‘Covid Response Blueprint for Endgame’

The world’s ongoing response to Covid-19 offers a precedent for drastic action to eliminate the tobacco industry, according to Stanford University professor John P. A. Ioannidis and health economist Prabhat Jha

While most anti-tobacco measures to date have targeted demand, the “endgame” might require reducing supply, the scholars write in The Lancet. The public health community has little experience enforcing major changes that disrupt markets, but the Covid-19 pandemic provides a natural experiment, they argue.

Measures taken to prevent the spread of Covid-19 have disrupted multiple sectors of the economy quickly and deeply, including travel, tourism, restaurants, entertainment and retail. The cumulative share of these markets before Covid-19 far exceeded the $1 trillion tobacco market.

“Even if all 100 million tobacco-related jobs were lost, this number is still much lower than the number of jobs lost by lockdown measures for Covid-19 worldwide,” the authors write, citing 400 million full-job equivalents lost because of the pandemic in the second quarter of 2020 alone.

“Moreover, of 100 million people among the tobacco workforce, manufacturing accounts for only 1-2 percent of jobs. 40 million people work in tobacco-growing and leaf-processing, 20 million work in home industries, and the remaining people work on distribution, sales and promotion.”

The authors suggest a safety net could be provided during a transition period to reduce poverty, similar to that activated for Covid-19-related unemployment.

The benefits of eliminating the tobacco industry would also exceed those achieved by anti-Covid measures, according to the authors. “Even under the most pessimistic projections, Covid-19 fatalities are well below the perpetuated burden of tobacco deaths,” the write. “Moreover, Covid-19 kills mostly older people with multiple underlying diseases, whereas half of tobacco deaths occur in people aged 30–69 years.”