increased to at least 60% of TIRSP, with the price now based on the weighted average price of cigarettes sold in the market it increased the minimum excise per 1000 cigarettes to 90 ( 1.80 per pack). Selected EU member states were allowed a transition period, until the end of 2017, to come into compliance with the new directive. Romania came into compliance with the directive by the beginning of 2015.
Cigarette Taxes per Pack, May 2004 - July 2016 90% Percent of Specific Tax in Total Excise Tax 80% 10 RON per Pack of 20 Cigarettes 70% 8 60% 50% 6 40% 4 30% 20% 2 10% 0 0% Specific Tax Ad Valorem Tax Value Added Tax Specific Share of Total Excise Source: Szab , L z r E, Buri n H, Rogers T, Foley K, br m Z, Meghea C, Ciolompea T, Chaloupka FJ.: The Economics of Tobacco and Tobacco Taxation in Romania, University of Medicine and Pharmacy of T rgu Mure , Romania, 2016
Cigarette Excise Taxes per Pack and Cigarette Excise Tax Revenues, 2007 - 2015 9 10 9 8 8 7 7 6 6 RON per Pack Billion RON 5 5 4 4 3 3 2 2 1 1 0 0 2007 2008 2009 2010 2011 2012 2013 2014 2015 Tax Revenue (in billions) Tax per Pack Source: Szab , L z r E, Buri n H, Rogers T, Foley K, br m Z, Meghea C, Ciolompea T, Chaloupka FJ.: The Economics of Tobacco and Tobacco Taxation in Romania, University of Medicine and Pharmacy of T rgu Mure , Romania, 2016
Price for a Pack of 20 Cigarettes, Most Sold Brand, European Countries, 2014 in US$ at Official Exchange Rates Source: Szab , L z r E, Buri n H, Rogers T, Foley K, br m Z, Meghea C, Ciolompea T, Chaloupka FJ.: The Economics of Tobacco and Tobacco Taxation in Romania, University of Medicine and Pharmacy of T rgu Mure , Romania, 2016
Taxes on a Pack of 20 Cigarettes, Most Sold Brand, European Countries, 2014, in US$ at Official Exchange Rates Source: Szab , L z r E, Buri n H, Rogers T, Foley K, br m Z, Meghea C, Ciolompea T, Chaloupka FJ.: The Economics of Tobacco and Tobacco Taxation in Romania, University of Medicine and Pharmacy of T rgu Mure , Romania, 2016
Inflation Adjusted Cigarette Prices and Cigarette Affordability, 1997-2015 10.25% 15 9.25% % of Per Capita GDP for 100 Packs RON per Pack of 20 Cigarettes 13 8.25% (2015 prices) 7.25% 11 6.25% 9 5.25% 4.25% 7 3.25% 5 2.25% 1997 2000 2003 2006 2009 2012 2015 Real Price Affordability Source: Szab , L z r E, Buri n H, Rogers T, Foley K, br m Z, Meghea C, Ciolompea T, Chaloupka FJ.: The Economics of Tobacco and Tobacco Taxation in Romania, University of Medicine and Pharmacy of T rgu Mure , Romania, 2016
Inflation Adjusted Cigarette Prices and Per Capita Cigarette Consumption, 2001 - 2015 15 2100 13 1900 Cigarettes per Capita RON per Pack 11 1700 9 1500 7 1300 1100 5 2001 2003 2005 2007 2009 2011 2013 2015 Per Capita Consumption Real Price Source: Szab , L z r E, Buri n H, Rogers T, Foley K, br m Z, Meghea C, Ciolompea T, Chaloupka FJ.: The Economics of Tobacco and Tobacco Taxation in Romania, University of Medicine and Pharmacy of T rgu Mure , Romania, 2016
Before our study, no studies have estimated the price elasticity of demand for tobacco products in Romania (Loubeau 2013). Our first cigarette demand analysis used annual aggregate cigarette sales data and the average price the price for a local brand of cigarettes sold in mid-priced stores from 1997 through 2015. We estimated that the price elasticity of cigarette demand in Romania is -0.58, implying that a ten percent increase in the inflation adjusted price of cigarettes would result in an almost six percent reduction in cigarette consumption. Source: Szab , L z r E, Buri n H, Rogers T, Foley K, br m Z, Meghea C, Ciolompea T, Chaloupka FJ.: The Economics of Tobacco and Tobacco Taxation in Romania, University of Medicine and Pharmacy of T rgu Mure , Romania, 2016
Our second cigarette demand analysis used the cross-sectional data from the 2011 GATS. In this model, we estimated that cigarette consumption among smokers is negatively and statistically significantly associated with average cigarette price. The average price elasticity derived from the regression coefficient for the price is -1.45, implying that a ten percent increase in the price of cigarettes reduces cigarette consumption among smokers by 14.5 percent. Given our use of a single cross-sectional survey, this estimate is likely to overstate the price elasticity of cigarette demand because the market level price measure we constructed from the self-reported prices in the survey reflect local brand choices and smokers' purchase behaviors. Source: Szab , L z r E, Buri n H, Rogers T, Foley K, br m Z, Meghea C, Ciolompea T, Chaloupka FJ.: The Economics of Tobacco and Tobacco Taxation in Romania, University of Medicine and Pharmacy of T rgu Mure , Romania, 2016
Impact of Increasing Cigarette Excise Taxes on Smoking Model parameters, baseline Current smokers Premature deaths in current smokers 4,451,871 2,225,936 Expected future smokers Premature deaths in future smokers 938,988 469,494 8.6 Average cigarette excise tax Average cigarette price 14.5 Excise tax as a percentage of price 59.5% Total Tax as a percentage of price 76.1%
Impact of Increasing Cigarette Excise Taxes on Smoking, Smoking- Attributable Mortality and Government Revenue Romania 2017 Model projections Increased average cigarette tax Increased average cigarette pack price Excise tax as a percentage of price Total tax as a percentage of price Assumed price elasticity 11.0 17.3 63.3% 80.0% 12.3 18.9 65.0% 81.7% -0.6 403,289 18.2 25.9 70.0% 86.7% 258,360 1,054,917 Reduction in number of current smokers Reduction in Premature Deaths Caused by Smoking among Current Smokers Percentage of premature deaths in current smokers averted by higher taxes 90,426 141,151 369,221 4.1% 6.3% 16.6% 108,987 170,124 445,006 Reduction in number of future smokers Reduction in Premature Deaths Caused by Smoking among Future Smokers Percentage of premature deaths in future smokers averted by higher taxes 54,493 85,062 222,503 11.6% 18.1% 47.4% 367,347 573,413 1,499,923 Total reduction in number of smokers Total Reduction in Premature Deaths Caused by Smoking Percentage of premature deaths among all smokers averted by higher taxes Additional Cigarette Excise Tax Revenues (RON Millions) 144,920 226,213 591,724 5.4% 8.4% 22.0% 1,008.1 1,348.7 884.3
Presentation of our Report in the Budget and Finances Committee of the Romanian Parliament
The Impact of Raising Taxes on Tobacco Products Simulation Based on Price Elasticity In 2016 8,60 RON Recommended 12,30 RON Average accise tax Average price per pack 14,50 RON 18,90 RON Accise tax as % of price 59,5% 65,0% Would make 400,000 adults to quit smoking Would stop 170,000 persons to start smoking Would prevent over 225,000 premature deaths Would raise with RON 1.3 billion the incomes of the budget
Presentation of our Report in the Budget and Finances Committee of the Romanian Parliament Recommendations (1) Implement a large increase in the cigarette excise tax that significantly raises cigarette prices and reduces cigarette smoking in Romania. (2) Include annual adjustments in cigarette taxes that ensure that the affordability of cigarettes is reduced as incomes increase. (3) Increase taxes on other tobacco products to be equivalent to cigarette taxes and to reduce the use of these products. (4) Increase the amount of earmarked tobacco taxes and allocate some of the new earmarked revenues to tobacco prevention and cessation efforts. (5) Strengthen tobacco tax administration, increase enforcement, and eliminate dutyfree sales of tobacco products in order to control tax avoidance and evasion.
What happened after the anti smoking law (15/2016) You should know that smoking in bars was not forbidden, it just became a privilege of wealthy ones. If you want to light up a cigarette inside, it costs you 500 RON (120 EUR) The new anti-tobacco law did not bother too much the smokers, but managed to bring them out to the streets. Source: www.catavencii.ro
What happened after the anti smoking law (15/2016) The MP who advocated most strongly for the law (Aurelia Cristea) was not included on the list of her party s candidates for the next parliamentary elections (late 2016) The analysis of the 2016 tax report data from the tax collecting agency shows that the revenues of restaurants increased by 19,8% and that of bars by 5,1% compared to the previous year (Ramona Brad, Smoke Free Romania Coalition ) Our colleagues in the project made PM 2.5 measurements in universities and public institutions. First measurements were made before the law was applied, then 3 month after the application and finally one year later by. The second measurements have shown a sharp decrease, but after a year the PM 2.5 values in public institutions were almost at the same level as at the first time.
What happened after the anti smoking law (15/2016) On a European scale of tobacco control policies Romania advanced on the 7th place in Europe from 19th. The 2017 Eurobarometer says, that exposure to smoke decreased: In bars - from 80% to 11% In restaurants - from 59% to 6% Opposition legislative proposal: Electronic cigarettes should be treated By the law exactly as normal cigarettes.
Current Level of Taxes on Tobacco in Romania The level of excise taxes is adjusted every year, based on the previous years September prices: - on April 1 for cigarettes - on January 1 for other tobacco products For year 2019: Cigarettes: 48,87 RON/1000 cigarettes Cigars and cigarillos: 48,87 RON/1000 pieces Tobacco for roll on your own: 63,52 RON/kg
The Impact of Differentiated Taxation on Tobacco Products in Romania Example: Marlboro Heets Marlboro Weight Tax Weight Tax 1 unit (cigarette) 645 mg 0.44874 RON 201.5 mg 0.077 RON 1 pack (20 cigarettes) 8.97 RON 1.54 RON 1 kg tobacco 1000000 mg 695.72 RON 1000000 mg 384 RON
Thank you! szabo.arpad@partium.ro
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