2003年-世界发展银行全球_A_Study_on_the_Economics_of_Tobacco_in_Nepal_108页_908kb

Summary of A Study on the Economics of Tobacco in Nepal

Core Content

This study, published as an HNP Discussion Paper by the World Bank and the World Health Organization's Tobacco Free Initiative, provides an in-depth analysis of the economics of tobacco in Nepal. It covers the country's demographic and health situation, tobacco production and trade, smoking behaviour and consumption patterns, the impact of prices and taxes on demand, and policy recommendations for tobacco control.

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Main Findings

1. Demographic and Health Situation

• Nepal's population was 23.1 million in 2001, growing at an annual rate of 2.27%.
• 40% of the population is under 15 years of age.
• Life expectancy in 2000 was 60 years.
• 90% of the population resides in rural areas.
• Literacy rates in 2001 were 67% for men and 41% for women.
• The main causes of death are infectious, maternal, and perinatal conditions (about 50%), followed by non-communicable and congenital conditions (about 40%).

2. Tobacco Production and Trade

• In 1996/97, Nepal had four cigarette manufacturers (three private, one public) and an agent for foreign cigarettes.
• Production of other tobacco products, such as bidi, is limited and declining.
• Tobacco and tobacco product imports are increasing, though they account for only 1% of total imports.
• Most tobacco is imported from India.
• Nepal's tobacco farming and exports are minimal.
• Tobacco smuggling, particularly of smokeless products, is believed to be common due to porous borders and local corruption.
• The introduction of a value-added tax in 1997 may have exacerbated smuggling, but there is no data to confirm this.

3. Smoking Behaviour and Consumption Survey

• A survey of 1,438 households (nearly 6,000 people) was conducted in November-December 2000.
• Annual per capita income was estimated at US$175, which is 25% lower than the official GDP.
• Urban households earned more than rural ones.
• Farm-related earnings accounted for 40% of total income, while non-farm income was 47%.
• Tobacco-related income was negligible (less than 1% of total income).
• The wealthiest 20% of households earned 56% of total income, indicating increasing income inequality since 1996.
• Smoking prevalence among males aged 15 and over was 37.4%, with males (47.4%) smoking more than females (27.6%).
• Smoking is more common in rural areas and among men.
• Annual average consumption among those aged 10 and over was just over 2,000 sticks.
• Females, except in the mountain region, tend to smoke more than males.
• Smokers spend about US$30 annually on tobacco products, which is 17% of their income.
• Cigarette smoking is associated with social status and is more prevalent among the young and less educated.

4. Prices, Taxes, and Demand

• Cigarette prices have fallen by about one-third since 1970, making them 60% more affordable in 2000 than in the early 1970s.
• Bidi and smokeless tobacco are generally more affordable than cigarettes.
• Three types of taxes apply to manufactured cigarettes: excise tax, health (smoking) tax, and a 10% value-added tax.
• Excise tax is the most significant, based on the type and length of the cigarette.
• In 2002/03, total tax incidence on cigarettes ranged from 25% on international brands to over 50% on domestic brands.
• This is lower than international standards, which often reach 75-85%.
• The health tax, used for cancer control, has not changed since 1994-95, but the real value of the currency has fallen by over 90%.
• Price and income elasticities were estimated:
  • Price elasticity of demand for cigarettes and bidi was -0.882, indicating that a 10% price increase would reduce consumption by 8.8%.
  • Income elasticity was positive but small (0.18), suggesting that a 10% increase in income would lead to a 1.8% increase in tobacco consumption.
• Poor and young people are most sensitive to price changes, as they have less disposable income and are less likely to be addicted.

5. Health and Tobacco Control

• Tobacco use is a major health risk, leading to chronic obstructive pulmonary disease (COPD), ischaemic heart disease (IHD), and cancer.
• The study notes that tobacco use combined with unventilated indoor fires increases the risk of lung disease.
• There is a lack of comprehensive data on smoking-related diseases in Nepal, but estimates suggest high morbidity and mortality rates.
• The Ministry of Health is actively involved in tobacco control, with the National Health Education, Information and Communication Centre (NHEICC) leading health education and communication efforts.

6. Policy Recommendations

• Real price increases through taxation of all tobacco products are recommended to reduce consumption, improve public health, and generate additional government revenue.
• These measures are especially effective in reducing smoking among the poor and young.
• The study argues that increasing tobacco taxes does not necessarily lead to reduced government revenue, as it can increase total tax collection and reduce health costs.
• Comprehensive bans on tobacco advertising and smoking in public places should be introduced.
• Collaboration between health and finance ministries is essential to implement effective and economically sound tobacco control policies.

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Key Information

• Tobacco Control: The study emphasizes the importance of cost-effective tobacco control measures, including taxation, public education, and advertising bans.
• Economic Impact: Tobacco control can bring net economic gains, including increased tax revenues and reduced health expenditures.
• Poverty and Health: Poor people are more likely to consume tobacco, which increases health risks and diverts scarce income.
• Taxation as a Tool: Taxation is identified as the most effective and cost-effective tool for reducing tobacco use, especially among vulnerable groups.
• Simulation Analysis: A 5% annual real price increase in tobacco products could generate an additional Rs 22,808 million (US$ 368 million) in government revenue between 2000 and 2010.
• Public Awareness: There is a need to improve public awareness of the health risks associated with tobacco use.

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Conclusion

The study concludes that increasing tobacco taxes and implementing effective tobacco control policies can significantly reduce tobacco consumption, improve public health, and generate substantial economic benefits for Nepal. It calls for a coordinated approach between health and finance ministries and highlights the importance of public education and anti-smoking legislation in addressing the tobacco epidemic.