2 lakh deaths, Tk87,000 crore in losses — yet cigarettes remain cheap for youths

Every morning before heading to class, 22-year-old Rahat stops at a small roadside shop near his university campus. A cup of tea and a cigarette costs him Tk22.

"I know smoking is harmful," he says. "But honestly, it never feels expensive enough to make me stop."

Rahat's story is not unique. Across Bangladesh, millions of young people and low-income consumers continue to purchase cigarettes with relative ease, even as the cost of almost everything else rises around them. This affordability lies at the heart of one of the country's most pressing public health challenges.

According to the World Health Organization's Global Tobacco Epidemic Report 2025, Bangladesh has the highest tobacco-use rate in South Asia. About 35.3% of adults use tobacco, compared to 28.6% in India and 19.1% in Pakistan. Nearly 3 crore 78 lakh adults currently consume tobacco products.

The consequences extend far beyond smokers themselves. Tobacco Atlas 2025 estimated that tobacco use contributes to nearly 18% of all deaths in Bangladesh. Every year, approximately 2 lakh people die from tobacco-related illnesses, including cancer, stroke, heart disease and chronic respiratory conditions.

For families, these deaths often mean more than grief. They mean lost incomes, mounting medical bills and long-term financial insecurity. Studies by the World Health Organization and the World Bank have shown that tobacco use imposes significant financial burdens on households through spending on tobacco products and treatment costs.

A recent study conducted by the Institute of Health Economics, Dhaka University, in association with the Johns Hopkins Bloomberg School of Public Health's Economics for Health programme, estimated that the government collected around Tk40,000 crore in revenue from the tobacco sector during FY2024-25.

During the same period, however, the economic and environmental damage caused by tobacco exceeded Tk87,000 crore. In other words, Bangladesh lost more than twice what it earned from tobacco, the study added.

"The discussion often focuses on revenue, but the broader economic burden is much larger," said Dr Rumana Huque, professor of Economics at the University of Dhaka.

"The costs include healthcare expenditures, productivity losses and environmental damage, all of which are ultimately borne by society."

She said one reason tobacco continues to exert such a heavy toll is that cigarettes have become increasingly affordable relative to income.

According to the Bangladesh Bureau of Statistics' Household Income and Expenditure Survey (HIES) 2022, average household income increased by 103% between 2016 and 2022, while per-capita income rose by 93%.

During the same time, essential food prices in Bangladesh rose sharply. Sugar increased by around 70–90%, potatoes by 90–120%, wheat flour by 70–100%, eggs by 40–70%, and soybean oil by nearly 90–120%, according to retail market data compiled from BBS and TCB price series.

Between 2016 and 2022, cigarette prices in Bangladesh increased across all tiers by roughly 50% to 100%, according to National Board of Revenue (NBR) budget data and tobacco taxation analyses. However, this increase was not sufficient to keep pace with income growth, resulting in improved affordability over time.

The affordability issue is particularly worrying because of its impact on young people. Among students aged 13–15 years in Bangladesh, tobacco use is estimated at around 9%, according to the Global Youth Tobacco Survey (GYTS).

Dr Rumana warned that low prices make it easier for adolescents to experiment with tobacco and eventually become long-term consumers.

She also said, "The current tax system is partly responsible. Bangladesh applies a four-tier cigarette tax structure consisting of low, medium, high and premium categories. While intended to differentiate products by price, critics argue that the system allows smokers to switch to cheaper brands instead of quitting altogether."

National Board of Revenue data shows that low-tier cigarettes accounted for 25% of the market in 2006-07. By 2023-24, that figure had risen to 76%.

Professor Dr Shafiun Nahin Shimul, director of the Institute of Health Economics at the University of Dhaka, believes the trend reflects a structural weakness in tobacco taxation.

"The more tiers you have, the easier it becomes for consumers to move from one product to another," he said. "Taxation becomes less effective at reducing consumption."

The tobacco industry frequently argues that higher taxes would encourage smuggling and illicit trade. Researchers, however, point to evidence suggesting otherwise. A World Bank study estimated that illicit cigarette trade accounts for only 1.8% of Bangladesh's cigarette market. The comparable figures are 17% in India, 38% in Pakistan and 36% in Malaysia.

Dr Shimul therefore argues that maintaining low cigarette prices is not necessary to prevent smuggling. Instead, they believe Bangladesh has an opportunity to simultaneously improve public health and increase government revenue.

A tobacco tax simulation study led by Prof Shimul, in collaboration with WHO and global partners, estimated that stronger tobacco tax reforms could generate around Tk44,000 crore in additional revenue, encourage about 5 lakh adults to quit smoking, and prevent more than 3.7 lakh young people from initiating tobacco use.

The government has set the minimum retail price for a pack of 10 cigarettes at Tk62 for the low-tier segment, Tk92 for the medium tier, Tk160 for the high tier, and Tk210 for the premium tier, while retaining the existing 67% supplementary duty.

For smokers like Rahat, the latest budget offered only a modest increase in cigarette taxes, leaving prices still relatively affordable. For policymakers, it raises a difficult question — whether incremental tax hikes are enough to reduce consumption, or whether stronger action is needed to ensure that future generations inherit a healthier Bangladesh rather than continue bearing the cost of cheap cigarettes.