NEW RESEARCH HAS revealed “alarming patterns” of tobacco use across the world, despite several years of global tobacco control efforts.
Almost half of adult men in developing countries still use tobacco products, women are increasingly starting to smoke at younger ages, and quitting rates remain low in most countries, The Lancet reports.
Major disparities remain in the use of tobacco and access to effective policies and treatments to limit its use, according to researchers, who point out that although 1.1 billion people have been covered by the adoption of the most effective tobacco-control policies since 2008, 83 per cent of the world’s population are not covered by two or more of these policies.
Lead researcher Gary Giovino from the University at Buffalo School of Public Health and Health Professions in New York said the findings had come at “a crucial point in tobacco control”, several years after the ratification of the Framework Convention on Tobacco Control (FCTC). The stark results underline the need for effective tobacco control, he said.
Global Adult Tobacco Surveys
Using data from the Global Adult Tobacco Surveys (GATS) undertaken between 2008 and 2010, the team compared patterns of tobacco use and cessation in adults (15+ years) from 14 countries of low and middle income (Bangladesh, Brazil, China, Egypt, India, Mexico, Philippines, Poland, Russia, Thailand, Turkey, Ukraine, Uruguay, and Vietnam), which account for most of the disease burden from tobacco use. They also included nationally representative data from the UK and the USA for comparison purposes.
Researchers say that the overall picture was “alarming”, and showed disproportionately high rates of tobacco smoking among men (41 per cent vs 5 per in women) and wide variation in smoking prevalence between GATS countries.
About 22 per cent of men in Brazil were smokers, compared to over 60 per cent in Russia, while 0.5 per cent of women in Egypt used tobacco in contrast with to almost 25 per cent in Poland. Women in the UK (21 per cent) and the USA (16 per cent) also reported some of the highest smoking rates.
China has more tobacco consumers than any other country, with approximately 301 million tobacco users, closely followed by India with near to 275 million. The research found the majority of tobacco users (64 per cent) smoke manufactured cigarettes, although smokeless tobacco use (eg, loose-leaf chewing tobacco and snuff) is particularly common in India (206 million users) and Bangladesh.
The authors said their “particular concern” was the rise in tobacco use among women at younger ages, noting: “Women are increasingly starting to smoke at an equivalent age to men.”
Picture by: PA/PA Wire/Press Association Images
To compound the problem, quitting rates were also noted to be very low in most GATS countries, with less than 20 per cent of adults who had ever smoked in China, India, Egypt, Bangladesh, and Russia saying they had stopped. Quit ratios were highest in the UK, USA, Brazil, and Uruguay with over 35 per cent of ever smokers saying they had stopped.
Commenting on the results, Jeffrey Koplan from Emory University in the USA and Judith Mackay from the World Lung Foundation in Hong Kong described the underinvestment in tobacco control “extraordinary” in light of the health burden of tobacco use.
“For example, core funding by governments for implementing the WHO Framework Convention on Tobacco Control (FCTC) within their own countries is woefully inadequate for the enormity of the epidemic. For example, in low-income countries, for every US$9100 received in tobacco taxes, only $1 was spent on tobacco control,” they said.
“With behaviours and lifestyle in flux globally and marketing rampant, we can expect initiation of tobacco use to begin at younger ages than at present, and pressures on young women to smoke to increase. Hopefully, with successful control efforts, there will be an increase in attempted and successful quit rates.” they added.
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