Tobacco Kills Millions Every Year
Tobacco is the only legal drug that kills many of its users when used exactly as intended by manufacturers. WHO has estimated that tobacco use (smoking and smokeless) is currently responsible for the death of about six million people across the world each year with many of these deaths occurring prematurely. This total includes about 600,000 people are also estimated to die from the effects of second-hand smoke. Although often associated with ill-health, disability and death from noncommunicable chronic diseases, tobacco smoking is also associated with an increased risk of death from communicable diseases.
Under a UN mandate to address four noncommunicable diseases (NCDs), the World Health Assembly established in 2013 a global voluntary tobacco target to help reduce prevent premature avoidable mortality from NCDs. The agreed global tobacco target is a 30 percent relative reduction in prevalence of current tobacco use in persons aged 15+ years.
The setting of this target not only provides a context for the development of policies and programs of actions to attain the target, it also provides an opportunity for policy makers to monitor progress towards achievement of the target over time.
To address the global burden of tobacco, the World Health Assembly in 2003 unanimously adopted the World Health Organization Framework Convention on Tobacco Control (WHO FCTC). In force since 2005, the main objective of the WHO FCTC is to protect present and future generations from the devastating health, social, environmental and economic consequences of tobacco consumption and exposure. Ratified by 180 Parties as at March 2015, the WHO FCTC currently covers about 90 percent of the world’s population. It is a legally binding treaty which commits Parties to the Convention to develop and implement a series of evidence-based tobacco control measures to regulate tobacco industry marketing activities and sales reach, reduce the demand for tobacco, and provide agricultural alternatives for those involved in growing and producing tobacco.
To assist countries to fulfil their WHO FCTC obligations, in 2008 WHO introduced a package of six evidence-based tobacco control demand reduction measures that are proven to reduce tobacco use. These measures known as the MPOWER package measures reflect one or more provisions of the WHO FCTC. MPOWER refers to M: Monitoring tobacco use and prevention policies; P: Protecting people from tobacco smoke; O: Offering help to quit tobacco use; W: Warning about the dangers of tobacco; E: Enforcing bans on tobacco advertising, promotion and sponsorship, and R: Raising taxes on tobacco.
The ability to monitor change in any indicator rests on the availability of data to measure the indicator adequately over time. The NCD tobacco target refers to tobacco use which includes both tobacco smoking and smokeless tobacco. The quality and quantity of data on tobacco smoking is enough to allow for an attempt to draw trends in tobacco smoking by country. Smokeless tobacco data, although improving rapidly, are still too scant to allow for derivation of meaningful underlying trends for many countries. For this reason, the work presented in this report focuses only on tobacco smoking.
After a careful analysis of data quality and completeness of data availability, WHO aims to undertake a similar exercise for smokeless tobacco, most likely only for a limited number of countries.
To generate the trends, WHO worked with a team of epidemiologists and biostatisticians from the University of Newcastle (Australia) and University of Tokyo to generate the underlying trend in tobacco smoking. The trend is based on fitting a Bayesian meta-regression using a negative binomial model. A full description of the method used has been published in The Lancet.
The data for the analysis were obtained from the following WHO databases: WHO FCTC Implementation Database, WHO Comprehensive Information Systems for Tobacco Control, WHO Infobase and from other sources.
The resulting trend lines are projections not predictions of future attainment. A projection indicates a likely endpoint if the country maintains its tobacco control efforts at the same level that it has implemented to date. Obviously the impact of recent interventions or new interventions that are undertaken as a result of the projection will most likely alter the expected endpoint. Countries like Ireland or Vietnam who have reported taking strong tobacco control measures will not capture the impact of their efforts until completing a new survey. The success or otherwise of these actions will only be reflected in the trends once the surveys are completed.
This report contains country specific estimates for four indicators: current and daily tobacco smoking and current and daily cigarette smoking, for males and females for the years 2000, 2005, 2010, 2015, 2020 and 2025.
It also contains information on age-specific prevalence estimates by sex for current tobacco smoking for 2000, 2010 and 2025, as well a short history of recent surveys undertaken by the country. The report also provides an assessment of the next survey due for the country based on the WHO advice to undertake a survey at least once every five years (acknowledging that some countries undertake surveys on a more regular basis).
If the 194 WHO Member States collectively achieved a 30% reduction from the 2010 level of 22.1%, they would be expected to reach a prevalence level of 15.4% in 2025. At this stage, it is projected that the prevalence level in 2025 will be 18.9%, or 3.5 percentage points above the target. This would represent a 14% relative reduction overall.
Read the full report about tobacco consumption trends
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