Eds Prabat Jha, Frank J Chaloupka
World Bank, £16, pp 122 
ISBN 0 8213 4519 2
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Rating: ★★★★
If you have been dining with conservative economists lately you may have heard something like this after the fourth port: “Tobacco is a wonderful thing. People start in their youth, contribute easily collectable tax for 40-50 years, and then about half have the decency to die around retirement age, thus saving the government the cost of their pensions and of treating their degenerative diseases in their final forsaken decades. The tobacco tax they contribute easily pays for any health costs they might run up under publicly funded healthcare systems.” The small problem with this argument is that health costs are not the only outcomes relevant to the economics of tobacco. Non-smokers don't slip daily deposits into jam jars under the bed and deprive the economy of the benefits of their expenditure. They spend money on other things, most of which are taxed and have better multiplier effects in the community than tobacco.
There are many other myths about the economics of tobacco and its control. This small book, compiled by a veritable World Cup squad of health economists for the World Bank, examines the main arguments and concludes that governments should aggressively pursue tobacco control and that empires will not crumble if they do.
A cardinal principle in economics is consumer sovereignty, with its assumption that consumers' choices reflect informed preferences. By this argument, whatever is spent on tobacco can be counted as a benefit on the ledger because consumers are expressing their preferences. The report provides examples of woefully uninformed populations, particularly in less developed countries, and argues for cigarette packs to be radically reformed to become portable factsheets rather than remain beguiling totemic badges for identity conscious smokers to carry as fashion accessories.
If the report lacks anything, it misses making an explicit statement about the values that underpin concern that smokers ought not to die on average six years early, after having an important part of their choice removed by nicotine addiction, and after living through a lifetime of information befogged by the tobacco industry's propaganda efforts. While the book deals with each of these issues, it considers the reasons why they matter as self evident. Lying and omission, indifference to causing early death and suffering, using pharmacological training to work out ways to make cigarettes more efficient drug delivery devices, and corrupting the language to allow words like “mild” to apply to carcinogens all deserve rather more blunt language.