There’s more than one way to reduce tobacco use and its nasty health consequences, but raising taxes seems to be a good way to start, according to a new study. A group of UK researchers went through health and tax data of 159 countries and found a reduction in neonatal and infant mortality as a direct consequence of raising taxes on tobacco.

Tobacco has severe, damaging adverse impacts on human health globally — especially on children. Exposure to secondhand smoke (SHS) is estimated to kill over 56,000 children each year around the globe just through exposure at home. Smoking during pregnancy or the exposure of pregnant women to SHS is another pathway through which smoking increases risks for the health of children and babies.

The World Health Organization (WHO) recommends a set of measures to discourage tobacco consumption. These include monitoring tobacco use, protecting people from SHS, offering help and incentives to quit, enforcing bans on tobacco advertising, and, most importantly, raising taxes — which has shown to be the most effective measure with documented health benefits among adults.

There are fewer studies examining the impact of tobacco taxation on child health outcomes than there are on adults. While these studies show mostly positive impacts of taxation on preterm birth and infant mortality, research has mostly been done only in high-income countries — meaning we’re less certain what happens in low- and middle-income countries with high air pollution and low awareness of tobacco-related harm.

“We know that tobacco smoke is harmful to the health of people of all ages, but that increasing levels of tax on tobacco can bring down smoking rates. But all of the research on how tobacco taxes can impact infant health comes from high-income countries, so we wanted to examine the impacts of tobacco taxation on infants,” Anthony Laverty, study author, told ZME Science.

Taxes and tobacco

Laverty and the group of researchers used data ranging from 2008 to 2018 on neonatal and infant mortality, tobacco taxation, gross domestic product, fertility rate, education, and access to drinking water, among other variants. Across the studied countries, the neonatal mortality rate was 14.4 and the infant mortality rate was 24.9 per 1,000 live births.

These rates were found to be much higher in low- and middle-income countries than in developed countries, the study showed. A total of 33 children aged under one in every 1,000 dies every year in low- and middle-income countries, compared to 4 newborns and 6 under-ones in every 1,000 in developed countries.

The researchers found that a 10% increase in total cigarette tax as a percentage of the retail price was associated with a 2.6% decrease in neonatal mortality and a 1.9% decrease in infant mortality globally. They estimated that 231,220 infant deaths could have been averted in 2018 if all countries had a total cigarette tax of at least 75%. Almost all of these averted deaths would have been in low- and middle-income countries.

Average total tobacco taxes were also found to be currently much higher in developed countries than in low- and middle-income countries. The World Health Organization recommends a 75% tax level on tobacco and most of the countries developed and developing, are not achieving this. This could be because of political resistance and a lack of awareness, Laverty said.

“Our study provides crucial new evidence to strengthen advocacy for increased tobacco taxation to protect child health. Increased taxation alongside other tobacco control measures should be better integrated into national and global strategies to reduce neonatal and infant mortality to accelerate progress in the achievement of SDG targets,” the researchers wrote

The study was published in the journal PLOS.