Tobacco use is on a declining trend worldwide, says a report from the World Health Organisation (WHO), reports Sanjeet Bagcchi for SciDev.Net. Women using tobacco remains a concern, especially in Europe, and in Asia Pacific 45% of men will still be using tobacco by 2025. Africa has the lowest tobacco use at 10% in 2020, down from 15% in 2010.
Taxes and advertising restrictions may have contributed to a decline in the number of people using tobacco of 20 million over five years, but more investment is needed to persuade users to quit, says WHO in the report published on 16 November 2021.
The number of tobacco consumers fell from 1.32 billion in 2015 to 1.3 billion in 2020 and is expected to drop to 1.27 billion by 2025 if the current trends persist. There are 60 countries now set to meet the global target of decreasing tobacco use by 30% between 2010 and 2025 – up from 32 countries in 2019.
Since the last report on global tobacco trends was released two years ago, the African and South-East Asia regions of WHO have joined the Americas region of the global health body to be on track to achieve the 30% reduction.
Luke Allen, a clinical research fellow at the London School of Hygiene and Tropical Medicine in the United Kingdom, told SciDev.Net that “implementation of effective tobacco policies is making the biggest contribution – think of taxes, plain packaging, advertising bans – along with shifting cultural values”.
“Whilst some have suggested that illicit tobacco is contributing to the declining rates, in reality it is almost impossible to get good data on this issue,” says Allen.
Suvadip Chakrabarti, consultant surgical oncologist at the Apollo Cancer Centre in Kolkata, India, told SciDev.Net that “many countries have increased the taxes on tobacco products which have made them dearer”.
He added that photographs of cancer patients – required to cover 33% of tobacco packaging in India and 67% in the case of Singapore – may have contributed to the decline in usage.
According to the WHO, a per capita annual investment of US$1.68 for evidence-based tobacco cessation measures including ‘brief advice’, ‘toll-free quit lines’ and ‘SMS-based cessation support’ “could help 152 million tobacco users” quit by 2030.
The WHO has established a tobacco cessation consortium, which will bring together partners to support countries in scaling up tobacco cessation, the report said.
The report also showed that 231 million women use tobacco globally compared to 244 million women in 2018. In WHO’s European region 18% of women still use tobacco, significantly more than in other regions.
Lawrence Gostin, a professor of Global Health Law at Georgetown University in Washington DC in the United States and director of the WHO Collaborating Center on National and Global Health Law, told SciDev.Net that tobacco use among women, especially mothers, is alarming.
“Not only does this affect the health and longevity of women but it also increases risks to families and children,” he says.
With about 432 million tobacco users, the WHO South-East Asian region – including India, Bangladesh, Indonesia and Nepal – has the highest rates of tobacco use but also the fastest decrease.
WHO’s Western Pacific region – including Malaysia, Cambodia, Vietnam and the Philippines – is projected to “become the region with the highest tobacco use rate among men, with more than 45% of men still using tobacco in 2025”.
Regarding the use of e-cigarettes, Sunday Azagba, an expert in tobacco control policy and associate professor at the Penn State Nese College of Nursing in the US, told SciDev.Net that “we need tighter regulations to prevent kids from taking up this behaviour”.
According to Gostin, e-cigarettes have escaped rigorous regulation in many countries and that is a problem in itself because of the harms they cause. “These electronic devices can be a gateway to tobacco use,” he says.
* This article is republished from SciDev.Net under a Creative Commons licence. See links to SciDev.net and the article below.
WHO urges countries to invest in helping more people to quit tobacco
Millions of lives have been saved by effective and comprehensive tobacco control policies under the WHO Framework Convention on Tobacco Control (WHO FCTC) and MPOWER – a great achievement in the fight against the tobacco epidemic – said WHO in a news release published on 16 November 2021.
“It is very encouraging to see fewer people using tobacco each year, and more countries on track to meet global targets,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General.
“We still have a long way to go, and tobacco companies will continue to use every trick in the book to defend the gigantic profits they make from peddling their deadly wares. We encourage all countries to make better use of the many effective tools available for helping people to quit, and saving lives.”
The report also urges countries to accelerate implementation of the measures outlined in the WHO FCTC in an effort to further reduce the number of people at risk of becoming ill and dying from a tobacco-related disease.
“It is clear that tobacco control is effective, and we have a moral obligation to our people to move aggressively in order to achieve the Sustainable Development Goals,” says Dr Ruediger Krech, Director of WHO Department of Health Promotion.
“We are seeing great progress in many countries, which is the result of implementing tobacco control measures that are in line with the WHO FCTC, but this success is fragile. We still need to push ahead.”
A new WHO report, Global Investment Case for Tobacco Cessation – reported in MedicalBrief last week – highlights that investing US$1.68 per capita each year in evidence-based cessation interventions such as brief advice, national toll-free quit lines, and SMS-based cessation support, could help 152 million tobacco users successfully quit by 2030, saving millions of lives and contributing to countries’ long-term economic growth.
To facilitate this process, WHO has established a tobacco cessation consortium, which will bring together partners to support countries in scaling up tobacco cessation.
The report and the investment case were released right after of the ninth session of the Conference of the Parties (COP9) and during the second session of the Meeting of the Parties (MOP2) to the Protocol to Eliminate Illicit Trade in Tobacco Products.
Delegates meet to counter the ambitions of the tobacco industry to keep millions hooked on its products, as recent evidence shows that the tobacco industry used the COVID-19 pandemic to build influence with governments in 80 countries.
Key findings of the WHO global report on trends in prevalence of tobacco use 2000-25:
In 2020, 22.3% of the global population used tobacco, 36.7% of all men and 7.8% of the world’s women.
Target: Currently, 60 countries are on track to achieve the tobacco use reduction target by 2025. Since the last report two years ago, two other regions – the African and South-East Asian regions – have joined the Americas region on-track to achieve a 30% reduction.
Children: Approximately 38 million children (aged 13-15) currently use tobacco (13 million girls and 25 million boys). In most countries it is illegal for minors to purchase tobacco products. The goal is to achieve zero child tobacco users.
Women: The number of women using tobacco in 2020 was 231 million. The age group with the highest prevalence rate among women for tobacco use is 55 to 64.
Trends in the Americas: Of all WHO regions, the steepest decline in prevalence rates over time is seen in the Americas Region. The average rate of tobacco use has gone from 21% in 2010 down to 16% in 2020.
WHO’s African Region trend: this region has the lowest average rate of tobacco use at 10% in 2020, down from 15% in 2010.
WHO’s European Region trend: in Europe 18% of women still use tobacco – substantially more than in any other region. Women in Europe are the slowest in the world to cut tobacco use. All other WHO regions are on track to reduce tobacco use rates among women by at least 30% by 2025.
WHO’s Eastern-Mediterranean Region trend: Pakistan is the only country in this region that’s on track to reach the tobacco reduction target. Four of the six countries in the world where tobacco use is increasing are in this region.
WHO’s South East Asian Region trend: The region currently has the highest rates of tobacco use, with around 432 million users, or 29% of its population. But this is also the region where tobacco use is declining fastest. The region is likely to reach tobacco use rates similar to the European Region and the Western Pacific Region by 2025.
WHO’s Western Pacific Region trend: This is projected to become the region with the highest tobacco use rate among men, with more than 45% of men still using tobacco in 2025.
Policy action: One in three countries are likely to achieve the 30% reduction target, and low-income countries are currently achieving the most progress against tobacco. Upper middle-income countries are, on average, making the slowest progress in reducing tobacco use.
In some 29 countries, data quality is low or insufficient to know the trend, so more monitoring is needed.
The data behind these estimates are from 1,728 national surveys run by countries between 1990 and 2020, which together asked 97% of the world’s population about their tobacco use. Article 20 of the WHO FCTC underlines the importance of running surveys to obtain evidence of the tobacco epidemic, and now 190 countries have run at least one national survey – up from 140 in 2004 when the treaty was not yet in force.
WHO and partners have made a large contribution to filling the data gaps in low- and middle-income countries via the Global Tobacco Surveillance System surveys, the STEPS survey and the World Health Survey.
Highlights from the Global Investment Case for Tobacco Cessation
To meet global targets in reducing tobacco use, cessation services need to be scaled up, along with strengthening tobacco control measures. Offering cessation services can accelerate the downward trend in tobacco use prevalence, saving more lives and protecting the health of more people.
Population-level cessation interventions include brief advice, national toll-free quit lines, and mCessation (support through mobile phone text messaging). These interventions cost very little yet deliver significant returns on investment within 10 years. Pharmacologic interventions including nicotine replacement therapy (NRT), Bupropion and Varenicline are more expensive but are proving effective.
Data from 124 low- and middle-income countries are used to generate the analysis.
See also from the MedicalBrief archives