In a country where each third brand from the budget goes to health and social, and at the same time almost half of the adult population smokes, the issue of detachment tobacco can no longer be able to observe only as a health issue, but also as economic.
According to the latest Eurobarometer survey, BiH is at the very top of Europe at the smoking rate with more than 40 percent of adults who consume cigarettes every day. If we translated it into the world of numbers, it would mean over 1.3 million people. We cannot say that all these people are bad, undisciplined or uninformed. Many are simply trapped in the forms of daily behavior that the market and the state for years do we observe.
The price of that silence is not small. According to the World Health Organization, countries with such consumption patterns lose between one and three percent of GDP on the cost of treating smoking diseases. In the case of BiH, which consumes about 1.4 billion KM annually on health, this could mean more than 40 million KM of additional budget expenditure. However, it should be noted that all indirect costs such as the loss of productivity, early retirement or premature mortality are not included.
EU studies indicate that smokers are on average a year to consume about 1,500 euros. If we design this figure on BiH, it is more than two billion KM that citizens stand out for products that endanger their health, and then further burden public funds. On the other hand, jobs are lost not only because of the disease, but also because chronic smokers on average have 30 percent more days of sick leave in relation to non-smokers. That is why it is high time to stop thinking exclusively in black and white categories. Smoking is harmful, but this does not mean that all alternatives are as harmful, nor does the state have to use only prohibitions as a policy instrument.
The experiences of other countries show that there is a middle path. Sweden reduced the daily smoking rate to only 5.4 percent, while receiving 36 percent fewer lung cancer compared compared to the EU average. The Czech Republic, by a combination of preventive measures and the introduction of new products with reduced risk, reduced smoking with 30 percent to 23 percent in three years. Greece, newly known for the high smoking rate, managed to reduce the number of smokers by as much as 600,000 in just three years. It is important to emphasize that all these examples speak one thing, and that is when people have an alternative and when these alternatives are available, they accept it. Alternatives are imploaded by potentially reduced risk, such as e-cigarettes, heated tobacco products, and especially nicotine bags that do not contain tobacco.
In the United Kingdom, the integration of crawling policies contributed to the smoking rate from 16.4 percent (2015) to 10.4 percent (2023). In Japan, sales of classic cigarettes fell by 52 percent thanks to the mass crossing to products with potentially minor risk. New Zealand, which set the goal to up to 2025. It has become a “smoke-free country”, managed to reduce the prevalence of smoking among adults in under nine percent, which is the lowest rate in the Asian and Pacific region.
Of course, this does not mean that the state should promote new products, but to regulate them smart. The right path is not repression, but proportionality in the way that produces larger health risk should be more severely taxed and regulated, while less harmful alternatives should be clearly marked, monitored and set up in a regulatory framework that encourages the transition to less risky forms of consumption. Smart regulation, therefore, does not imply state passivity, but its active risk management, which is a big difference. Such an approach has already adopted many developed countries that I have already mentioned. The United Kingdom uses a range as part of public health programs, Japan has reduced classic cigarettes for more than half, and New Zealand has announced the sale of cigarettes after 2009. years, but not to prohibit existing ones, but by gradual truncation through generations.
In Bosnia and Herzegovina, we have all the reasons to go this route. Our health system is under pressure, and our resources are limited. If the prevalence of smoking was reduced only by 10 percent, it would mean tens of millions of marks less expense of treatment per year. This money could be focused in prevention, strengthening primary health care and new staff, where we need the most. Not to talk about the effects of budget savings, tax database and general work productivity. Smart regulation does not exclude education, but on the contrary, it is complemented. Citizens are entitled to information, but also to less harmful products, provided that they are under strict supervision and clearly regulated, which is in fact a path that respects reality, respects the freedom of choice, but also sets the responsible boundaries.
In Bosnia and Herzegovina, the system of taxation of tobacco and related products is still not fully adapted to the degree of health risk that individual products carry. Although there are certain differences in the treatment of classic cigarettes and alternative products, the regulatory framework does not recognize a clear potentially lower risk that some innovations can carry. With the introduction of differentiated excises, where reduced risk products would have a lower tax burden, the transition of adult smokers could be further encouraged to less harmful options, without losing budget revenues. On the contrary, with greater migration on these products, the long-term budget cost and costs could feel positive effects.
It is time to start making decisions in BiH, which do not control the past models, but open space for modern public policy, which is too much needed. Politics in which health of citizens and economic sustainability do not stand against another, but go hand in hand, because, in essence, they are inextricably connected, writing Independent newspapers.
