Progress with the global tobacco epidemic

Abstract

During the 20th century, tobacco smoking killed some 100 million people, most of them in high-income countries. 1 Jha P Avoidable global cancer deaths and total deaths from smoking. Nat Rev Cancer. 2009; 9: 655-664 Crossref PubMed Scopus (364) Google Scholar In the 21st century the corresponding figure is likely to be about 1 billion, most in low-income and middle-income countries. 1 Jha P Avoidable global cancer deaths and total deaths from smoking. Nat Rev Cancer. 2009; 9: 655-664 Crossref PubMed Scopus (364) Google Scholar , 2 Mathers CD Loncar D Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med. 2006; 3: e442 Crossref PubMed Scopus (7392) Google Scholar Similar to the evolution of smoking within populations of high-income countries, the global smoking epidemic is now moving from the rich to the poor. Driven by the financial heft of transnational tobacco companies with a combined income higher than most individual countries, 3 Callard C Follow the money: how the billions of dollars that flow from smokers in poor nations to companies in rich nations greatly exceed funding for global tobacco control and what might be done about it. Tob Control. 2010; 19: 285-290 Crossref PubMed Scopus (32) Google Scholar built on a business model of peddling an addictive product to children and young people, and sustained by practices that prioritise corporate profit over health, the current global epidemic of smoking represents a triumph of corporate self-interest over human wellbeing. 4 Gilmore AB Fooks G Drope J Bialous SA Jackson RR Exposing and addressing tobacco industry conduct in low-income and middle-income countries. Lancet. 2015; 385: 1029-1043 Summary Full Text Full Text PDF PubMed Scopus (199) Google Scholar It is also a challenge that national and international health systems remain ill-equipped to face. What will it take to create a tobacco-free world?Last month, British American Tobacco released their preliminary results for 2014. “I am delighted with the excellent progress we have made”, said chief executive, Nicandro Durante. It has been “another strong performance in 2014”, he added. The Group's revenue continued to grow by 2·8% and its adjusted profit from operations increased by 4·4%. Of the 667 billion cigarettes sold in 2014, 197 billion were sold in the Asia-Pacific and 227 billion were sold in Europe, the Middle East, and Africa—regions known as “high-growth markets”. Full-Text PDF Deaths and taxes: stronger global tobacco control by 202510 years ago the WHO Framework Convention on Tobacco Control (FCTC) entered into force, and more than 170 countries have now signed this treaty.1 This anniversary marks an appropriate time to review progress on global tobacco control. Full-Text PDF Global trends and projections for tobacco use, 1990–2025: an analysis of smoking indicators from the WHO Comprehensive Information Systems for Tobacco ControlOur findings show that striking between-country disparities in tobacco use would persist in 2025, with many countries not on track to achieve tobacco control targets and several low-income and middle-income countries at risk of worsening tobacco epidemics if these trends remain unchanged. Immediate, effective, and sustained action is necessary to attain and maintain desirable trajectories for tobacco control and achieve global convergence towards elimination of tobacco use. Full-Text PDF Exposing and addressing tobacco industry conduct in low-income and middle-income countriesThe tobacco industry's future depends on increasing tobacco use in low-income and middle-income countries (LMICs), which face a growing burden of tobacco-related disease, yet have potential to prevent full-scale escalation of this epidemic. To drive up sales the industry markets its products heavily, deliberately targeting non-smokers and keeps prices low until smoking and local economies are sufficiently established to drive prices and profits up. The industry systematically flaunts existing tobacco control legislation and works aggressively to prevent future policies using its resource advantage to present highly misleading economic arguments, rebrand political activities as corporate social responsibility, and establish and use third parties to make its arguments more palatable. Full-Text PDF