Politics

Tobacco use is declining but success is ‘fragile’



Tobacco use is gradually declining around the world but there remain 1.3 billion smokers worldwide, a World Health Organization report has found. 

A total of 60 countries are now on track to achieving the voluntary global target of a 30 per cent reduction in smokers between 2010 and 2025 – up from 32 countries two year ago.

Although millions of lives have been saved by tobacco control policies, and the total number of smokers has fallen by 200 million since 2015, the WHO says continued success is “fragile”.

Global health leaders are urging countries to invest an additional $1.68 (£1.25) per person per year, which would see 152 million more people successfully quit, and nearly three million lives saved by 2030.

The WHO says that beyond the investment period, benefits would continue to accrue – saving 16 million lives in total.

The total economic loss due to tobacco is estimated as $1.4 trillion annually.

Dr Tedros Adhanom Ghebreyesus, the WHO director-general, warned that there is “still a long way to go”. 

“Tobacco companies will continue to use every trick in the book to defend the gigantic profits they make from peddling their deadly wares”, he said. “We encourage all countries to make better use of the many effective tools available for helping people to quit, and saving lives.”

In 2020, 22 per cent of the global population used tobacco, including approximately 38 million children aged 13-15.

In 2019, tobacco caused nearly eight million deaths and 200 million disability-adjusted life years. Smokers are at heightened risk for death, disability, and chronic health issues such as ischaemic heart disease, chronic obstructive pulmonary diseases, cancers and stroke.

Over 60 per cent of smokers report that they want to quit, and over 40 per cent have attempted to do so in the past year. The WHO warns many will fail without assistance.

Currently, only 30 per cent of the world’s population has access to appropriate smoking cessation services.

The report urges countries to accelerate investment in cessation measures. These include: a national toll-free quit line, intensive behavioural support, nicotine replacement therapy and non-nicotine treatments. 

Implementing these measures results in a two to 5 per cent increase in the proportion of tobacco users who quit for six months or more, over no intervention.

The intervention which is said to have the biggest impact is the use of Varenicline, a non-nicotine medicine which reduces cravings and withdrawal symptoms, and decreases the pleasurable effects of cigarettes. Fifteen per cent of users who took Varenicline quit tobacco, research shows.

Dr Ruediger Krech, the director of the WHO’s department of health promotion, said: “It is clear that tobacco control is effective, and we have a moral obligation to our people to move aggressively.”

The WHO also advises governments to monitor tobacco use, warn about the dangers of tobacco, enforce bans on advertising, and raise taxes on tobacco products.

It recommends encouraging the use of digital tools, including text messaging, chat bots and apps to distract users from cravings.

Over 80 per cent of today’s tobacco users are in low- and middle-income countries. When they die, the majority are in their most productive years (30-65 years). The WHO says this implies tobacco’s stranglehold on economic development is highest in developing countries.

Of all the regions, the steepest decline in usage has been seen in the Americas region, where the rate has dropped from 21 per cent in 2010 to 16 per cent in 2020. The lowest rate of tobacco use is in the African region, which sat at 10 per cent in 2020.

In Europe, 18 per cent of women use tobacco – substantially more than in any other region.



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