The world is facing growing economic uncertainty. Rising energy prices and supply shortages are pushing up costs and straining economies. In Bangladesh, this comes at a critical moment: budget season. The country already faces major health and development challenges that continue to hold back productivity and long-term human capital development. At the same time, public debt is rising and is expected to exceed 45 percent of GDP in the coming years, narrowing fiscal space just as the need for investment in health and development becomes more urgent.
One clear opportunity to address both challenges is stronger tobacco taxation, a WHO-recommended best-practice policy that protects public health while strengthening public finances needed to invest in future growth.
Every year, tobacco use kills nearly 200,000 people in Bangladesh, around 25 percent more than a decade ago. It remains a major driver of cardiovascular disease, cancer, and chronic respiratory illness, and a major risk factor for tuberculosis, increasing both the likelihood of developing the disease and poorer treatment outcomes.
The economic burden is equally severe. In 2024 alone, tobacco use imposed an estimated burden of Tk 875 billion through healthcare expenditure, lost productivity, premature death, and environmental damage. This is more than double the tax revenue generated from tobacco consumption.
Despite these harms, tobacco use remains widespread. More than one in three adults in Bangladesh use tobacco. Particularly concerning is the early uptake of tobacco use among young people: almost 10 percent of students aged 13-17 already use tobacco.
A key driver of this is affordability. Cigarettes in Bangladesh are among the cheapest in Southeast Asia and globally. Low- and mid-priced brands dominate the market. A popular pack (of 20 sticks) costs about $1.20, and 100 packs can be purchased for less than four percent of an individual’s income on average. The solution, therefore, is simple: reduce affordability by increasing retail prices and simplifying the tax structure to eliminate the artificial division between low- and medium-segment cigarettes.
Tobacco taxes are already a major source of revenue for the National Board of Revenue, while the tobacco industry continues to argue that higher taxes will fuel illicit trade and reduce government revenues. These claims have helped slow stronger reform efforts. So, the real challenge is not taxation itself, but enforcement. Stronger tax administration, supply-chain monitoring, licensing systems, and track-and-trace tools can effectively curb illicit trade while strengthening compliance, protecting revenues, and expanding the tax base.
Bangladesh is already moving in this direction, with plans to introduce QR codes on tobacco packaging. As a party to the WHO Framework Convention on Tobacco Control, the country already has a strong foundation to build on. Joining the Protocol to Eliminate Illicit Trade in Tobacco Products and implementing its global best practices would be a logical next step to strengthen enforcement and support stronger tobacco taxation reforms.
Importantly, stronger tobacco taxation should be accompanied by equally strong regulation of emerging nicotine and tobacco products, including e-cigarettes and nicotine pouches. For a country with a very young population, recent policy changes, including lighter regulation and regulatory carve-outs for these products, risk undermining progress in tobacco control while creating new opportunities for industry manipulation and the targeting of young people.
The stakes are particularly high because nicotine addiction increasingly begins early. Industry marketing strategies such as flavoured products, attractive packaging, and digital promotion are specifically designed to appeal to adolescents and young adults. Evidence shows that young people who use e-cigarettes are more likely to start smoking conventional cigarettes later, threatening to reverse decades of public health progress.
For both public health and public finances, and for both present and future generations, Bangladesh now faces a critical moment for action. Stronger tobacco taxation, combined with robust regulation and enforcement, offers one of the clearest opportunities to reduce preventable deaths, lower long-term healthcare costs, and generate additional domestic resources for development priorities. Bangladesh cannot afford inaction in this regard.
Dr. Ahmed Jamsheed Mohamed is WHO representative in Bangladesh.
Views expressed in this article are the author's own.
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