BACKGROUND: Smoking is a leading cause of preventable death globally, responsible for over 7 million deaths annually, with the burden expected to rise, particularly in low- and middle-income countries. In China, smoking contributes significantly to mortality, disability, poverty, and healthcare costs. While tobacco taxation is a proven strategy to reduce smoking, it remains underutilized in China. This study aims to estimate the burden of smoking-related cancers in China and evaluate the potential health and economic impacts of increasing tobacco taxes.
METHODS: In this modeling study, we simulated the disease burden of 10 smoking-related cancers under varying tobacco tax rates in China. Population data were based on the China Statistical Yearbook 2024. A Markov model was used from 2024 to 2033, with tobacco consumption and cessation modeled based on price elasticity. We evaluated the resulting reduction in disease burden and healthcare costs.
RESULTS: We assessed the impact of increasing tobacco taxes on the incidence of lung, colorectal, esophageal, stomach, liver, pancreatic, breast, cervical, kidney, and head and neck cancers. A 5% increase in tobacco tax would prevent 32272 cancer cases over 10 years, while a 10% increase would avert 64462 cases. A 13.6% increase, reaching the WHO-recommended level of 75%, could prevent 87694 cases. The largest reductions in incidence were seen in lung cancer (59602 cases), followed by stomach cancer (8212 cases) and liver cancer (7010 cases), with significant reductions across other cancer types as well. The direct medical costs saved over the 10-year period were estimated to be $314 million, $628 million, and $854 million, respectively, for the 5%, 10%, and 13.6% tax increases.
CONCLUSIONS: Smoking-related cancers impose a significant health and economic burden in China. Increasing tobacco taxes to 75% could significantly reduce the incidence of smoking-related cancers in China, lower healthcare costs, and generate substantial economic benefits.