Abstract
Background: Smoking tobacco products remains a significant public health problem. The Foundation for a Smoke-Free World commissioned a 13-country survey to gain a clearer understanding of the current landscape of smoking behavior and preferences across the world. Methods: Over 17,000 participants in 13 countries, representing different regions and income groups, answered questions on their smoking patterns and product use, their social context, their motivation to smoke, quit, or switch, and their perception of risks of products and substances. Rim weighting was done for each country to align responses with population demographics, and an additional 200 smokers for each country were surveyed to achieve sufficient sample size for sub-analyses of smoker data. Results: The observed prevalence of smoking ranged from an age-adjusted high of 57.5% in Lebanon to 8.4% in New Zealand among men, with lower rates for women. The majority of smokers were between 25-54 years old, had daily routines and social patterns associated with smoking, used boxed cigarettes, and rated their health more poorly compared to never smokers. Among a range of products and substances, smokers tended to give both cigarettes and nicotine the highest harm ratings. Smokers in high income countries were largely familiar with electronic nicotine delivery systems; the most commonly given reasons for using them were to cut down or quit smoking. A majority of smokers had tried to quit at least once, and while many tried without assistance, motivations, intentions, and methods for smoking cessation, including professional help, nicotine replacement therapies or medications, or electronic cigarettes, varied among countries. Conclusions: Smoking is deeply integrated in smokers' lives worldwide. Although a majority of smokers have tried to quit, and are concerned for their health, they do not seek help. Smokers lack understanding of the harmful components of smoking tobacco products and the risk profile of alternatives.
Highlights
While the worldwide rate of tobacco smoking has declined substantially in recent years, the absolute number of people currently smoking has increased from approximately 720 million smokers in 1980 to an estimated 1.1 billion today, the consequence of population growth outpacing declining smoking prevalence in many low and middle income countries[1,2,3]
An analysis of 10 years of National Health Interview Surveys in the United States (US) reported that in 2015, 68% of smokers wanted to quit and 55.4% had tried to quit within the previous year; only 7.4% were successful in quitting that year despite a range of available smoking cessation counseling and pharmacologic options[6]
The observed prevalence of smoking in adults 18 years and older in this survey ranged from an age-adjusted high of 57.5% in Lebanon to 8.4% in New Zealand among men, and from 48.4% in Lebanon to 1.0% in India among women (Table 1)
Summary
While the worldwide rate of tobacco smoking has declined substantially in recent years, the absolute number of people currently smoking has increased from approximately 720 million smokers in 1980 to an estimated 1.1 billion today, the consequence of population growth outpacing declining smoking prevalence in many low and middle income countries[1,2,3]. There are significant differences between countries in terms of the epidemiology of smoking and tobacco product preferences. Methods: Over 17,000 participants in 13 countries, representing different regions and income groups, answered questions on their smoking patterns and product use, their social context, their motivation to smoke, quit, or switch, and their perception of risks of products and substances. The majority of smokers were between 25-54 years old, had daily routines and social patterns associated with smoking, used boxed cigarettes, and rated their health more poorly compared to never smokers. A majority of smokers had tried to quit at least once, and while many tried without assistance, motivations, intentions, and methods for smoking cessation, including professional help, nicotine replacement therapies or medications, or electronic cigarettes, varied among countries. Smokers lack understanding of the harmful components of smoking tobacco products and the risk profile of alternatives
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