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Incentives for Life

Cash-on-Delivery Aid for Tobacco Control in Developing Countries

Farmer Noor Din, 53, smokes a bidi, or an Indian leaf cigarette, in front of saccharum grass on the outskirts of Jammu on November 22, 2011. (Mukesh Gupta/Reuters)

BY

  • Thomas J. Bollyky
    Bloomberg Chair in Global Health; Senior Fellow for International Economics, Law, and Development; and Director of the Global Health Program
  • Amanda Glassman
    Director of Global Health Policy and Research Fellow, Center for Global Development

Overview

Though developed countries have made great strides in tobacco control, tobacco use is increasing in many developing countries due to higher incomes, aggressive marketing by multinational tobacco corporations, and freer trade. Already widespread in Asia, eastern Europe, and Latin America, tobacco use is increasing in Africa and among women throughout the world. Though tobacco control programs are cost-effective and evidence-based, successful implementation and enforcement of such programs have proven to be elusive in many parts of the developing world. In this joint report, Thomas J. Bollyky, CFR senior fellow for global health, economics, and development, and Amanda Glassman, director of global health policy at the Center for Global Development, propose applying Cash-on-Delivery (COD) Aid as a new incentive mechanism for tobacco control in low- and middle-income countries. The authors discuss identifying the right indicator of progress, country, reward, and funders for such a model, as well as a potential COD Aid pilot project in Uttar Pradesh, India.