The tobacco industry survives and thrives. It adapts to legislative and regulatory attempts to hinder the sale, promotion, and use of its products.
The number of smokers has increased from 0·99 billion in 1990 to 1·14 billion in 2019, who consumed 7·41 trillion cigarette-equivalents of tobacco in 2019.
5·96 million (77·5%) of 7·69 million smoking-attributable deaths in 2019 occurred in low-income and middle-income countries and that 66 (93%) of 71 countries that had significant increases in such deaths were low-income and middle-income countries.
WHO reported that although global tobacco cultivation decreased by 15·7% between 2012 and 2018, it increased by 3·4% in Africa. The number of adult users of tobacco in Africa increased from 64 million in 2000 to 73 million in 2018.
Cigarette taxes could be set high enough to crush the tobacco industry, but no governments will go that far. They rely on this revenue for deficit reduction and for things other than curbing smoking.
The vaunted 1998 Master Settlement Agreement between the US state attorneys general and the tobacco industry, ostensibly to recover medical costs for disease caused by smoking, epitomises government addiction to tobacco money. States have spent only 3% of the annual payments to them from the industry to fight smoking, which in some instances is less than before the Master Settlement Agreement.
Increases in tobacco taxation might have reduced sales to the poorest consumers, but US cigarette manufacturers are still making huge profits and tobacco stocks remain a healthy investment.
In contrast to the trillions of dollars allocated by US Congress to address COVID-19, no major funding has ever been approved to fight smoking and its promotion.
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