# Interpreting results, impacts and implications from WHO FCTC tobacco control investment cases in 21 low-income and middle-income countries

## TL;DR

This paper summarizes the economic and health impacts of tobacco use in 21 countries and shows that implementing WHO tobacco control measures would reduce these impacts and provide a positive return on investment.

## Contribution

The paper provides a synthesis of tobacco investment cases across 21 low- and middle-income countries, highlighting the socioeconomic costs and benefits of WHO FCTC measures.

## Key findings

- Tobacco use causes annual socioeconomic losses of up to US$1.6 billion in upper-middle-income countries.
- These losses are equivalent to 1.1% to 2.9% of the average annual GDP in the countries studied.
- Implementing WHO FCTC measures would reduce tobacco use and provide a positive return on investment in all countries.

## Abstract

Tobacco control investment cases analyse the health and socioeconomic costs of tobacco use and the benefits that can be achieved from implementing measures outlined in the WHO Framework Convention on Tobacco Control (WHO FCTC). They are intended to provide policy-makers and other stakeholders with country-level evidence that is relevant, useful and responsive to national priorities and policy context.

This paper synthesises findings from investment cases conducted in Armenia, Cabo Verde, Cambodia, Chad, Colombia, Costa Rica, El Salvador, Eswatini, Georgia, Ghana, Jordan, Laos, Madagascar, Myanmar, Nepal, Samoa, Sierra Leone, Sri Lanka, Suriname, Tunisia and Zambia. We examine annual socioeconomic costs associated with tobacco use, focusing on smoking-related healthcare expenditures, the value of lives lost due to tobacco-related mortality and workplace productivity losses due to smoking. We explore potential benefits associated with WHO FCTC tobacco demand-reduction measures.

Tobacco use results in average annual socioeconomic losses of US$95 million, US$610 million and US$1.6 billion among the low-income (n=3), lower-middle-income (n=12) and upper-middle-income countries (n=6) included in this analysis, respectively. These losses are equal to 1.1%, 1.8% and 2.9% of average annual national gross domestic product, respectively. Implementation and enforcement of WHO FCTC tobacco demand-reduction measures would lead to reduced tobacco use, fewer tobacco-related deaths and reduced socioeconomic losses.

WHO FCTC tobacco control measures would provide a positive return on investment in every country analysed.