The high rates of tobacco consumption in Bangladesh impose an increasing health and economic burden on the country. A 2004 epidemiological study found that 1.2 million tobacco-related illnesses and nearly 57,000 deaths attributable to smoking were reported each year (WHO 2007). More current information shows that approximately a quarter of all deaths among men ages 25–69 in Bangladesh are attributable to smoking (Alam et al. 2013). The overall economic cost of tobacco use has been estimated at Tk 110 billion (US$1.85 billion) or over 3 percent of gross domestic product (GDP) (WHO 2007).

The government has undertaken efforts to tackle tobacco consumption. It was among the first to sign (June 2003) and ratify (June 2004) the World Health Organization’s Framework Convention on Tobacco Control, the world’s first public health treaty, which urged governments to adopt comprehensive policies to limit tobacco use. The country’s participation in the framework convention has led to advances in tobacco control policy, in particular through the 2005 Smoking and Tobacco Usage Act. The new law restricted smoking in certain locations, though health care facilities, educational facilities, sport venues, and taxis were the only 100 percent smoke-free environments in Bangladesh at the time.<sup>5</sup> Warning labels on cigarette packages and the limited advertising of tobacco products were also mandated as part of the 2005 law. According to the 2009 Global Adult Tobacco Survey and the International Tobacco Control Bangladesh Survey, tobacco consumption rose between 2009 and 2012, despite the government’s actions to restrain it. Among the negatives of the Smoking and Tobacco Usage Act were the low levels of enforcement of non-tax measures, including the advertising ban and smoke-free public places, and relatively low levels of implementation of the warning labels. In April 2013, the National Assembly passed the Tobacco Control Law Amendment Bill and Rules to close many of these loopholes. A major contribution of the amendment was the requirement that packages contain pictorial warnings. In addition, smokeless tobacco was included under the definition of tobacco; restaurants and indoor workplaces were included among completely smoke-free environments; the fines for noncompliance were raised; advertisements at points of sale were banned; and the sale of tobacco to minors was prohibited.

Although tobacco taxation has been recognized as one of the most effective strategies to reduce smoking, the tobacco tax structure has helped make cigarette prices in Bangladesh among the lowest in the region and in the world despite some of the highest tax rates (table 1). There is a variety of taxes on tobacco products in Bangladesh. These include supplementary duties on cigarettes, bidis, and chewing and pipe tobacco, duties on imported tobacco products and on tobacco leaf, and a 15 percent value added tax on all tobacco products.<sup>6</sup> Cigarettes are classed into four brand tiers, commonly known as slabs in Bangladesh, and the ad valorem excise tax rate is based on the administered retail price, which varies across these four price categories. However, the gaps between brands in the different tier categories create incentives for smokers to substitute less expensive brands in response to price increases and for manufacturers to position brands between price slabs to avoid paying higher taxes (ITC Project 2014). To minimize tax evasion, continuous tier structures were introduced in 2015,

> 5 Smoking is also restricted in restaurants, bars, and workplaces. However, these offer designated smoking areas.

> 6 The value-added tax is applied to the retail price.

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