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Tobacco Smoking – Major Public Health Threat in Asian Countries

Tobacco Smoking – Major Public Health Threat in Asian Countries

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  • Mortality rates due to tobacco smoking continue to rise in Asia and smoking associated problems may soon become a major public health threat if appropriate control measures are not implemented soon
  • More than 7 million deaths across the world are related to tobacco each year. The number of tobacco-related deaths is expected to rise to 8.3 million by 2030, with low and middle-income countries accounting for a major proportion of this increase
  • Currently, nearly 50 percent of male smokers are from three Asian nations namely China, India and Indonesia. Asia has the dubious distinction of being the world’s biggest tobacco producer as well as consumer

Tobacco-related deaths continue to rise among Asian men and will pose a major public health concern if urgent strict and comprehensive policy measures are not implemented according to a recent large meta-analysis of pooled data from over 20 studies across China, Japan, South Korea, Singapore, Taiwan and India.

Design of Study

The current study aims to estimate tobacco smoking patterns and the mortality rates in birth cohorts (persons born during a similar period of time) attributable to tobacco smoking in Asian populations.


  • The analysis included 1,002,258 participants who were Asian smokers from China, Japan, South Korea, Singapore, Taiwan and India 
  • Mortality rates were assessed according to birth cohort groups, i.e. men born in a similar period namely before 1920, during the 1920s, and 1930s and later 
  • Data including age at starting smoking, number of cigarettes per day and age of quitting were obtained from all participants
  • The participants were followed up for an average duration of 12 years

Key Findings of the Study

  • There were 144,366 deaths (with 9,158 from lung cancer) among 1002258 participants during an average follow-up of almost 12 years
  • Tobacco smoking accounted for 12.5 percent of total deaths and 56.6 percent of lung cancer deaths in men born before 1920
  • Among those born in the 1920s, tobacco deaths accounted for 21.1 percent of total deaths and 66.6 percent of lung cancer deaths
  • Among men born in 1930 or later, tobacco accounted for 29.3 percent of total deaths and 68.4 percent of lung cancer deaths
Thus, the findings of the study suggest that tobacco-related deaths continue to rise in each successive birth cohorts, a finding reported from earlier studies as well from Asia and Western countries.
  • Men belonging to more recent birth cohorts tend to start smoking earlier and smoke more cigarettes compared to men from an earlier period. Also, men in the most recent birth cohort tended to quit at an earlier age, perhaps due to intervention policies
  • Despite the rising tobacco epidemic in Asian men, it is interesting to note that in comparison Western men begin to smoke earlier and smoke more heavily than Asian men
  • In Asian countries, other background risk factors (i.e, household and outdoor air pollution and secondhand smoke) are major influencers in lung cancer mortality

Adverse Effects of Smoking & Tobacco Use

Tobacco in any form is harmful, in particular, inhaling tobacco smoke carries serious risks and exposes persons to over 7000 lethal agents and at least 70 carcinogens, and affects the whole body. Typically, a regular smoker loses over 10 years of his life. Some of the health hazards of smoking include the following:
  • Lung cancer and chronic obstructive pulmonary disease (COPD)
  • Oral cavity and nasal cavity cancers
  • Urinary tract cancers
  • Cervical cancer in women
  • Heart attacks
  • Peripheral vascular disease and gangrene
  • Cataracts and blindness
  • Wrinkling of skin and premature aging
  • Gum disease, teeth discoloration and plaque formation
  • Poor wound healing
  • Injuries due to accidental cigarette burns
  • Fires caused by carelessly tossing burning cigarettes

Ways to Control the Growing Tobacco Epidemic

  • Strict tobacco control policies should be implemented by governments
  • Increase taxes on tobacco and raise the price of tobacco products
  • Enforce strict smoking bans with costly fines and punishment for offenders
  • Discourage or even ban the advertisement of tobacco products on mass media
  • Accessible and affordable health care for persons wishing to quit smoking or tobacco use
  • Place warnings and deterrent messages on cigarette packs


Smoking-related deaths among Asian men continue to rise rapidly and will soon pose a significant health hazard if not addressed urgently. Strict measures need to be implemented but at the end of the day the only way to put an end to this tobacco epidemic in Asia is to quit smoking.

Reference :

  1. Tobacco Smoking and Mortality in Asia - (doi:10.1001/jamanetworkopen.2019.1474)

Source: Medindia

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