Tobacco linked to 70,795 Thai deaths and B352.6bn economic loss
A new Thai study puts tobacco-related losses at B352.6bn and 70,795 deaths, as youth vaping rises and researchers press for tax reform.
Tobacco use and exposure were linked to 70,795 deaths in Thailand in 2024 and cost the economy an estimated 352.59 billion baht, according to new research released in Bangkok on Wednesday.
The deaths accounted for 11.2% of all fatalities nationwide. The economic damage was 6.8 times the government’s tobacco-tax revenue and equal to 213.2% of the Public Health Ministry’s budget for the year.
Rugsapon Sanitya, head of Thailand’s Burden of Disease Index Development Unit at the International Health Policy Program Foundation, presented the findings at a press conference at Vic3 Bangkok hotel on July 22.
The report, The Economic Burden of Diseases Attributable to Tobacco Consumption in Thailand in 2024, was presented at an event titled “Disease Burden vs Taxation: Choices and a Way Forward for Tobacco Control”.
The Tobacco Control Research and Knowledge Management Center at Ramathibodi Hospital’s Faculty of Medicine, Mahidol University, organised the event with the International Health Policy Program Foundation and academic networks. The Thai Health Promotion Foundation provided funding.
Premature deaths drive most of the losses
More than 80% of the estimated economic damage came from productivity lost through premature deaths.
Smoking caused the largest share of tobacco-attributable deaths, followed by exposure to second-hand smoke, e-cigarette use and chewing tobacco, according to the study.
Conventional smoking also imposed the greatest economic burden. Among the diseases examined, stroke generated the largest losses through treatment, disability and premature mortality.
Researchers said the burden attributed to e-cigarettes was still much smaller than that caused by conventional cigarettes, but the health and economic effects were becoming more visible as vaping spread.
The cost estimates far exceeded the amount collected through tobacco duties, prompting researchers to call for higher and better-designed taxes, stricter enforcement and measures aimed at stopping children and young people from becoming new smokers.
Youth vaping rate more than doubles
A separate assessment presented at the conference attributed about 770 deaths and more than 39,000 disability-adjusted life years, or DALYs, to e-cigarette use in Thailand in 2024.
Chayut Pinichka, a researcher at the International Health Policy Program Foundation, said the calculation covered both the direct health effects on users and the later harm caused when some users moved from vaping to conventional cigarettes.
Most of the healthy years lost came from premature deaths rather than years lived with illness.
Stroke accounted for the largest share of the disease burden associated with e-cigarettes, followed by cardiovascular disease, diabetes and depression.
The seventh Thai National Health Examination Survey, conducted in 2024 and 2025, found that the overall rate of tobacco-product use had changed little over the previous five years. The types of products being used, however, had shifted sharply.
E-cigarette use among people aged 15 to 29 rose from 3.6% to 8.4%, more than doubling over five years. This age group recorded the highest vaping rate in the country.
Thailand had an estimated 1.6 million e-cigarette users. About 35%, or roughly 560,000 people, were under 20.
Women accounted for 19% of users, equivalent to about 304,000 people.
The figures point to heavy exposure among teenagers, young adults and people entering the workforce, despite Thailand’s ban on e-cigarette imports and sales.
Researchers urged authorities to target online shops and advertisers, which have allowed e-cigarettes to remain widely accessible to children and young people.
Experts target two-tier cigarette tax
Professor Isara Santisart, an expert member of the National Tobacco Products Control Committee, called for an overhaul of Thailand’s cigarette-excise system.
Isara, a former economics lecturer at Chulalongkorn University and former World Health Organisation adviser on tobacco taxation, said higher excise duties had played a central role in reducing tobacco consumption by raising retail prices.
Thailand replaced its previous cigarette-tax structure in September 2017 with a mixed system comprising a specific duty and two ad valorem rates for lower-priced and higher-priced cigarettes.
The government had planned to replace the two rates with a single tax equivalent to 40% of the retail price from October 2019, but postponed the change.
When new rates took effect in October 2021, the specific duty increased across all price levels and the ad valorem rates rose. The two-tier structure remained in place.
An analysis comparing the tax systems found that smoking prevalence did not fall as it had after earlier tax increases, and cigarette-excise revenue declined.
Research based on Excise Department data also identified a weakness in dividing the market into lower- and higher-priced segments. The structure gave manufacturers an incentive to declare unusually low retail prices to keep products within the lower tax band and reduce their liabilities, researchers said.
Isara described this primarily as a tax-collection problem. Higher tobacco taxes generally cut smoking, but the structure must prevent manufacturers from using low-priced brands to blunt the effect of a tax increase.
He recommended recalculating the specific duty to reflect the economic cost imposed by each packet of cigarettes. Such a system, he said, could raise prices across the market, reduce smoking and increase excise revenue.
