Archive for September 26th, 2012

The Global Adult Tobacco Survey

Wednesday, September 26th, 2012

In countries like the United Kingdom and the United States, smoking is now accepted as a definite health hazard. Research has indicated clear links between smoking and a wide range of potentially lethal illnesses. Whereas at one time almost everyone smoked, this is no longer the case and in many people’s eyes smoking is now regarded as an anti-social activity.

This is not the case in the developing world. The largest survey to date on international tobacco use has revealed that in many developing countries nearly half of all men and one in ten of all women are regular users of tobacco.

The Global Adult Tobacco Survey looked at smoking trends among people aged from 15 years and above in 16 sample countries. 14 of these were low or middle-income countries: Bangladesh, Brazil, China, Egypt, India, Mexico, the Philippines, Poland, Russia, Thailand, Turkey, Ukraine, Uruguay and Vietnam, while the United States and the United Kingdom were included as comparisons.

By the use of extensive sampling it was possible to estimate the smoking habits of 3 billion people and this indicated that there are 852 million tobacco users in these countries.

49% of men and 11% of women used tobacco, with cigarette smoking being the most popular; 41% of men and 5% of women. According to the World Health Organisation (WHO), 6 million people die from tobacco-related causes each year, which is surely a good enough reason to quit.

Countries with the highest numbers of quitters, not surprisingly include the UK and the US, but also Brazil and Uruguay. It is significant that tobacco controls are the strongest in these four countries.

Other countries such as China, India, Russia and Egypt have little or no control and in these countries quit rates are the lowest. So-called smokeless tobacco is very popular in some countries. This is generally chewed or taken as snuff. In India and Bangladesh, where smokeless tobacco use is very high, oral cancer rates are among the highest in the world.

Given that China has the world’s highest population, it is not surprising that it has the highest number of tobacco users. 53% of men and 2% of women use tobacco, totalling 301 million people. One of the problems in China is the complete lack of regulation. It seems that China National Tobacco, a government-owned company, is the sponsor of dozens of elementary schools, where students are subjected to pro-tobacco propaganda, suggesting in some cases that there is a link between smoking and academic success.

Russian smoking rates are even higher than those in China. 60% of Russian men and 22% of Russian women use tobacco, but it is Indonesia that tops the world where nearly 70% of men over the age of 15 are cigarette smokers.

Indonesia is the world’s fifth-largest producer of cigarettes and there is an enormous pro-tobacco lobby. Indonesia is among a small handful of countries that have not signed up to the WHO 2005 tobacco treaty. Cigarettes are very cheap and large hoardings advertising cigarettes and tobacco products are everywhere to be seen. In addition, tobacco companies routinely sponsor sporting events and concerts, a practice that has been banned in most other countries.

With its population of 240 million, 200,000 Indonesians are estimated to die each year from smoking related illnesses. Although laws were passed in 2009 calling for tighter controls, the country’s powerful tobacco lobby has effectively blocked all regulation attempts.

The influence of these pro-tobacco forces should not be under-estimated. As tobacco use in the industrial world continues to decline, the tobacco industry is continually seeking new markets. New factories have opened in the developing world and in countries like Indonesia the tobacco industry is a major employer.

Any restriction in smoking and the consequent cut in the number of cigarettes being purchased would cause a shrinking of the market, leading to a reduction in output that could have an extremely damaging effect on the country’s economy.

Countries in the developing world are also subjected to fierce marketing strategies and mass media advertising campaigns. Since men have always smoked more than women, women are particularly targeted. The campaigns take pains to make smoking seem glamorous and equate tobacco use with Western themes, such as freedom and gender equality.

What the campaigns obviously fail to point out is that smoking kills up to half of its users. As mentioned above, nearly six million people die each year from the results of smoking and 600,000 of these are non-smokers who have been exposed to second-hand smoke. Tobacco use accounts for one in ten of all deaths with approximately one person dying every six seconds.

If current trends continue, according to WHO, by 2030 the annual death toll will have reached eight million and by the end of the present century smoking will have killed a billion people.