Mbankomo workshop explores fiscal strategies to curb tobacco use and fund healthcare

For three intensive days, policymakers, health officials, and technical partners gathered in Mbankomo not to discuss hospital construction or drug procurement, but to focus on an unexpected yet transformative solution: tobacco taxation. The discussions centered on a critical question—how can fiscal policies save lives while securing sustainable funding for Cameroon’s healthcare system?

Organized with support from the World Health Organization, the workshop brought together representatives from the Ministry of Public Health, the Ministry of Finance, Customs, parliamentarians, civil society, and technical partners. Their goal was to explore the often-overlooked potential of tobacco tax reforms as a dual driver of public health and economic development.

The silent epidemic: tobacco’s toll on Cameroon

Tobacco remains one of the most preventable causes of death worldwide, and its impact on Cameroon is severe. An estimated 9% of adults and over 10% of adolescents aged 13 to 15 smoke, while 37% of the population is exposed to secondhand smoke. Annually, tobacco claims approximately 66,000 lives in the country. Beyond mortality, its consequences are far-reaching: increased risks of cancer, cardiovascular diseases, strokes, and chronic respiratory illnesses. The economic burden extends to households, overwhelmed healthcare services, and the national economy.

Despite these alarming statistics, cigarettes remain disturbingly affordable in Cameroon. In 2024, a pack of the most popular brand cost just $4.07 (adjusted for purchasing power parity), well below Africa’s average of $5.06 and the global average of $6.98. Shockingly, tobacco taxes accounted for only 36% of the retail price—far below the 75% threshold recommended by the WHO.

Tax hikes as a lifesaving intervention

National leaders at the workshop emphasized that raising tobacco taxes is one of the most effective measures to reduce consumption, particularly among youth. Price sensitivity is high among adolescents, and higher taxes make initiation less appealing. Beyond immediate health benefits, such reforms can prevent disease, disability, and premature death for decades to come.

The economic advantages are equally compelling. A well-structured tax system generates additional national revenue that can be reinvested in healthcare infrastructure, non-communicable disease prevention, and universal health coverage. This dual impact underscores a key insight: health and economic progress are not mutually exclusive—they can—and should—go hand in hand.

Data-driven decisions: the backbone of effective policy

Before implementing reforms, policymakers need reliable data. The workshop participants analyzed consumption patterns, economic costs, disease burdens, current tax structures, market dynamics, and international best practices. Dr. William Maina, Senior Project Officer at WHO Africa, highlighted the global health burden of tobacco, linking it not only to cancer but also to cardiovascular diseases, strokes, chronic respiratory illnesses, and developmental issues in adolescents.

Contrary to common misconceptions, the evidence shows that well-designed tax increases do not lead to job losses or a surge in illicit trade. In fact, international data confirms that properly structured reforms can enhance public revenue while protecting public health. The message was clear: public policy must be grounded in evidence, not perception.

Modeling the future: WHO’s tax simulation tool in action

The highlight of the workshop was the presentation of the WHO TaXSiM model, which enables governments to assess the health and fiscal impacts of tax reform options before implementation. Using Cameroon’s data, several scenarios were simulated to evaluate potential outcomes.

The results were unequivocal. Two progressive tax increases were modeled:

• Raising the specific minimum tax from 5,000 FCFA to 10,000 FCFA per 1,000 cigarettes in 2027;
• Further increasing it to 15,000 FCFA in 2028, applying uniformly to both imported and locally produced cigarettes.

The projected impact was substantial. Cigarette sales were expected to decline from 162.9 million packs in 2026 to 144.1 million in 2027 and 131.9 million in 2028—a cumulative reduction of 19%. The number of smokers would decrease by approximately 66,000, from 810,000 to 744,000 by 2028.

Excise revenue would surge from 15.2 billion FCFA to 28.8 billion FCFA in 2027, and to 38.3 billion FCFA in 2028. Total tax revenue would rise from 32.6 billion FCFA to 57.3 billion FCFA, generating nearly 25 billion FCFA in additional funds—all while improving public health outcomes.

These findings dispelled the myth that health and economic goals are incompatible. Instead, they demonstrated that ambitious tobacco taxation can simultaneously reduce smoking and strengthen public finances.

Funding health for generations: a strategic opportunity

In an era of declining international health funding, tobacco taxation presents a strategic opportunity to mobilize domestic resources. The projected revenue could support:

• Universal health coverage initiatives;
• Prevention programs for non-communicable diseases;
• Smoking cessation support services;
• Strengthening of healthcare infrastructure;
• Health promotion activities.

Participants concluded that tobacco tax reform is one of the few policies capable of simultaneously improving population health, reducing future disease-related costs, and enhancing the financial resilience of the healthcare system.

A growing concern: the rise of nicotine products targeting youth

The workshop also sounded the alarm over the rapid proliferation of emerging nicotine products. Disguised as pens, smartwatches, lipsticks, toys, candies, or chewing gum, these products use sophisticated marketing to appeal to adolescents. A video presentation depicting an adolescent using an e-cigarette hidden in a smartwatch left a strong impression on attendees.

The WHO emphasized that these products are not harmless. They foster addiction, expose users to toxic substances, and risk normalizing nicotine use among young people. Participants called for proactive regulatory and fiscal frameworks to prevent their entrenched market presence in Cameroon.

Concrete steps: a roadmap for action

At the conclusion of the three-day workshop, participants issued a series of evidence-based recommendations:

• Gradually raise the specific minimum tax to 15,000 FCFA per 1,000 cigarettes by 2028;
• Apply tax increases uniformly to imported and locally produced cigarettes;
• Enhance regional dialogue within CEMAC on excise duties;
• Establish a national technical working group on tobacco taxation;
• Develop a permanent monitoring and evaluation system;
• Improve the availability of fiscal and trade data;
• Accelerate the creation of a National Tobacco Control Fund;
• Implement a national traceability system for tobacco products.

Recognizing that effective tobacco control requires collective action, participants also urged expanded awareness campaigns—especially targeting youth—support for tobacco farmers in transitioning to alternative crops, full implementation of the Protocol to Eliminate Illicit Tobacco Trade, and the adoption of a national traceability system.

The path forward: leadership and collaboration

Dr. Colette Taka Joro, Permanent Secretary of the National Committee for Drug Control, stressed the need for high-level dialogue with government, parliament, and stakeholders to accelerate reform adoption and ensure ownership.

Closing the workshop, Dr. Hassan Ben Bachir, Director of Health Promotion at the Ministry of Public Health, framed the vision clearly: “Tobacco taxation is more than a revenue tool—it is an investment in the health of our people. By protecting youth from starting to smoke and securing sustainable funding for our health system, we are investing in the future of Cameroon. The recommendations from this workshop provide a solid roadmap to translate scientific evidence into public policy for the benefit of all.”

In Mbankomo, a shared conviction emerged: tobacco taxation is not merely a fiscal matter. It is a prevention tool, a youth protection mechanism, a driver of domestic resource mobilization, and a long-term investment in the nation’s human capital. The data is clear—ambitious tobacco tax policy can reduce consumption, save lives, ease the burden of non-communicable diseases, and generate substantial resources to fund national health priorities.

Every tax increase represents thousands of lives protected. Every evidence-based reform shapes a Cameroon where fewer young people start smoking, families are shielded from the consequences of tobacco, and the health system is equipped to meet the needs of its people sustainably. By positioning tobacco taxation as a strategic lever for public health and sustainable financing, Cameroon has the opportunity to build a healthier, more resilient future for generations to come.