Dr. Tony Gale Advocates an Approach of Health Over Profit

Submitted by Dr. Tony Gale (Retired)
Dr. Tony Gale (Retired)

Dr. Tony Gale (Retired)

This letter is a response to articles in the media discussing the concerns of the Minister of Finance about the urgent necessity of reducing recurrent government expenditures, as well as the concerns of the Minister of Health about the high and unsustainable costs of our hospital and other medical services.

A single measure, i.e. legislation prohibiting the production, marketing and sale of tobacco products on the grounds that they are lethal could be a remedy for both these concerns.

It would not be difficult to enforce such legislation; since only 6% of Males and 1% of Females in Barbados are tobacco smokers, and tobacco consumption is no longer socially acceptable in Barbados.

Let me explain.

According to actuarial studies by economists of the Centre for Communicable and Non-Communicable Diseases in the USA and the World Bank, the net loss caused by tobacco consumption in the USA is $3,391. per person per year and each packet of cigarettes costs the nation $7.18 in medical costs and reduced productivity.

Similar Actuarial studies have never been done in Barbados or the Commonwealth Caribbean but taking into consideration the differences in the prevalence of smoking between the USA and Barbados (22.7% vs 7%), the differences in the size of their populations (USA 284,797,000 vs Barbados 268,792), the annual costs of treating tobacco related diseases in the USA and Barbados, and the differences in the value of their currencies USA $1 = Barbados $2), the annual economic losses caused by the tobacco industry in Barbados can be crudely estimated to be at least $120,000,000. This is ten times more than the tax revenues currently collected from the tobacco industry.

This estimate is a measure of the magnitude of the economic burden imposed on the people of Barbados by the tobacco industry and the immense economic benefits to be derived from prohibiting the manufacture, marketing and sale of tobacco products. It is also likely that demonstrating the huge benefits of prohibiting the production and consumption of tobacco products would stimulate interest of both consumers and public and private policy makers in other measures designed to promote the pursuit of health at all levels of society e. g. the prevention and reduction non-communicable diseases. At least 60% of the morbidity and mortality in Barbados is caused by non- communicable diseases other than tobacco consumption; so since it is likely that the economic losses caused by these diseases annually is at least $360,000,000. Preventing and reducing these diseases, therefore, would obviously be preferable to the pursuit of “blue sky” scenarios such as medical tourism and the privatization of medical services currently advocated in the media and other public fora by persons who sanctify the market economy as the sole source of a prosperous, healthy and happy society.

The evidence to support these “blue sky” scenarios has never been stated explicitly. But contrastingly the success and benefits of the tobacco control program of the Barbados Cancer Society and similar programs in other countries are well recognized and well documented. For instance statistical analysis shows that since 1982 when this program was started the Barbados Cancer Society the prevalence of tobacco consumption has declined from 18% to 7%, and the annual cost of treating tobacco related diseases has declined by $102,579,750 from $167,845,500 in 1982 to $65,276,750 in 2015.

Similar programs in the USA, notably in California have produced equally impressive benefits. And according to an article in the journal PLOS Medicine August 26 2008 by James Lightwood, Alexis Dinno and Stanton Glantz; “The Effect of the California Tobacco Control Program on Personal Health Expenditures”, for every dollar invested in Tobacco Control measures, there has been a 50 Fold reduction in personal health expenditures, and a corresponding increase in the productivity in all sectors of the economy, public or private.

Are there any investments in Barbados, public or private that have produced or could produce such large economic benefits?

I believe that the pursuit of health not the pursuit of profit is the key to health, happiness and sustainable prosperity. And Furthermore that this shows that when Jesus of Nazareth, who was sent by God The Father to redeem Mankind told his disciples “That to him that hath it shall be given, but to him that hath not it shall be taken away”, his words applied not only to Spiritual Health but to all manifestations of health in our world, namely mental health, emotional health, social health, economic heath and above all the health of our Environment.

D.A.Gale, MB. ChB. Birmingham University, 1949
Retired General Practitioner,
Former Honorary Director Tobacco Control Program
Barbados Cancer Society, (1985 to 2008)


  • Dear Dr Gale, I appreciate your concern for the health and wealth fare of all Barbadians. This government has been especially prone to passing legislation in what would seem as blatant attempts to control the lives and actions of citizens. control to which I believe there should be some pushback before we are state controlled in our entirety.

    Can you really feel justified in encouraging further encroachment by suggesting that legislation be enacted to control 7% of the male population and 1% of the female population under the pretext of protecting their health? Where would the line be drawn between “Freest Black Nation in the World” and freedom to do what the state allows?

    I know that your intentions are honorable but we must be careful that this massive intrusion by the state does not get further out of hand.

    (Disclaimer – I am not a smoker and have never been).


  • In a related matter did anyone hear minister of health John Boyce braying on the news this week about all the initiatives being implemented by government to curb the rise of NCDs? Yet the number keeps rising as fast food joints continue to be popular.

    We love to talk.


  • I have seen studies that suggest focusing on poor eating habits result in a much higher benefit to the health system. As Dr Gale noted, a small percentage of the population smoke, but nuff people still eating unhealthy fast foods, deep fried meat, etc. I don’t have the stats to back this up, but I am sure there are more health issues from being overweight and lacking in exercise than smoking. I read a Nation article a few months ago that talked about the number of amputations due to diabetes in Bim. Should the focus not be on this first?


  • Not to mention the high consumption of sugar in soft drinks, juices, and other foods.


  • The chef and the kernel sending nuff Bajans to the QEH and not a policy maker will say so but they will mealy mouth statistics that suit them.Boyce is among the worse in promoting meaningful changes in the eating habits of Bajans.Just a lot of hot air..btw Dr Gale must be in the 90’s.I recall as a boy being taken to the General Hospital with an injury and he was the attending doctor.He ordered the male nurse to “give him a stitch”..no anaesthetic or anything so.Just a needle and catgut or whatever name it’s called.Pure cruelty to a little boy.i never forgot Dr Gale nor his manner.


  • This is my response to the comments on my proposals on measures to reduce tobacco consumption. As I said in making these proposals it would not be difficult enforce legislation prohibiting tobacco consumption; since only 6% of males and 1% of females use tobacco. In Addition at least 90% of tobacco smokers regret starting and like to stop. And the remarkable success of the tobacco control program of the Barbados Cancer Society in the absence of any legislative measures or any educational programs by other Agencies public or private to support it Is proof that nearly all non-smokers would understand and fully accept my proposals. I agree that all Barbadians have a right to question government policies. But they do not as some of the criticisms of my proposals imply have the right to deny elected governments the right and the duty to propose and enact legislation to implement those policies.

    Dr. D.A. Gale


  • The problem with the Bajan “diet” ……. Too much salt, too much grease, too much sugar.

    Barbecued pig tails, fried pork chops, chicken wings and fried fish. Too much “fried”. add to this NOT enough exercise.


  • Hants

    I gather from your comment that you haven’t had Puerto Rican cuisine? It is the worse cuisine in the world and the quickly road to myocardial infraction because everything is composed of grease and salt.


  • Mixed smoke signals

    Leanne Tasher, leannetasher@nationnews.com



    BAN A POSITIVE MOVE: co-owner of Payne’s Bar and Grocery, Coaston Payne, said he supported the position of the Ministry of Health on public advertisements for cigarettes. (Picture by Ricardo Leacock.)

    STAMPING OUT smoking will take more than a legal ban on cigarette advertisements.

    That was the view expressed by several shopkeepers regarding the pending legislation to ban advertising for cigarettes.

    The legislation was prompted when the Chinese company Hongyang Manufacturers Ltd erected several billboards around the island advertising the brand, Caribbean Sea, which was a breach of the agreement between the Ministry of Health and retailers.

    When the SUNDAY SUN visited several shops across the island last Wednesday, most retailers reported a drop in cigarette sales but said some persons, mainly men, continued to buy their smokes in spite of warnings from the Ministry of Health.

    At Boom’s Bar in lower Westbury Road, St Michael, around 10:46 a.m., a group of men were chatting over beers near the entrance while two others watched sports.

    Please read the full story in today’s Sunday Sun, or in the eNATION edition.


  • I’ve recently started a web site, the info you offer on this site has helped me greatly. Thank you for all of your time & work. “One of the greatest pains to human nature is the pain of a new idea.” by Walter Bagehot.


  • You made some nice points there. I did a search on the topic and found most individuals will go along with with your blog.


  • Extremely helpful website. It is like you wrote the book on it or something. Hi from Oklahoma!


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