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close this bookFact sheet No 118: The Tobacco Epidemic: A Global Public Health Emergency Tobacco Use - May 1996 (WHO, 1996, 6 p.)
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View the documentThe Tobacco Epidemic: A Global Public Health Emergency Tobacco Use
View the documentSmoking Prevalence
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View the documentEconomics of Tobacco
View the documentTobacco Control Measures

The Tobacco Epidemic: A Global Public Health Emergency Tobacco Use

By the end of the 20th century, manufactured cigarettes have come to be the predominant form by which tobacco is consumed around the world. However there are many other methods by which tobacco is consumed, and in some regions, these other forms predominate. In India, for example, eight times more bidis (tobacco wrapped in a temburni leaf, widely consumed on the Indian subcontinent) than manufactured cigarettes are consumed annually.

· Between 65-85% of global tobacco consumption is in the form of cigarettes including bidis and kreteks (clove-flavoured cigarettes, particularly popular in Indonesia). An additional 15-35% of tobacco is consumed in the form of all other tobacco products.

· Global consumption of cigarettes per adult has remained steady from the early 1970s to the early 1990s, however, as the global population has continued to increase the absolute number of cigarettes consumed has continued to increase. WHO has estimated that a total of 6.05 x 1012 cigarettes were consumed annually in the period 1990-92. Unmanufactured tobacco consumption increased at about the same rate in the early 1990s, and by 1994, global consumption totalled 7 million tonnes.

· According to WHO estimates, there are around 1.1 thousand million smokers in the world, about one-third of the global population aged 15 years and over.

· In recent years, tobacco use has been declining in many countries of North America and Western Europe, but increasing in many developing countries, particularly in Asia.

· For the period 1970-72 to 1990-92, cigarette consumption has increased in some regions and decreased in others. For example, consumption decreased in the American Region and increased most rapidly in the Western Pacific Region. Although consumption has decreased in developed countries since 1980-82, this decrease has been counterbalanced by a comparable increase (1.4% per year) in less developed countries. Global cigarette consumption has remained relatively steady at about 1650 cigarettes per adult from the period 1980-82 to 1990-92.

· In China, the growth in estimated per capita consumption of cigarettes has been particularly rapid, increasing by 260% from the early 1970s to the early 1990s, with consumption estimated at around 1900 cigarettes per adult per year. In China there are about 300 million smokers, about the same number as in all developed countries combined.

· China , the world's most populous country is also the world's leading consumer of cigarettes. The world's second most populous country, India ranks only 14th for manufactured cigarettes, however when bidis are taken into account, India ranks second globally for total cigarette consumption.

· Substantially fewer cigarettes are smoked per day per smoker in developing countries than in developed countries. In the early 1990s, average adult per capita consumption in developed countries was 2590 vs 1410 in developing countries. However, the gap in per adult cigarette consumption is narrowing. Unless effective tobacco control measures take place, daily cigarette consumption in developing countries is expected to increase as economic development results in increased real disposable income. If current trends continue, per adult consumption in developing countries will exceed that of developed countries shortly after the turn of the century.

· There has been a dramatic shift if the group of countries with the highest rates of per adult tobacco consumption from the early 1970s to the early 1990s. In the early 1970s, consumption was highest in Canada, Switzerland, Australia and the UK while in the early 1990s, it was highest in Poland, Greece, Hungary, Japan, and the Republic of Korea.

· WHO is concerned about the decreasing age of smoking initiation. Data revealed that in many countries, the median age of smoking initiation was under the age of 15. This is of particular concern, since starting to smoke at younger ages increases the risk of death from a smoking-related cause. Among those who continue to smoke throughout their lives, about half can be expected to die from a smoking-related cause, with half of those deaths occurring in middle age. In countries such as France and Spain where more than 40% of young people aged 18-24 smoke (and most beginning at an early age) a very heavy future death toll from tobacco use can be expected.