Cigarette consumption from a life-course perspective in low- and middle-income countries.

Objective: To calculate the total life-course expenditure of smokers on cigarettes alone, before or without accounting for any economic losses as a result of smoking-attributable death and disease. Method: We used data from Global Adult Tobacco Surveys to calculate annual cigarette consumption and expenditure in 15 low- and middle-income countries. We extracted data on average earnings from the ILOSTAT database of the International Labour Organization. We calculated life-course cigarette expenditures using cohort life expectancies and inflation, and converted these expenditures into net present value terms using a 3% social discount rate. Findings: The average age of adult cigarette smokers in our sample was 40 years, and their average expenditure on cigarettes was equivalent to 7.2% of annual average earnings. Given an average life expectancy of 55 years at the age of 15 years, we estimated an average life-course consumption of 217 752 cigarettes and a full life-course expenditure of 8481 United States dollars (US$) in net present value terms, more than twice the current average annual earnings of workers. However, by quitting, current adult smokers can avoid an average of US$ 6612 in expenditure on cigarettes over their remaining life-course. Conclusion: The affordability of cigarettes is an important determinant of cigarette use and tax policies can have a large effect on consumers, especially young adults. These costs will only increase over time as governments continue to raise taxes to address the market failures inherent within the tobacco market.