Tobacco Use Around The World

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A reader from Australia requested some comparative information on tobacco use around the world. By far the best source of such information is a superb book called, “The Tobacco Atlas” (2nd Edition) written by Dr. Judith Mackay, Dr. Michael Eriksen, and Dr. Omar Shafey. Large parts of the book are available online via the link below, but I’ll try to summarize the parts I found most interesting.

The most striking thing is the enormity of it. Taking cigarettes alone, global cigarette production continues to increase dramatically, from 1,686 billion cigarettes in 1950 to 5,604 billion in 2002. The magnitude of tobacco consumption in Asia generally and China in particular is mind-boggling. More than 300 million men smoke in China (70% of men) – more than the entire population of the United States, and they consume 30% of the world’s cigarettes each year. The other striking factor is that in many countries in the world (particularly Asia, Africa and the Middle East) smoking is largely a male past-time, with male smoking rates about 10 times those in women.

Because of these marked sex differences in smoking in some countries, around a billion men smoke and around 250 million smoke around the world. It is largely the high smoking rates among women in North America and Europe that causes the overall smoking rates in these countries to be relatively high – in most other countries male smoking is higher but female smoking is much less common. In fact the only country in the world that has had consistently higher female than male cigarette smoking rates over the past 10 years is Sweden. Sweden has the lowest male smoking rates in Europe, and is the only member of the European Union that allows the sale of smokeless tobacco. More men now use smokeless tobacco than smoke in Sweden.

In countries like the UK, USA and Australia there is a clear linear relationship between smoking rates and education/socioeconomic status, with smoking rates being much higher in the poorest, least educated sections of society. However, it is not like that across the globe. For example, in southern European countries such as Greece, female university students are more likely to smoke than young women not attending university. Amazingly in some countries (e.g. Turkey and Bulgaria) the smoking rates are higher among health professionals than in the general population. In China 57% of male doctors smoke!

The China National Tobacco Corporation is the biggest tobacco company in the world, having a monopoly in China as part of the Chinese government, and therefore having about a third of the global tobacco market. Then there are 5 major multinational tobacco companies with significant global market shares: Altria (Philip Morris): 17.6%, British American Tobacco (15.1%), Japan Tobacco Inc (9.5% including recent take-over of Gallaher Group PLC), Imperial Tobacco Group (3.6%) and Altadis (2%). In 2004, Philip Morris sold $57 billion worth of cigarettes in over 160 countries. Interestingly, in 2003, 851 billion cigarettes were reported as being exported around the world but only 664 billion were reported as being imported. Unless we are exporting to aliens on another planet, almost 200 billion cigarettes went “missing” in the process!

And to return to our Australian colleague, in fact Australia is one of the world leaders in tobacco control, with an adult smoking prevalence of around 17.6% (as compared with around 26% in UK and around 22% in USA). I often hear Americans return from vacation in Europe commenting on how “everyone” smokes over there. However, it depends which part of the USA one lives in whether smoking rates are much lower. In Utah and California smoking rates are much lower than most countries in Europe, but in Nevada and Kentucky smoking rates are higher than in many European countries.

For those of you with an interest in global tobacco, I’d strongly recommend taking a look at The Tobacco Atlas.
http://www.cancer.org/docroot/AA/content/AA_2_5_9x_Tobacco_Atlas.asp
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About the Author


MA, MAppSci, PhD

Dr. Jonathan Foulds is an expert in the field of tobacco addiction.

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