Jigmi Wangdi

Consumption of tobacco products claims the lives of over 400 individuals each year in Bhutan, according to data from 2019. This results in significant financial burdens, with healthcare costs amounting to approximately Nu 209 million.

The value associated with the loss of life due to tobacco-related deaths is estimated at Nu 712 million.

This is according to a report titled Investment Case for Tobacco Control in Bhutan, which was completed in collaboration with WHO, UNDP, the Secretariat of the WHO Framework Convention on Tobacco Control (WHO FCTC), and the Ministry of Health.

The report specifies six key policies of the WHO FCTC that would enable Bhutan to reduce the burden that comes with the use of tobacco.

In 2019, tobacco use in Bhutan caused around Nu 1.2 billion in economic losses. These losses are equivalent to 0.7 percent of Bhutan’s gross domestic product (GDP).

According to the WHO STEPwise approach to surveillance (STEPS) survey conducted in 2019, 24 percent of the population aged 15-60 currently use tobacco products, out of which 10.6 percent use smoked tobacco, 14.5 percent use smokeless tobacco and 1.4 percent use both.

Men, according to the report, are almost three times more likely to use tobacco products than women.

The report also found a higher prevalence of smoking among younger age groups (14.9 percent of those 15-24 years old compared to 3.5 percent of those 55-69 years old), while smokeless tobacco use is higher among older age groups (17.6 percent of those 55-69 years old compared to 8.8 percent of those 15-24 years old).

The Global Youth Tobacco Survey (GYTS) revealed that in 2019, 22 percent of students aged 13-15 years old reported tobacco use. This figure breaks down to 31 percent among boys and 13.5 percent among girls.

More than 4 in 10 cigarette smokers in Bhutan stated that they began smoking between the ages of 12-13 years old.

How WHO FCTC policies can help Bhutan?

If the government were to implement the six policy actions recommended by the WHO FCTC, the report highlighted that Bhutan would significantly change the burden on tobacco in the next 15 years (2023 to 2037).

According to the report, if Bhutan was to implement the modelled WHO FCTC measures, it would prevent more than 1,200 deaths, with approximately 80 deaths prevented annually, save Nu 411 million in healthcare expenditures and prevent Nu 1.3 billion in losses due to tobacco-attributable mortality.

It would also generate economic benefits of Nu 2.3 billion, which would significantly outweigh the costs of Nu 330 million of implementation and enforcement, a 7:1 return on investment, the report suggests.

The report says that implementing the six WHO FCTC policy actions could reduce the prevalence of cigarette smoking, relatively by 34 percent over 15 years. It could also result in Bhutan avoiding 17 percent of the economic loss that is expected to occur from tobacco use in the next 15 years.

In total, the report stated that Bhutan would save around Nu 2.3 billion which could otherwise be lost.

The six policy actions of the WHO FCTC are: increasing tobacco taxation, creating smoke-free public places and workplaces to protect people from the harms of tobacco smoke, requiring graphic warning labels on tobacco product packages, implementing plain packaging of tobacco products, promoting and strengthening public awareness of tobacco control issues, including the health risks of tobacco use, and promoting quitting of tobacco use and treatment for tobacco dependence by training health professionals to provide brief advice to quit tobacco use.

According to the Bhutan Trade Statistic 2023, Bhutan imported tobacco products valued at a total of Nu 542 million.