Global Tobacco: A State of Affairs

by helen on January 29, 2009

Editor: Chronic diseases are now prevalent worldwide. We wanted to provide you with a snapshot of the spread of tobacco globally, its effects on global health, and efforts by states to mitigate tobacco’s harms.

Tsight of someone pulling out a cig in the middle of a crowded Borders café would be bizarre. And if that someone were bold enough to “light up,” furrowed stares would immediately laser all through the café. Indignant whispers would swish around the room. Finally, the café barista will walk over and gently ask the perpetrator to please go outside, 20 feet away from the store, to smoke.

But careful! Situated directly across from Borders is Marshalls, and 90 degrees to Borders and Marshalls is Target, all of which require the distance of at least 20 feet between the smoker and each respective building. As the smoker huddles outside in the winter cold, puffing away in his one allotted square foot, the patrons in Borders stare out at him through frosty big windows as if he’s some rare zoo specimen in its natural (and small) habitat.

California is not a friendly place to smokers.

The same setting transported to Shanghai, China would render a different image. The ostracized man looking sadly in at the warm, laughing people inside will have no cigarette because, in China, the oddball is the non-smoker concerned with inhaling.

This man is probably an American.

Very few quirks expose the American in foreign lands better than when they start warning others in the dangers of smoking. Actually, there is: when they start warning about second-hand smoking.

It’s hard to understand the kind of anti-smoking culture that exists in California if you don’t live in California. For most of the world, the attitude toward smoking is more akin to the one in Shanghai than in San Francisco and the fervent anti-smoking vibe of California is met, more or less, with eye rolls. After all, everyone smokes.

And in the coming decades, that statement is about to become more true. Tobacco use is rising fast and strong, and soon, the ubiquitous slim, white cylinder will soon be hanging from more eager mouths than ever. The “everybody does it” mentality can create a false sense of comfort, so it may surprise people to know that tobacco has silently become the single deadliest, yet preventable, killer in the world.

thank you for smoking
photo credit : the half-blood prince

We went over the World Health Organization’s Report On The Global Tobacco Epidemic, 2008 1. The report was released as part of the MPOWER package, and is a very comprehensive overview of the status of global tobacco use and prevention methods. We’ve pulled out some of the most relevant information and reproduced the graphs for you. Enjoy our comprehensive overview of their comprehensive overview.


Did you know…

Tobacco Death Toll : Quick Facts

Tobacco’s devastating health effects are not immediately evident. As global tobacco use is rising, years or decades will go by until the wave of tobacco-related illnesses hits.

6 seconds a person dies from tobacco use
5 million annual deaths due to tobacco, more than AIDS+TB+malaria combined
10 % percentage of adult deaths worldwide attributable to tobacco
8 million projected annual death due to tobacco use by 2030, if unchecked
100 million tobacco-related deaths in the 20th century
500 million people currently still alive who will die from tobacco, if current trends continue
1 billion estimated tobacco-related deaths in the 21st century


Tobacco & the Developing World
80 % percentage of tobacco deaths that will be exclusively in low-income countries by 2030

Most of the world’s population lives in low and middle-income countries where tobacco consumption is steadily increasing; they represent a vast, untapped marketplace still relatively lax on anti-tobacco laws and restrictions. The tobacco epidemic will be most harmful to these people, as their countries have fewer resources to address all the consequences of tobacco use.

100 million Chinese men currently under age of 30 who will die from tobacco use

Developing countries like China currently in the early stages of the tobacco epidemic have yet to experience the full weight of tobacco-related illnesses that have already hit wealthier countries.


Tobacco, Youth & Addiction
24 % percentage of adults worldwide addicted to tobacco

Low prices, billions of dollars in aggressive marketing, and a lack of education about tobacco keep the population addicted and coming back for more.

21 People who do not start smoking before the age of 21 are unlikely to ever begin smoking

The younger someone is when they try tobacco, the more likely they are to be addicted for life. This is why tobacco companies spend billions of dollars annually on marketing to youth. The tobacco industry is now using marketing and lobbying tricks (often banned in developed countries) on teens in the developing world.
Tobacco-Related Diseases and Shortened Life Spans
33-50% percentage of people prematurely killed by tobacco [an average of 15 years early]

Tobacco-related illnesses cause not only physical pain and premature death, but also lead to high health-care costs and loss of economic mobility and productivity.

90 % percentage of lung cancers caused by tobacco

Many tobacco users don’t understand the health ramifications of smoking and many are unaware that other than lung cancer, smoking can also cause heart disease, stroke, and many various other types of cancer.


Tobacco & Second-Hand Smoke
40% of countries lack protection of children from second-hand smoke in schools.

In total, 80 countries do not ban smoking in either schools or hospitals, or both, thereby failing to protect choolchildren and/or the sick.

Each year:
430 cases of sudden infant death syndrome
1900 pre-term deliveries
3400 lung cancer deaths

Exposure to second-hand smoking increases risk of lung cancer in non-smokers by 20-30 percent.

24500 low-birth-weight babies
46000 heart disease deaths

Exposure to second-hand smoking increases risk of coronary heart disease by 25-30 percent.

200000 episodes of childhood asthma


Tobacco & Economic Impact on the Poor

The poor are more likely to get sick, stay sick, and die prematurely of tobacco-related illnesses. Aggravating the situation, up to half of all tobacco-related deaths will occur during the prime productive years, eliminating much needed household income.

50 million Chinese people impoverished from medical costs due to smoking

Example: A 45-year-old Chinese man dies from smoking-related illnesses because his family doesn’t have enough money for adequate healthcare, in turn his family in a cycle of poverty.

10 % percentage of total household expenditure spent on tobacco among the poorest in Egypt

In poorer countries, a significant enough percentage of household income is used on fueling a tobacco addiction that less money can be spent on food, education, shelter, etc.

1000 % percentage of money spent more on tobacco than education among the poorest in Bangladesh
15 % percentage of total household expenditure spent on tobacco among the poorest in Indonesia
11 % Percentage of total household expenditure spent on tobacco among the poorest in Mexico

Tobacco & Economic Impact on Countries
$10 billion cost of second-hand smoking in the U.S.

Second hand smoking costs billions of dollars in direct and indirect medical costs such as disability and lost wages.

$81 billion annual health-care cost of treating tobacco-related problems in the U.S.
$92 billion annual loss of economic opportunities due to tobacco-related deaths in the U.S.
$156 million annual cost of direct medical care, long-term care, and productivity loss due to second-hand smoking in Hong Kong.


Underfunding of Tobacco Control
Governments take in about 500 times as much from tobacco taxes as they spend on tobacco control.


Tobacco Control Policies
The U.S. Centers for Disease Control and Prevention recommend that governments spend roughly $ 2–4 per person each year on anti-tobacco health communication. This makes up for only about 15%–20% of total tobacco control program costs.


Tobacco Monitoring
Most of the world’s population lack systems for monitoring information regarding tobacco use. Again, monitoring systems are especially lax in low to middle income countries, although basic monitoring need is not expensive and is within reach of virtually all countries.


Tobacco Dependence Programs
Example: In a mere 5 years, New Zealand went from offering almost no tobacco cessation treatment to offering one of the world’s most advanced initiatives. Government spending on smoking rehabilitation programs was US$ 10 million per year and the initiatives include a national quit line that is now one of the busiest in the world, subsidized nicotine replacement therapy and quit services.


Current State of Tobacco Health Warnings
Experience and observation in many different countries have shown that health warnings on tobacco packages, particularly pictorial warnings, provide youth and people in countries with low-literacy rates with compelling information that may dissuade them from smoking.


Current State of Tobacco Taxation
With tobacco revenue raking up $66.5 billion from low to middle income countries, only $14 million is spent on tobacco control.



Tobacco control is not expensive. Tobacco taxes increase government revenues and enforcement of smoke-free laws and advertising, promotion and sponsorship bans do not require large expenditure.

Smoking Bans
Smoking bans in public places often generate widespread public support. Uruguay became the first country in the Americas to become completely smoke-free in all public arenas and 80 percent of the people approve.


Increasing the price of tobacco through higher taxes is the most effective way to decrease consumption. Tobacco taxes are usually the most popular kind of tax with a majority of the public and significantly decreases smoking among the young and the poor.
A 70% increase in price could prevent up to a quarter of all smoking-related deaths worldwide.


Various Therapies
Three types of treatment should be included in any tobacco prevention effort:
(i)Tobacco cessation advice incorporated into primary health-care services
(ii)Easily accessible and free quit lines
(iii)Access to low-cost pharmacological therapy


  1. WHO Report on the Global Tobacco Epidemic, 2008:
    The MPOWER package.
    Geneva, World Health Organization, 2008. 

Leave a Comment

{ 2 comments… read them below or add one }

Shauna Plumer November 10, 2009 at 11:43 am

I was just wondering if I could use the picture that shows the diseases caused by smoking and the diseases cause by second hand smoke, for my college essay. I am doing a paper on the ban on smoking and I need a photo showing everyone how dangerous smoking and SHS is to people. Not only will my audience read what I have to say but they will be able to see it too.

I want to be sure I can use this image before posting it, if not I will try to find one elsewhere.
Thank you so much.
Shauna Plumer

Hilda Hagerman April 12, 2010 at 8:36 pm

I am doing a speech on second-hand smoke in May 2010 and I find your statistics on world numbers staggering. This is a serious global issue and it made me cry. I feel your information will be very useful and helpful for my speech. I want to continue to be an advocate for children in my community so that they can be in more smoke-free environments. They are innocent victims that need to be protected and be able to breathe clean air. It is our human right and we all need to have clean air. Thank you so much.