At What Cost? The Economic Impact of Tobacco Use on National Health Systems, Societies and Individuals : A Summary of Methods and Findings

By The World Bank | Go to book overview

Chapter 1:
Introduction to the
Tobacco Epidemic

1.1 The Tobacco Epidemic

Tobacco use is now widely acknowledged to be the single most important preventable cause of health problems worldwide (1). Despite this consensus, approximately 1.1 billion people smoke worldwide, and over 4 million people currently die of tobacco use each year (1). Between 2025 and 2030, the total number of smokers is expected to reach about 1.6 billion out of a global population of 8.5 billion, with approximately 10 million smokers dying annually (2). Current worldwide smoking patterns suggest that 500 million people alive today will eventually die of tobacco use (2). About 100 million of these deaths will occur among Chinese men alone (2).

“Very rarely do we have the ability to predict an epidemic so far in the future and also have the knowledge to prevent it!’

11th World Conference on Tobacco or Health (9)

Once largely a problem in developed countries, the tobacco epidemic has become a growing concern in many developing countries as well. In high-income countries, the trend in overall numbers of smokers has shown a general decline over the past three decades. In low- and middle-income countries, however, the overall number of smokers is increasing, and these now account for more than 80% of today’s total worldwide smoking population (2). The tobacco epidemic has therefore expanded from its original locus, high-income countries, to low-income regions.

A 1988 WHO press release reported that while tobacco markets are decreasing in Western, industrialized countries at the rate of 1% per year, tobacco consumption is increasing in developing countries at an average rate of 2% per year, outstripping global population growth (3). Of the estimated 10 million annual tobacco-related deaths expected by 2030, 7 million will occur in developing countries (4).

People in developing countries now consume approximately one-third to just over one-half of the world’s tobacco (1). To illustrate this, between 1970 and 1990, for every tonne of tobacco that Canadian adults gave up, populations in the low- and middle-income countries of Africa, Latin

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