Tobacco-related illnesses cost the Fijian economy FJD$319 million (US$159.5 million) every year, equivalent to 2.7 percent of its GDP and about 4.3 times more than the revenue generated by cigarette taxes.
They also kill more than 1,200 Fijians annually.
Implementing the World Health Organisation (WHO) Framework Convention on Tobacco Control represents one of the most cost-effective means for improving people’s lives and advancing sustainable development.
These were the findings of a new report jointly developed by the Ministry of Health and Medical Services, the United Nations Development Programme (UNDP), the Secretariat of the WHO Framework Convention on Tobacco Control and WHO that makes the case for scaling up evidence-informed, feasible and popular tobacco control measures.
The Investment Case for Tobacco Control in Fiji finds that tobacco use impedes Fiji’s efforts to increase efficiency in the health and economic sector, thereby hindering the country’s broader development priorities within the country’s 20-Year Development Plan (2017-2036) and the comprehensive 5-Year Development Plan (2017-2021).
Tobacco use is a leading preventable risk factor linked to noncommunicable diseases such as heart disease, stroke, cancers, diabetes, and chronic respiratory diseases, which contributes a significant economic burden. Tobacco use is also associated with deaths from communicable diseases such as tuberculosis and other health conditions including vision loss, hearing loss and reduced fertility.
The Investment Case for Tobacco Control in Fiji looked at the costs and benefits of implementing the following five priority tobacco control measures with the baseline of 2019:
*Increasing taxes on tobacco;
*Making all indoor public places and workplaces smoke-free;
*Implementing plain packaging of tobacco products;
*Enacting and enforcing a comprehensive ban on all forms of tobacco advertising, promotion and sponsorship; and
*Offering support for quitting tobacco use and treatment for tobacco dependence at the primary care level.
Investing now in these five proven tobacco control measures that reduce demand for tobacco, smoking prevalence and exposure to tobacco smoke can significantly reduce the burden of tobacco in Fiji.
The economic benefits of strengthening tobacco control in Fiji far outweigh the costs of implementation, with an estimated FJD$900 million (US$450 million) in economic benefits over 15 years, compared to the FJD$15 million (US$7.5 million) required investment. All five tobacco control measures modeled have positive returns on investment.
Investing in these five tobacco control measures over 15 years could avert FJD$32 million(US$16 million) in healthcare expenditures in Fiji. Of this, the Government would save FJD$22 million (US$11 million) in healthcare expenditures, Fijians would save FJD$5 million (US$2.5 million) in out-of-pocket healthcare costs, and FJD$5 million (US$2.5 million) would be saved from other sources of healthcare expenditures.
Over the 15-year period, enforcing bans on tobacco advertising, promotion and sponsorship is expected to have the highest return on investment (returning 273 dollars for every dollar invested), followed by increasing tobacco taxes (returning $163(US$81) for every dollar). On average, enacting strong cigarette tax increases could generate an additional FJD$36.7 million (US$18 .35 million) annually, equivalent to about 13.4 percent of total government healthcare expenditures in 2018.
Cigarette taxes can play a meaningful role in contributing to the country’s finances too. Moreover, strong tax increases would decrease smoking prevalence by about 9 percent over 5 years, saving lives, averting costly household and government expenditures to treat avoidable conditions caused by tobacco use, and avoiding economic productivity losses.
The 1,200 annual deaths from tobacco-related illnesses account for nearly 17 percent of all deaths in the country. This includes about 472 deaths from ischemic heart disease, 310 deaths from diabetes mellitus type 2, and approximately 102 deaths from stroke, among other causes.
Almost three-quarters (71 percent) of tobacco-related deaths are premature, meaning they occur among individuals younger than 70. Twenty-seven percent of tobacco-related deaths are due to exposure to secondhand smoke.
Of tobacco’s total economic burden (FJD$319 million (US$159.5 million), 4 percent was attributed to healthcare expenditures (FJD$11.5 million (US$5.75 million), and 96 percent (FJD$307 million (US$153.5 million)) to lost productivity from people exiting the workforce prematurely due to death or disability, missing work, being less productive at work, and taking smoke breaks at work.
Investing in five tobacco control measures over 15 years would reduce the prevalence of cigarette smoking by 47 percent and prevent more than 5,400 deaths.
Fully scaling the five tobacco control measures would avert FJD$900 million (US$450 million) in health costs and economic losses by 2035.
For every Fijian dollar invested in five tobacco-control measures, Fiji will result in FJD$22 (US$11) in averted costs and economic losses by 20254 and FJD$59 (US$29) by 2035. Banning tobacco advertising, promotion, and sponsorship, and raising tobacco taxes, are projected to produce the greatest returns by 2035.
