World Bank Group
The main objectives of this paper are to estimate the burden of tobacco-caused mortality as a whole and by main tobacco-related diseases in Kazakhstan, the Russian Federation, and Ukraine, and to assess the distributional health impact of an increase in tobacco taxation in these three countries. According to the results obtained, in 2012 smoking caused around 310,000 deaths in Russia, about 70,000 in Ukraine, and 14,300 in Kazakhstan, representing a key factor of mortality among the working-age population. Using data from various sources, the paper estimates the distributional consequences of a hypothetical tax rise in the three countries that leads to an approximately 30 percent increase of the average retail price of cigarettes. The analysis includes an estimation of changes in smoking prevalence, mortality, life expectancy, and public health expenditures by income quintile and gender. Considered excise growth can lead to about 3.5 to 4.0 percent fall in smoking prevalence, which in turn can avert about 600,000 tobacco-related deaths in Russia, 140,000 in Ukraine, and 30,000 in Kazakhstan over a 50 years period. Reduced tobacco-related morbidity will also result in substantial decrease in health expenditures for the treatment of tobacco-related diseases. Positive health effects are expected to be pro-poor, as almost 60 percent of the reduction in mortality is concentrated in the two lower-income quintiles of the population of the three countries.