Low and middle income countries should bring about policy changes urgently in order to curb the widespread use of tobacco, according to an international survey conducted in 16 different countries.
"Governments around the world need to start giving economic and regulatory advantages to agricultural products that promote health instead of to products like tobacco that kill people," Gary A. Giovino, lead author of the study from the University at Buffalo School of Public Health and Health Professions, said.
According to Giovino, the results of the Global Adult Tobacco Survey, (GATS) paint a disturbing picture of global tobacco use influenced by powerful and manipulative pro-tobacco forces.
While 100 million lives were lost prematurely due to tobacco use in the last century, the study notes that the World Health Organization estimates that if current trends continue, the number of preventable, premature deaths in this century will be far greater.
"In the absence of effective actions, about one billion people worldwide will die prematurely in the next century from tobacco use and most of those deaths and the healthcare and economic costs that come with them, will be borne by lower- and middle-income countries," he said,.
The study focused on 14 low- and middle-income GATS countries (Bangladesh, Brazil, China, Egypt, India, Mexico, the Philippines, Poland, Russia, Thailand, Turkey, Ukraine, Uruguay and Vietnam), making comparisons with the United States and the United Kingdom.
The nationally representative surveys were conducted in GATS countries from 2008 to 2010, via face-to-face interviews with 248,452 respondents. Data on another 188,895 respondents from the U.S. and UK were also included.
The research found that 49 percent of men and 11 percent of women in the GATS countries used tobacco (smoked, smokeless, or both). Although women's tobacco use rates remain low, women are beginning to smoke as early as men, around age 17 instead of in their 20s.
While tobacco is consumed in various ways, from chewing tobacco and snuff to waterpipes and hand-rolled bidis, most tobacco users (64 percent) smoked manufactured cigarettes.
China had the highest number of tobacco users at 301 million people (including 52.9 per cent of men) followed by India, with 274 million people ( 47.9 percent of men).
The study also found that quit ratios were highest in the U.S. and the UK as well as in Brazil and Uruguay, where tobacco control activities are strongest; they were lowest in China, India, Russia and Egypt.
According to Giovino, the magnitude of global tobacco use revealed in the current study reflects powerful pro-tobacco forces that often overpower the less well-funded tobacco control strategies.
The study has been published in The Lancet.