Next time you are walking down the street in Ha Noi or other towns and cities in Viet Nam, pay attention to how many people are smoking cigarettes or other tobacco products: most likely you will see that many men are smoking. It is a common habit – and one that is very harmful, not only to the health of the individual smokers. High rates of smoking are threatening Viet Nam’s ability to achieve national tobacco control and health targets, as well as its long-term aspiration of becoming a high-income country by 2045.
With 41% of adult men currently smoking and a total of more than 15 million smokers in Viet Nam, tobacco use is causing a significant — and growing — burden of illness and early deaths, as well as significant health costs. Economic losses from tobacco are estimated at VND 108 trillion or 1.14% of GDP annually, including losses in economic participation and productivity. These avoidable costs come at the expense of Viet Nam’s current and future prosperity.
It is clear that we need to take stronger action to reduce tobacco use in Viet Nam, and in doing so, protect health and save lives – and one of the most powerful means of doing this is by increasing tobacco taxes and prices. The National Assembly has a unique opportunity to do this during its upcoming session, when it discusses the revision of the Excise Tax Law.
This week, WHO launched a policy brief, Tobacco Taxation to Advance Health and Sustainable Development in Viet Nam. In it, we show the level of tobacco tax that is needed to meet the National Tobacco Control Strategy target of reducing smoking among men from 41.1% to below 36% by 2030.
Viet Nam has made some good progress in the fight against tobacco harm in the past decade or so. However, we have seen worrying signals that tobacco consumption may actually be starting to increase again in Viet Nam – with the General Statistics Office reporting that total cigarette production increased by more than 17% between 2021 and 2023 (and only a small increase in exports during this time). There is no reason to believe this will change without stronger action to reduce demand for tobacco products.
Tobacco is the only legal product that, when used according to the manufacturer's instructions, kills at least half of the people who use it. So tobacco harm should be of enormous concern to us all.
Smoking kills more than 100,000 people a year in Viet Nam, according to estimates from the latest Global Burden of Disease Study. Of the total, 84,500 are smokers, another 18,800 people die from exposure to second-hand smoke. Tobacco use is a major risk factor for cardiovascular and respiratory diseases, over 20 different types or subtypes of cancer, and many other debilitating health conditions. Most smoking deaths are of men in their prime, leaving behind spouses, children, parents, friends and workplaces.
One of the reasons for Viet Nam’s high smoking rate is that tobacco is incredibly cheap – and because of low tobacco taxes. Tobacco tax in Viet Nam makes up just 36% of the retail price, compared to the global average of 62% and WHO’s recommendation of at least 75% of the retail price.
Over time, tobacco has become more affordable as people’s incomes have increased and tobacco prices have lagged behind. Between 2010 and 2022, Viet Nam’s GDP per capita tripled, while the price of the most-sold brand of cigarettes increased by only 55%.
Significantly raising tobacco taxes and prices is the single most effective measure for reducing smoking rates. Increasing tobacco tax acts as a ‘price signal’ – when you raise the price of tobacco, smokers receive the signal that they should consume less or quit. Tobacco taxation as a lever for reducing tobacco consumption is also a measure specifically called for in the WHO Framework Convention on Tobacco Control, the international tobacco control treaty which Viet Nam has ratified.
Young people are most sensitive to price increases – which is, in itself a very strong rationale for increasing tobacco taxes. We must do all we can to protect young people from taking up tobacco or any product containing nicotine. If we do, it is like giving them a vaccine which protects them for life – because people are much less likely to start using tobacco when they are older.
To help countries make informed decisions about tobacco tax, WHO developed a tobacco tax simulation model, TaXSiM, that predicts how changes in tobacco tax affect the price of cigarettes, consumption – and therefore health – and Government revenues.
WHO officials used TaXSim to analyse the Ministry of Finance’s two published tobacco tax options. Both are steps in the right direction as they would lead to reductions in the rate of men’s smoking. But to achieve Viet Nam’s health and economic ambitions, the tax increase needs to be higher. TaXSim modelling shows that a higher specific tax, reaching 15,000 VND per pack by 2030, on top of the current tax, would reduce men’s smoking to 35.8%, around the national target. Tobacco control targets and economic targets are inextricably linked – because fewer people using – and dying from – tobacco, means a healthier and more productive labour force.
A higher specific tobacco tax would also massively increase annual tax revenues, bringing in an extra 29.3 trillion VND per year in 2030 compared to 2020. This option is WHO’s very strong recommendation, as it will be ‘win-win’ – helping to prevent disease and improve health, while at the same time mobilizing additional revenue that can be invested in key priorities to advance the Government’s broader ambitions for sustainable development.
Applying a higher rate of tobacco tax will help to protect Viet Nam’s most precious capital, the health of its people, and in doing so, support the achievement of the Government of Viet Nam’s ambitions for a healthier and more prosperous future.