tobacco epidemic is one of the biggest public health threats the world has ever
faced, killing more than 7 million people a year. More than 6 million of those
deaths are the result of direct tobacco use while around 890 000 are the result
of non-smokers being exposed to second-hand smoke.
Around 80% of the 1.1 billion smokers worldwide live in low-and-middle-income countries, where the burden of tobacco-related illness and death is heaviest.
Tobacco users who die prematurely deprive their families of income, raise the cost of health care and hinder economic development.
In some countries, children from poor households are frequently employed in tobacco farming to provide family income. These children are especially vulnerable to “green tobacco sickness”, which is caused by the nicotine that is absorbed through the skin from the handling of wet tobacco leaves.
Good monitoring tracks the extent and character of the tobacco epidemic and indicates how best to tailor policies. Only 1 in 3 countries, representing 39% of the world’s population, monitors tobacco use by repeating nationally representative youth and adult surveys at least once every 5 years.
Second-hand smoke is the smoke that fills restaurants, offices or other enclosed spaces when people burn tobacco products such as cigarettes, bidis and water-pipes. There are more than 4000 chemicals in tobacco smoke, of which at least 250 are known to be harmful and more than 50 are known to cause cancer.
There is no safe level of exposure to second-hand tobacco smoke.
In adults, second-hand smoke causes serious cardiovascular and respiratory diseases, including coronary heart disease and lung cancer. In infants, it causes sudden death. In pregnant women, it causes low birth weight.
Almost half of children regularly breathe air polluted by tobacco smoke in public places.
Second-hand smoke causes more than 890 000 premature deaths per year.
In 2004, children accounted for 28% of the deaths attributable to second-hand smoke.
Every person should be able to breathe tobacco-smoke-free air. Smoke-free laws protect the health of non-smokers, are popular, do not harm business and encourage smokers to quit.
Over 1.4 billion people, or 20% of the world’s population, are protected by comprehensive national smoke-free laws.
Studies show that few people understand the specific health risks of tobacco use. For example, a 2009 survey in China revealed that only 38% of smokers knew that smoking causes coronary heart disease and only 27% knew that it causes stroke.
Among smokers who are aware of the dangers of tobacco, most want to quit. Counselling and medication can more than double the chance that a smoker who tries to quit will succeed.
National comprehensive cessation services with full or partial cost-coverage are available to assist tobacco users to quit in only 26 countries, representing 33% of the world’s population.
Hard-hitting anti-tobacco advertisements and graphic pack warnings – especially those that include pictures – reduce the number of children who begin smoking and increase the number of smokers who quit.
Graphic warnings can persuade smokers to protect the health of non-smokers by smoking less inside the home and avoiding smoking near children. Studies carried out after the implementation of pictorial package warnings in Brazil, Canada, Singapore and Thailand consistently show that pictorial warnings significantly increase people’s awareness of the harms of tobacco use.
Only 78 countries, representing 47% of the world’s population, meet the best practice for pictorial warnings, which includes the warnings in the local language and cover an average of at least half of the front and back of cigarette packs.
Mass media campaigns can also reduce tobacco consumption by influencing people to protect non-smokers and convincing youths to stop using tobacco.
Around 44% of the world’s population live in the 43 countries that have aired at least 1 strong anti-tobacco mass media campaign within the last 2 years.
A Guest Editorial