The American Cancer Society and the World Lung Foundation last week unveiled the fifth edition of The Tobacco Atlas. The report details the effects of tobacco use on health worldwide and claims the tobacco industry is using a “well-resourced array of tactics” that are hindering global interventions to reduce tobacco use.
The health implications of tobacco use are well established. Smoking is the cause of around 90% of lung cancer deaths and is responsible for around 80% of deaths from chronic obstructive pulmonary disease (COPD). Each year, smoking kills more than 480,000 Americans.
Worldwide, measures have been put in place to reduce tobacco use and its effects on health. As part of the World Health Organization (WHO) Global Action Plan for the Prevention and Control of Noncommunicable Diseases (NCDs), for example, a goal was set to reach a 30% reduction in tobacco use prevalence by 2025.
But according to the authors of the report – including Michael Eriksen, a professor and founding director of the Georgia State University School of Public Health – the tobacco industry is “committing unprecedented resources to litigate, threaten and interfere with efforts to introduce, implement and enforce tobacco control,” meaning such interventions are likely to fail unless “bolder, faster” action is taken.
Figures from the report reveal that there are more than 1 billion smokers across the globe, while a further 300 million are users of smokeless tobacco.
What is more, the report also reveals that cigarette smoking among women is on the rise, contributing to a rise in lung cancer cases among this population, and any declines in cigarette use are offset by increases in China – the world’s most populated country.
The report also reveals that tobacco is killing as many as two thirds of users. Last year, around 6.3 million people died from tobacco-related causes, with more than 80% of tobacco-related deaths occurring in low- and middle-income countries.
The top six transnational tobacco companies are making a profit of $44.1 billion, according to the authors. This equates to around $7,000 for every tobacco-related death, increasing from $6,000 in 2012.
And it is low- and middle-income countries the report claims the tobacco industry is highly targeting in order to protect its profits and “influence or derail regulation.”
Some of the tactics the authors say the tobacco industry is using include:
- “Aggressively targeting” developing economies in the Middle East, Asia, Africa and Latin America
- Raising tobacco prices above taxes in 146 countries between 2008 and 2012, causing consumers to blame governments for increased prices while the tobacco industry makes a profit
- Funding and promoting “misleading” research in relation to tobacco taxes, smoke-free laws, pack size restrictions and plain packaging, among other tobacco intervention measures
- Increasing the threat or use of legal action in an attempt to halt tobacco control.
If such tactics continue, the authors say, around 1 billion people will lose their lives as a result of smoking and tobacco exposure this century.
In addition, governments will be unable to reach goals for tobacco control – such as the 30% reduction in tobacco use set by WHO.
“Smoking has already prevented countries from meeting Millennium Development Goals related to mortality associated with tuberculosis (TB),” they note. “It will be 2029 before any region (the Americas) meets its goal while smoking is still prevalent. In the Western Pacific and Africa, TB mortality goals will never be achieved while smoking is prevalent.”
The authors recommend a number of ways in which governments can take action to reduce tobacco use and its related health problems.
They suggest that income from tobacco taxes should be reinvested in tobacco control. At present, only 0.69% of tobacco excise tax revenue is used as such, and 96% of that is reinvested in high-income countries.
Another strategy, the authors say, is for governments to implement tobacco advertising, promotion and sponsorship bans immediately, noting that around a third of youths start smoking as a result of exposure to such marketing.
Use of mass and social media to inform the general public about the harms of tobacco use and how to quit should be increased, the report recommends, noting that a quit smoking video in Thailand that was posted on YouTube led to a 40% rise in calls to the national quitline.
In addition, the report authors say governments, health experts and tobacco users should not assume electronic cigarettes (e-cigarettes) will contribute to a reduction in tobacco use. They point out that almost half of US adults who use the devices continue to use tobacco, and some studies have suggested they may encourage conventional cigarette use.
Commenting on the report, John R. Seffrin, PhD, chief executive officer of the American Cancer Society, says:
“We encourage public health advocates; colleagues across legal, environmental, and developmental specialisms; governments; economists; educators; and the media to use this vital tool to tell people the truth about how a cohesive, well-funded tobacco industry is systematically causing preventable deaths, destroying the environment, and crippling economies – all for its own profit. These truths will help us create support for the change so bitterly opposed by the tobacco industry.”
Earlier this month, Medical News Today reported on a study published in the journal Health Communication, in which researchers suggest vaping in e-cigarette advertisements may encourage tobacco smoking.