The most comprehensive data on global trends in smoking highlight its enormous global health toll.
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The number of smokers worldwide has increased to 1.1 billion in 2019, with tobacco smoking causing 7.7 million deaths – including 1 in 5 deaths in males worldwide.
Of particular concern are the persistently high rates of smoking among young people, with over half of countries worldwide showing no progress in reducing smoking among 15-24 year olds.
89% of new smokers become addicted by age 25. Protecting young people from nicotine addiction during this critical window will be crucial to eliminate tobacco use among the next generation.
Using data from 3,625 nationally representative surveys, the three new studies published in The Lancet and The Lancet Public Health by the Global Burden of Disease collaboration provide global estimates on smoking prevalence in 204 countries in men and women aged 15 and over, including age of initiation, associated diseases, and risks among current and former smokers, as well as the first analysis of global trends in chewing tobacco use.
Published ahead of World No Tobacco Day (31st May), the authors call on all countries to urgently adopt and enforce a comprehensive package of evidence-based policies to reduce the prevalence of tobacco use and prevent initiation, particularly among adolescents and young adults.
Since 1990, global smoking prevalence among men decreased by 27.5% and by 37.7% among women. However, twenty countries saw significant increases in prevalence among men, and 12 saw significant increases among women.
In half of countries, reductions in prevalence have not kept pace with population growth, and the number of current smokers has increased. The ten countries with the largest number of tobacco smokers in 2019, together comprising nearly two-thirds of the global tobacco smoking population, are China, India, Indonesia, the USA, Russia, Bangladesh, Japan, Turkey, Vietnam, and the Philippines – one in three current tobacco smokers (341 million) live in China.
In 2019, smoking was associated with 1.7 million deaths from ischaemic heart disease, 1.6 million deaths from chronic obstructive pulmonary disease, 1.3 million deaths from tracheal, bronchus, and lung cancer, and nearly 1 million deaths from stroke. Previous studies have shown that at least one in two long-term smokers will die from causes directly linked to smoking, and that smokers have an average life expectancy ten years lower than never-smokers.
Approximately 87% of deaths attributable to smoking tobacco occurred among current smokers. Only 6% of global deaths attributable to smoking tobacco use occurred among individuals who had quit smoking at least 15 years previously, highlighting the important health benefits of cessation.
7.4 trillion cigarette-equivalents of tobacco (combining smoked tobacco products include manufactured cigarettes, hand-rolled cigarettes, cigars, cigarillos, pipes, shisha, and regional products such as bidis and kreteks) were consumed in 2019, amounting to 20.3 billion each day worldwide. Countries with the highest consumption per person were mostly in Europe. Globally, one in three male and one in five female smokers consume 20 or more cigarette-equivalents per day. ■