Publication: The Tobacco Epidemic in Southeast Europe : Consequences and Policy Responses
Loading...
Published
2004-03
ISSN
Date
2013-05-30
Author(s)
Editor(s)
Abstract
Smoking is the single largest cause of premature mortality in the developed world. Obtaining accurate estimates of smoking's impacts in south east Europe (SEE) is hindered by the lack of accurate data.. None of the countries of the region yet conduct regular national surveys of adult smoking prevalence and some have no recent nationally representative data available. The very high rates among medical personnel are cause for concern. Youth smoking surveys are now conducted in most countries as part of international projects and show rates broadly similar to the EU. The collapse of communism and the end of the conflicts in the 1990s has led to major changes in the region's tobacco industry. The previously state-owned tobacco monopolies have either undergone or are undergoing privatization and the transnational tobacco companies have been increasingly active both in importing their cigarettes to, and investing in, the region. These changes can be expected to increase competition in the tobacco industry which will in turn drive down prices and increase advertising, thereby stimulating consumption. The available statistics, combined with the changes to the region's tobacco industry, suggest that the health impacts of tobacco in SEE will continue to worsen over coming years.
Link to Data Set
Citation
“Bozicevic, Ivana; Gilmore, Anna; Oreskovic, Stipe. 2004. The Tobacco Epidemic in Southeast Europe : Consequences and Policy Responses. HNP discussion paper;. © World Bank. http://hdl.handle.net/10986/13710 License: CC BY 3.0 IGO.”
Digital Object Identifier
Associated URLs
Associated content
Other publications in this report series
Journal
Journal Volume
Journal Issue
Related items
Showing items related by metadata.
Publication Tobacco Control in Brazil(World Bank, Washington, DC, 2007-08)The objective of this study was to assess the smoking situation in Brazil, and the role of the tobacco control program, and compare it to experience in other countries. The study assessed key trends in smoking rates and lung cancer in Brazil, and reviewed price and non-price interventions. A discussion of fiscal instruments and smuggling is also included in this report. This study aimed at further evaluating the smoking situation in Brazil, the role of the tobacco control program in the country, and compares it to global best practice and experience in other countries. The study report is structured into three main parts: in the first chapter, trends in smoking prevalence, consumption, and cigarette expenditures in Brazil are reviewed, including the illegal market; in the second chapter, trends in lung cancer mortality and health care costs of smoking-related diseases in the country are analyzed; in the third chapter, non-price and price interventions are reviewed, including those taken by the Brazil tobacco control program, as well as the impact increases in cigarette prices and taxes would have on smoking prevalence and tax revenue. The report concludes with recommendations for further action to protect the Brazilian population from premature death and disease caused by smoking, and to reverse the negative impact of smoking on public expenditures.Publication Progression of Tobacco Control Policies : Lessons from the United States and Implications for Global Action(World Bank, Washington, DC, 2008-05)This paper examines the historical experience of tobacco control in the last five decades and shares important lessons of public health interventions to inform current and future tobacco control programs in other countries. The paper is divided into four parts. The first part gives an overview of the political economy, principal influences and interventions in tobacco control in the United States. It stresses the importance of information shocks and the role played by grassroots organizations. The current situation of tobacco control in the United States is further discussed in the second part, with emphasis on the economic case that led to litigation, as well as the response of the industry and the States. The third part focuses on the present efforts of multilaterals like the World Bank, technical United Nation (UN) agencies such as the World Health Organization, in the context of the new global governance structure: the Framework Convention on Tobacco Control (FCTC). The last section discusses lessons learned and provides recommendations for comprehensive tobacco control programs.Publication Research on Tobacco in Indonesia : An Annotated Bibliography and Review of Research on Tobacco Use, Health Effects, Economics, and Control Efforts(World Bank, Washington, DC, 2003-10)This report summarizes 46 studies on various aspects of tobacco in Indonesia published since 1990. Studies are arranged alphabetically by author's last name. The studies include tobacco use surveys, studies on tobacco-related mortality and diseases including costs, and health problems associated with environmental tobacco smoke. Some studies cover interventions to reduce tobacco use, and tobacco control policies, including price increases. Some studies look at specific groups such as children, street vendors, drivers, youth, athletes or nurses. Studies were traced using bibliographies of an initial set of studies collectedPublication The Economics of Tobacco in Estonia(World Bank, Washington, DC, 2004-06)The study examines prevalence of tobacco use in Estonia, expenditures by smokers, and the prevalence of prominent diseases for which tobacco use is an important risk factor. It estimates private and public direct and indirect costs associated with smoking in Estonia for 1998, looking at health care costs, fires, loss of household income, productivity losses, sickness benefits and disability, retirement and survivors' pensions. The total cost to the government in additional expenditures and lost revenues is estimated to be well over EEK 200 million greater than the tobacco tax revenues generated and reduced pension expenditures resulting from premature deaths attributable to tobacco. The second part of the paper estimates the relationship between cigarette prices (adjusted for inflation) and demand, including legal and illegal purchases by Estonians and by foreign visitors to Estonia. The price elasticity of cigarette demand is estimated at -0.34, implying that each 10 percent rise in the real price of cigarettes in Estonia will cause consumption to fall by about 3.4percent. The analysis shows that a tobacco tax rate increase will increase tax revenue from local consumption despite substitution between legal and illegal consumption, but that revenues will be greatly affected by the extent to which visitors (mostly from Finland) continue to buy (tax paid) cigarettes in Estonia. Stricter tobacco control measures, including higher taxation of cigarettes, would lead to healthier people, the avoidance of premature death, and increased productivity, which can only improve the economic performance of the country.Publication Towards a Political Economy of Tobacco Control in Low- and Middle-Income Countries(World Bank, Washington, DC, 2009-08)This study provides the basis for constructing a political economy of tobacco control in low- and middle-income countries (LMICs). The authors first undertook a literature review of tobacco control in LMICs to explore the forces that oppose the adoption, implementation, and enforcement of tobacco control strategies. The authors then used the sources collected to conduct a stakeholder analysis, as a first step in constructing a political economy of tobacco control in LMICs. The authors focused primarily at the international level because of the dominant role of transnational tobacco companies (TTCs). The author's review of the literature suggests four broad conclusions. First, a political economy approach has been applied only rarely as a formal analytical methodology in the literature on the tobacco control in LMICs. Second, even when the term "political economy" was used in a document, the paper typically did not explicitly conduct this kind of analysis and did not directly consider political strategies for advancing tobacco control. Third, translating the framework convention on tobacco control into tobacco use reductions at the national level is likely to require national-level political economy analyses to define political strategies appropriate to the particular national setting. Fourth, tobacco control's present and past is well documented, but analyses of future scenarios have focused on projections of health consequences and smoking trends. How TTCs will try to grow in the future has not been adequately addressed in the literature.
Users also downloaded
Showing related downloaded files
Publication Impact Evaluation in Practice, First Edition(World Bank, 2011)The Impact Evaluation in Practice handbook is a comprehensive and accessible introduction to impact evaluation for policymakers and development practitioners. The book incorporates real-world examples to present practical guidelines for designing and implementing evaluations. Readers will gain an understanding of the uses of impact evaluation and the best ways to use evaluations to design policies and programs that are based on evidence of what works most effectively. The handbook is divided into three sections: Part One discusses what to evaluate and why; Part Two outlines the theoretical underpinnings of impact evaluation; and Part Three examines how to implement an evaluation. Case studies illustrate different methods for carrying out impact evaluations.Publication Rethinking School Feeding Social Safety Nets, Child Development, and the Education Sector(World Bank, 2009)This review highlights three main findings. First, school feeding programs in low-income countries exhibit large variation in cost, with concomitant opportunities for cost containment. Second, as countries get richer, school feeding costs become a much smaller proportion of the investment in education. For example, in Zambia the cost of school feeding is about 50 percent of annual per capita costs for primary education; in Ireland it is only 10 percent. Further analysis is required to define these relationships, but supporting countries to maintain an investment in school feeding through this transition may emerge as a key role for development partners. Third, the main preconditions for the transition to sustainable national programs are mainstreaming school feeding in national policies and plans, especially education sector plans; identifying national sources of financing; and expanding national implementation capacity. Mainstreaming a development policy for school feeding into national education sector plans offers the added advantage of aligning support for school feeding with the processes already established to harmonize development partner support for the education for all-fast track initiative.Publication Ten Steps to a Results-Based Monitoring and Evaluation System : A Handbook for Development Practitioners(Washington, DC: World Bank, 2004)An effective state is essential to achieving socio-economic and sustainable development. With the advent of globalization, there are growing pressures on governments and organizations around the world to be more responsive to the demands of internal and external stakeholders for good governance, accountability and transparency, greater development effectiveness, and delivery of tangible results. Governments, parliaments, citizens, the private sector, Non-governmental Organizations (NGOs), civil society, international organizations, and donors are among the stakeholders interested in better performance. As demands for greater accountability and real results have increased, there is an attendant need for enhanced results-based monitoring and evaluation of policies, programs, and projects. This handbook provides a comprehensive ten-step model that will help guide development practitioners through the process of designing and building a results-based monitoring and evaluation system. These steps begin with a 'readiness assessment' and take the practitioner through the design, management, and importantly, the sustainability of such systems. The handbook describes each step in detail, the tasks needed to complete each one, and the tools available to help along the way.Publication Universal Health Coverage for Inclusive and Sustainable Development : A Synthesis of 11 Country Case Studies(Washington, DC: World Bank, 2014-06-25)The goals of Universal Health Coverage (UHC) are to ensure that all people can access quality health services, to safeguard all people from public health risks, and to protect all people from impoverishment due to illness, whether from out-of-pocket payments for health care or loss of income when a household member falls sick. Countries as diverse as Brazil, France, Japan, Thailand, and Turkey that have achieved UHC are showing how these programs can serve as vital mechanisms for improving the health and welfare of their citizens, and lay the foundation for economic growth and competitiveness grounded in the principles of equity and sustainability. Ensuring universal access to affordable, quality health services will be an important contribution to ending extreme poverty by 2030 and boosting shared prosperity in low income and middle-income countries (LMICs), where most of the world s poor live.Publication Digital Africa(Washington, DC: World Bank, 2023-03-13)All African countries need better and more jobs for their growing populations. "Digital Africa: Technological Transformation for Jobs" shows that broader use of productivity-enhancing, digital technologies by enterprises and households is imperative to generate such jobs, including for lower-skilled people. At the same time, it can support not only countries’ short-term objective of postpandemic economic recovery but also their vision of economic transformation with more inclusive growth. These outcomes are not automatic, however. Mobile internet availability has increased throughout the continent in recent years, but Africa’s uptake gap is the highest in the world. Areas with at least 3G mobile internet service now cover 84 percent of Africa’s population, but only 22 percent uses such services. And the average African business lags in the use of smartphones and computers as well as more sophisticated digital technologies that catalyze further productivity gains. Two issues explain the usage gap: affordability of these new technologies and willingness to use them. For the 40 percent of Africans below the extreme poverty line, mobile data plans alone would cost one-third of their incomes—in addition to the price of access devices, apps, and electricity. Data plans for small- and medium-size businesses are also more expensive than in other regions. Moreover, shortcomings in the quality of internet services—and in the supply of attractive, skills-appropriate apps that promote entrepreneurship and raise earnings—dampen people’s willingness to use them. For those countries already using these technologies, the development payoffs are significant. New empirical studies for this report add to the rapidly growing evidence that mobile internet availability directly raises enterprise productivity, increases jobs, and reduces poverty throughout Africa. To realize these and other benefits more widely, Africa’s countries must implement complementary and mutually reinforcing policies to strengthen both consumers’ ability to pay and willingness to use digital technologies. These interventions must prioritize productive use to generate large numbers of inclusive jobs in a region poised to benefit from a massive, youthful workforce—one projected to become the world’s largest by the end of this century.