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The COVID-19 pandemic which originated in China in late 2019 has spread rapidly and taken much of the world by surprise, creating a health and economic emergency likely to have significant impacts for many years. The magnitude of the threat has forced both governments and businesses to urgently elevate public health above economic principles, adapt and reinvent in an attempt to contain the spread of the disease. Business closures have created sudden and widespread unemployment.1 2 Nationalisation of industries such as private healthcare3 and airlines4 has happened, or is being considered. Governments are pumping money into their economies through stimulus packages and income support, where previously austerity was the order of the day.5 6 In the private sector, car makers are pivoting to making medical equipment,7 alcohol companies are manufacturing hand sanitiser8 and digital transformation across many sectors is being fast-tracked,9 among other examples of business adaptation.10 The COVID-19 pandemic is an extraordinary event requiring extreme measures due to the potential for healthcare systems to be overwhelmed. However, the tobacco epidemic exerts a greater, sustained strain. At the time of writing, the global death toll from COVID-19 stood at just over 53 000,11 compared with over 8 million from tobacco use annually (including deaths attributed to secondhand smoke exposure).12 The cumulative death toll from tobacco use was 100 million during the 20th century and estimates indicate this could reach 1 billion this century.13 The number of COVID-19 deaths will likely continue to rise for many months, with the …
Hefler et al. (Mon,) studied this question.