Towards a tobacco-free Bangladesh: A call to advance tobacco control reforms

Bangladesh has earned international recognition for its remarkable achievements in public health. Significant progress in immunisation, maternal and child health, family planning, and communicable disease control has made the country a global success story.

Yet, alongside these achievements, tobacco use has emerged as one of the country's greatest public health threats, fuelling an epidemic of non-communicable diseases.

Every year, nearly 200,000 Bangladeshis die prematurely from tobacco-related diseases. Millions more suffer from cancer, cardiovascular disease, stroke, chronic respiratory illness, and other debilitating conditions caused or aggravated by tobacco use. Beyond its devastating human toll, tobacco imposes an enormous economic burden through healthcare expenditure, productivity loss, and premature mortality. The overall economic cost of tobacco use far exceeds the revenue generated from tobacco taxation.

Despite these challenges, Bangladesh has been a global leader in tobacco control. It was among the first countries to sign and ratify the World Health Organization Framework Convention on Tobacco Control (WHO FCTC), the world's first legally binding international public health treaty. This achievement remains a proud milestone in Bangladesh's public health history.

The Bangladesh Nationalist Party (BNP) government (2001–2006) played an important role during this historic period. Under the leadership of the then Minister of Health and Family Welfare, Dr. Khandaker Mosharraf Hossain, Bangladesh actively participated in the international negotiations that led to the adoption of the WHO FCTC. I had the privilege of serving as a member of the Bangladesh delegation and witnessed first-hand the country's commitment to advancing global tobacco control.

During the same period, the Smoking and Tobacco Products Usage (Control) Act, 2005 was enacted, laying the legal foundation for tobacco control in Bangladesh. Subsequently, I was directly involved in developing national tobacco control strategies, regulations, implementation plans, and other policy initiatives. Tobacco control has therefore been not only a professional responsibility but also a long-standing personal commitment.

I was greatly encouraged to see that the Bangladesh Nationalist Party has reaffirmed its commitment to achieving a Tobacco-Free Bangladesh by 2040 in its election manifesto. This is a visionary and evidence-based public health commitment. The national budget now presents the first major opportunity to translate that political commitment into meaningful action.

Unfortunately, the proposed budget does not fully reflect this commitment.

The proposed retail price for a 10-stick pack of low-tier cigarettes has been set at Tk 62, while the mid-tier has been proposed at Tk 92. However, in reality these products are already being sold in the market at approximately Tk 70 and Tk 100, respectively. Consequently, tobacco taxes continue to be collected on artificially lower official prices, while consumers are already paying significantly higher market prices.

This discrepancy allows tobacco companies to retain excessive profits while depriving the government of an estimated Tk 5,512 crore in annual tax revenue.

This is not merely a fiscal issue; it is also a matter of good governance and public health. Tobacco taxation is designed not only to generate revenue but also to discourage tobacco consumption. When official tax bases fail to reflect actual retail prices, both objectives are undermined.

Most importantly, revising the official prices of low-tier cigarettes from Tk 62 to Tk 70 and mid-tier cigarettes from Tk 92 to Tk 100 would not increase the financial burden on consumers, because these are already the prevailing market prices. Instead, the government would recover substantial additional revenue while reducing unjustified windfall profits enjoyed by tobacco companies.

At the same time, Bangladesh should gradually move toward a Specific Excise Tax system, simplify the tobacco tax structure, reduce price tiers, and strengthen tax administration.

International evidence consistently shows that such reforms increase government revenue while reducing tobacco consumption, particularly among young people and low-income populations.

The additional revenue generated could be invested in universal health coverage, cancer prevention, primary healthcare, tobacco cessation services, education, and social protection programmes. In this way, tobacco taxation would become a powerful instrument for improving both public health and national development.

Hon'ble Prime Minister, Bangladesh once demonstrated global leadership in tobacco control. Today, history offers another opportunity. The commitment made in the election manifesto can now be translated into concrete action through the national budget and stronger tobacco control policies.

Such action will not only increase government revenue; it will save lives, discourage youth smoking, reduce the future burden of cancer and other non-communicable diseases, and bring Bangladesh closer to achieving its vision of a Tobacco-Free Bangladesh by 2040.

With your visionary leadership, Bangladesh has achieved remarkable progress in many sectors. We sincerely hope that your government will once again demonstrate bold leadership by aligning tobacco taxation with market realities, reforming the tobacco tax structure, and implementing evidence-based tobacco control policies.

A tobacco-free Bangladesh is not an unattainable dream. It is an achievable national goal—requiring only political commitment, evidence-based policy, and timely action.

Prof Syed Md Akram Hussain, FCPS, MPH, FRCP, FACP, PhD is the Chairman of Department of Clinical Oncology at Bangladesh Medical University (BMU). He is a former member of the Health Sector Reform Commission and the Bangladeshi Delegation to the WHO FCTC Negotiations

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