A new study, published in The Lancet, highlights the alarming patterns of tobacco use even after years of global tobacco control efforts.

According to the report, almost 50% of adult men in developing countries still use tobacco products, while women seem to start smoking at younger ages.

The researchers reveal that there are still major disparities in the use of tobacco and access to effective policies and treatments to limit its use.

Gary Giovino from the University at Buffalo School of Public Health and Health Professions in New York who directed the study, said:

“Although 1.1 billion people have been covered by the adoption of the most effective tobacco-control policies since 2008, 83% of the world’s population are not covered by two or more of these polices. Our findings come at a crucial point in tobacco control, several years after the ratification of the Framework Convention of Tobacco Control (FCTC)… and reinforce the need for effective tobacco control.”

The team compared patterns of tobacco use and cessation in adults from 14 countries of low and middle income by using data from the Global Adult Tobacco Surveys (GATS) conducted between 2008-2010.

The countries included:

  • Bangladesh
  • Brazil
  • China
  • Egypt
  • India
  • Mexico
  • Philippines
  • Poland
  • Russia
  • Thailand
  • Turkey
  • Ukraine
  • Uruguay
  • Vietnam

Nationally representative data from the UK and the USA were also included for comparison.

The team found disproportionately high rates of tobacco smoking among men (41% vs 5% in women) and wide variation in smoking prevalence between GATS countries.

China has more tobacco consumers than any other country, with an estimated 301 million tobacco users. India comes in second with 275 million users. 64% of tobacco users smoked manufactured cigarettes, although smokeless tobacco use, such as loose-leaf chewing tobacco and snuff, was found to be common in India (206 million users) and Bangladesh.

The researchers explained that one concern is the increase in tobacco use among younger women. They said “women are increasingly starting to smoke at an equivalent age to men.”

In China, India, Egypt, Bangladesh, and Russia, less than 20% of adults who had ever smoked quit. The UK, USA, Brazil and Uruguay had the highest quit rations, with over 35% of adult smokers saying they had quit.

In an associated comment, Jeffery Koplan from Emory University in the USA and Judith Mackay from the World Lung Foundation in Hong Kong, said:

“In view of the health burden of tobacco use, the underinvestment in tobacco control is extraordinary. For example, core funding by governments for implementing the WHO Framework Convention on Tobacco Control (FCTC) within their own countries is woefully inadequate for the enormity of the epidemic. For example, in low-income countries, for every US$9100 received in tobacco taxes, only $1 was spent on tobacco control.

With behaviors and lifestyle in flux globally and marketing rampant, we can expect initiation of tobacco use to begin at younger ages than at present, and pressures on young women to smoke to increase.

Hopefully, with successful control efforts, there will be an increase in attempted and successful quit rates. Thus, repeated GATS or their equivalent will be an essential element of tobacco control…The main challenge is how to translate the findings from GATS and other surveys into health policy.”

Written by Grace Rattue