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War on tobacco: Renewed and sustained efforts needed on control policies
June 4, 2017, 5:07 pm

Tobacco kills more than seven million people every year and over half of these deaths occur in just four countries — China, India, USA and Russia, according to the latest Global Burden of Disease (GBD) study conducted by the Institute for Health Metrics and Evaluation (IHME), an independent population health research center at the University of Washington.

Tobacco threatens the health, economies and development of people around the world.The global annual costs from tobacco use are US$1.4 trillion in healthcare expenditure and lost productivity from illnesses and premature death.      

Globally around 226 million tobacco users live in poverty. In low-income countries, sometimes more than 10 percent of household income is spent on tobacco products, leaving less money for food, education and healthcare.

The study shows that12 percent of deaths of all people aged over 30 are due to tobacco. Tobacco related illnesses, including heart and lung diseases and cancer leaves many families without their main salary earners while increasing healthcare costs.

The tobacco industry targets women by implying that smoking equates to gender equality, and enhances glamor, sociability and success.

Up to 7 in 10 tobacco farm workers are women and are often exposed to hazardous chemicals.

Second hand smoke affects 1 in 2 children worldwide.

Up to 14 percent of children from families who farm tobacco do not attend school and instead work in tobacco fields.

The new estimates from the GBD study are based on smoking habits in 195 countries and territories between 1990 and 2015, and illustrate that smoking remains a leading risk factor for death and disability. With growing and ageing populations already heightening the burden of tobacco, it will be crucial to support more smokers to quit and stop people from starting smoking.

World No Tobacco Day which is held each year on 31 May aims to raise awareness and encourage governments and the public to undertake measures to promote health and development by confronting the global tobacco crisis.

Since the implementation of the WHO Framework Convention on Tobacco Control in 2005, many countries have applied tobacco policies resulting in reductions in smoking prevalence, but the authors of the study warn that the war against tobacco is far from won, and argue that policy makers need renewed and sustained efforts to tackle the epidemic.

Worldwide, between 1990 and 2015, smoking prevalence decreased by almost a third (29.4%) to 15.3 percent in 2015. A new study shows that a 5 percent increase in the price of tobacco results in a 3.5 percent drop in consumption. Nevertheless, today one in four men (25%) worldwide smoke, as do one in 20 women (5.4%). Moreover, population growth has led to an increase in the overall number of smokers, increasing from 870.4 million in 1990 to 933.1 million in 2015. Deaths attributable to smoking increased by 4.7 percent in 2015 compared with 2005 and smoking was rated as a bigger burden on health — moving from third to second highest cause of early death and disability.

The 10 countries with the largest number of smokers in 2015 were China, India, Indonesia, USA, Russia, Bangladesh, Japan, Brazil, Germany and the Philippines, who together accounted for almost two-thirds of the world’s smokers (63.6%).

The study shows thatIndonesia has very high smoking levels and has not yet ratified the WHO Framework Convention on Tobacco Control. In contrast, Brazil, which has been a leader in tobacco control, showed one of the largest reductions in smoking prevalence for men and women between 1990 and 2015 — halving from 28.9 percent to 12.6 percent in men and 18.6 percent to 8.2 percent in women.

Today, the smoking epidemic is being exported from the rich world to low-income and middle-income countries, slipping under the radar while apparently more immediate priorities occupyand absorb scarce available human and financial resources. Having previously targeted Eastern Europe successfully, the tobacco industry is now setting its sights on sub-Saharan Africa. The industry is expanding its market by exploiting the region's patchwork tobacco control regulations and its limited resources to combat the industry's marketing tactics.

Despite progress in some settings, the war against tobacco is far from won, especially in countries with the highest numbers of smokers. To markedly bend the global tobacco epidemic's trajectory, a renewed and sustained focus is needed on comprehensive tobacco control policies around the world. 

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