Abstract

Abstract This presentation addresses the global tobacco epidemic as it enters its second century. The epidemic began in the late 19th century with the monopolistic rise of American Tobacco, the first multinational tobacco company. In the United States and Europe, smoking rates rose, first in men around the time of World War I, and subsequently in women, around the time of World War II. In these countries, smoking rates peaked in the 1950s and 1960s and have since declined substantially because of evidence-based tobacco control. However, smoking rates are now high among men in a number of low- and middle-income countries and the tobacco industry is aggressively marketing in these countries as its developed-country markets shrink. The most recent data on smoking at the global level were obtained through the new Global Adult Tobacco Survey (GATS) for adults and through the ongoing Global Youth Tobacco Survey (GYTS). Using nationally representative household surveys with comparable methods to obtain relevant information from individuals aged 15 years or older in 14 low-income and middle-income countries (Bangladesh, Brazil, China, Egypt, India, Mexico, Philippines, Poland, Russia, Thailand, Turkey, Ukraine, Uruguay, and Vietnam), 48.6% (95% CI 47.6–49.6) of men and 11.3% (10.7–12.0) of women were current tobacco users. Early initiation of smoking in women and low quit ratios across many of the participating countries were also reported. The GYTS, a school-based survey of 13-15 year olds that has now been conducted in 140 countries and 11 territories worldwide for up to two rounds per country, has found that 9.5% (7.9-11.3) of children were regular smokers (12.1% of boys and 6.8% of girls). In 2012, tobacco control action by governments, non-governmental organizations (NGOs), academia and civil society as a whole, at international, national and sub-national levels, continues to be implemented with the impetus of the Framework Convention on Tobacco Control (FCTC). The evidence foundation for tobacco control globally has been summarized by the World Health Organization in its MPOWER package: M for monitoring or surveillance; P for protection of nonsmokers from exposure to secondhand smoke; O for offering effective cessation; W for warn through appropriate pack warnings; E for enforcement of tobacco control policies and regulations; and R for raise taxes to an appropriate level. The GATS and the GYTS provide an approach for tracking the impact of tobacco control at the global level.

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