Smoking

Global Smoking Prevalence

While there are various ways to consume tobacco, cigarette smoking is the most widespread. Cigarettes constitute about 96 percent of total tobacco sales worldwide. Half of all cigarettes produced annually are smoked in five countries: China, the United States, the Russian Federation, Japan, and Indonesia. China accounts for about one-third of all cigarettes smoked in the world.

Globally, about one in three adults and one in ten youth smoke. Among adults, smoking is significantly higher among men—almost 1 billion men smoke compared to about 250,000 women. Male smoking is higher in the developing world, with prevalence averaging about 50 percent as compared to 35 percent in developed countries. Female smoking is higher in developed countries, although smoking rates among women are increasing in several developing countries.

The Global Youth Tobacco Survey (GYTS) reveals that among youth aged 13 to 15, gender differences in smoking are minimal. Over half of the countries surveyed showed no difference between boys and girls smoking. This finding foreshadows increases in adverse reproductive outcomes and tobacco-related deaths among women in the future. Consequently, gender-sensitive approaches to reducing smoking, especially among youth, are crucial. The GYTS also confirms that use of other tobacco products is as prevalent as smoking among young people, highlighting the need to address alternate forms of tobacco consumption.

Scientific evidence confirms that smoking harms nearly every organ in the body, causing multiple diseases and impairing the health of smokers. The adverse health effects can begin before birth and continue across the life span. The 2004 U.S. Surgeon General's Report concluded that evidence is sufficient to infer a causal relationship between smoking and the following:

• Cancer of the bladder, cervix, esophagus, kidney, larynx, lung, oral cavity, pancreas, stomach, and leukemia
• Cardiovascular diseases—abdominal aortic aneurysms, hardening of the arteries, stroke, and coronary heart disease
• Respiratory diseases, both acute (pneumonia, acute bronchitis) and chronic (emphysema and chronic bronchitis), and impaired lung function
• Other diseases and conditions—peptic ulcer, cataracts, hip fractures, low bone density, and poor wound healing after surgery
• Adverse reproductive outcomes for women who smoke during pregnancy, including infertility, premature labor, complicated labor, stillbirth, low birth weight babies, and sudden infant death syndrome (SIDS)
• Decreased overall health, manifested as increased absenteeism from work and increased use of medical services

Evidence indicates that smoking harms nonsmokers too. According to the 2006 Surgeon General's Report, infants and children exposed to secondhand smoke are at an increased risk of SIDS, acute lung infections, ear problems, worsening asthma, and impaired lung growth. Adults exposed to secondhand smoke are at higher risk for lung cancer and heart disease. Workplace exposure to secondhand smoke is widespread. The World Bank reports that in 1996, in China, over 130 million adult nonsmokers experienced occupational tobacco smoke exposure. Almost half of youth surveyed by the GYTS reported exposure to secondhand smoke at home, and over 60 percent reported exposure in public places. Recent studies demonstrate the efficacy of smoke-free laws in reducing exposure to secondhand smoke. These findings reinforce the importance of legislative strategies to protect nonsmokers from exposure to cigarette smoke.

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