3.36 The global tobacco pandemic

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3.0 Background

3.1 Tobacco—a leading preventable cause of death and disease

3.2 Cardiovascular diseases

3.3 Lung cancer

3.4 Respiratory diseases

3.5 Other cancers caused by or associated with smoking

3.6 Reproductive health and smoking

3.7 Pregnancy and smoking

3.8 Infant health and smoking

3.9 Increased susceptibility to infection in smokers

3.10 Eye diseases

3.11 Dental diseases

3.12 Gastrointestinal diseases

3.13 Bone density and risk of fractures

3.14 Effects of smoking on the skin

3.15 Smoking and complications in medical treatment

3.16 Smoking and diabetes

3.17 Poorer levels of general health

3.18 Smoking, motor vehicle crashes and other injuries

3.19 Burns and fires caused by tobacco use

3.20 Tobacco poisoning

3.21 Health effects for younger smokers

3.22 Genetic influences on tobacco-caused disease

3.23 Smoking, dementia and cognitive decline

3.24 Lung disease, smoking and occupational exposures

3.25 Air pollution, cigarette smoking and ill health

3.26 Health effects of smoking brands that claim to deliver lower levels of tar, nicotine and carbon monoxide

3.27 Health effects of smoking tobacco in other forms

3.28 Health 'benefits' of smoking?

3.29 Morbidity (ill health) attributable to tobacco-caused disease

3.30 Deaths attributable to tobacco by disease category

3.31 Morbidity and mortality due to tobacco-caused disease and socioeconomic disadvantage

3.32 Health effects of smoking other substances

3.33 Health effects of chewing tobacco, and of other smokeless tobacco products

3.34 Public perceptions of tobacco as a drug, and knowledge and beliefs about the health consequences of smoking

3.35 Health benefits of cessation

3.36 The global tobacco pandemic

Acknowledgments

References

Death and disease caused by tobacco use now constitutes a pandemic. Smoking is the leading risk factor for cancer mortality in countries of low, middle and high income.240 Globally, about 1.3 billion people currently use tobacco products,241 and almost five million deaths are caused by tobacco each year, accounting for 12% of total adult mortality (in the population aged 30 and over).186 If these patterns of tobacco use do not decline, then the numbers of deaths caused by worldwide tobacco use will more than double by the year 2030.242 Last century, smoking caused an estimated 100 million deaths worldwide; this century, the death toll from tobacco use will be more than one billion, based on current smoking patterns.242 The only other threats to public health that are increasing at such a rapid pace are Human Immunodeficiency Virus (HIV) infection, and possibly, in Western countries, obesity.242

International research on current smoking prevalence and behaviours among youth aged 13–15 has reported disturbing trends for the future.243 The Global Youth Tobacco Survey, assessing data from more than 130 countries and principalities, has found that the gap in smoking rates between school-aged girls and boys is decreasing, a finding of particular importance for those countries in which smoking has previously been negligible among the female population; that use of tobacco products other than cigarettes is widespread; that a sizable proportion of children who currently do not smoke are contemplating adopting the behaviour; and that children are widely exposed to secondhand smoke. Each of these findings can be expected to have a significant impact on morbidity and mortality from tobacco use in forthcoming decades.243

While the current burden of death is distributed evenly between developing and industrialised countries,186 most of the future burden of death will occur in low and middle-income countries, where more than 80% of the world's smokers live.244 Smoking rates are for the most part well in decline in Western Europe, the United Kingdom, the USA, Canada, New Zealand and Australia. However, in some countries in Asia, South America and Africa, the prevalence of smoking is still increasing.210 In China, home to one third of the world's population, the death toll from smoking currently stands at about 800,000 per year and it has been estimated that smoking will cause three million Chinese deaths annually by the middle of this century.245

For further information on the prevalence of tobacco use worldwide, see Chapter 1, Section 1.13. International data on consumption are presented in Chapter 2, Section 2.7.