Number of smokers has reached all-time high of 1.1 billion, study finds
Governments told to focus on stopping young from taking up habit that killed 8 million people in 2019
Smoking killed almost 8 million people in 2019 and the number of smokers rose as the habit was picked up by young people around the world, according to new research.
A study published in the Lancet on Thursday said efforts to curb the habit had been outstripped by population growth with 150 million more people smoking in the nine years from 1990, reaching an all-time high of 1.1 billion.
The study’s authors said governments need to focus on reducing the uptake of smoking among young people, as 89% of new smokers were addicted by the age of 25 but beyond that age were unlikely to start.
“Young people are particularly vulnerable to addiction, and with high rates of cessation remaining elusive worldwide, the tobacco epidemic will continue for years to come unless countries can dramatically reduce the number of new smokers starting each year,” said the study’s lead author Marissa Reitsma, a researcher at the Institute for Health Metrics and Evaluation.
Though the prevalence of smoking has reduced globally over the past three decades, it increased for men in 20 countries and for women in 12. Just 10 countries made up two-thirds of the world’s smoking population: China, India, Indonesia, the US, Russia, Bangladesh, Japan, Turkey, Vietnam and the Philippines. One in three tobacco smokers (341 million) live in China.
In 2019, smoking was associated with 1.7 million deaths from ischaemic heart disease, 1.6 million deaths from chronic obstructive pulmonary disease, 1.3 million deaths from tracheal, bronchus and lung cancer, and nearly 1 million deaths from stroke. Previous studies have shown that at least half of long-term smokers will die from causes directly linked to smoking, and that smokers have an average life expectancy 10 years lower than those who have never smoked.
The research examined trends in 204 countries and was produced as part of the Global Burden of Disease consortium of researchers, which studies health issues that lead to death and disability.
According to the study, half of all the countries had made no progress in stopping uptake among 15- to 24-year-olds and the average age for someone to start was 19, when it is legal in most places.
Reitsma said the evidence suggested that if young people faced delays in picking up the habit they would be less likely to end up becoming smokers at all.
“Ensuring that young people remain smoke-free through their mid-20s will result in radical reductions in smoking rates for the next generation,” said Reitsma.
Despite 182 countries signing a 2005 convention on tobacco control, enforcing policies to reduce smoking had been varied. Researchers said taxation was the most effective policy but there was a significant discrepancy between the high cost of a packet of cigarettes in developed countries and a significantly lower costs in low- and middle-income countries.
The study’s co-author, Vin Gupta, said there needed to be stronger commitment to tackling smoking, as well as products such as flavoured cigarettes and e-cigarettes that could be enticing young people.
“Despite progress in some countries, tobacco industry interference and waning political commitment have resulted in a large and persistent gap between knowledge and action on global tobacco control,” said Gupta.
“Bans on advertising, promotion and sponsorship must extend to internet-based media, but only one in four countries have comprehensively banned all forms of direct and indirect advertising.”
1.1 billion people smoked in 2019 — a record high, study says. But smoking decreased in the US
Although smoking has decreased in the United States since the 1990s, new research shows there was a global record high of 1.1 billion people who smoked in 2019.
The number of smokers was directly tied to population growth, according to the peer-reviewed study published Thursday in the medical journal The Lancet.
The study said that in the last 30 years, smoking tobacco accounted for more than 200 million deaths. The annual economic costs exceeded $1 trillion.
"I'm not surprised at all. Tobacco use smoking is still the No. 1 preventable cause of death worldwide," Dr. Albert Rizzo, the chief medical officer for the American Lung Association, told USA TODAY.
Ten countries made up two-thirds of the global tobacco smoking population: China, India, Indonesia, the U.S., Russia, Bangladesh, Japan, Turkey, Vietnam and the Philippines.
The U.S. Centers for Disease and Control Prevention reported smoking decreased in the U.S. from 20.9% in 2005 to 14% in 2019. The U.S. also saw the lowest number of cigarette smokers ages 18 to 25.
Despite the reported decrease in smoking, Rizzo said, other data remains high because nicotine is one of the most addictive substances. He said the early adoption of smoking in teens makes quitting difficult later in life.
Roughly 89% of smokers become addicted by age 25, and the authors of the study said there needs to be a targeted focus on young people, the Guardian reported.
Rizzo added nicotine addiction needs to be tackled with multiple interventions, including pharmacologic and counseling support. But he said health care coverage for medications and counseling may not be accessible to everyone.
Many smokers use nicotine as a stress reliever. Rizzo said the past year has brought on job, family and relationship stressors that can make it harder to quit.
Rizzo and the study’s lead author, Marissa Reitsma, agree smoking won't end anytime soon.
“Young people are particularly vulnerable to addiction, and with high rates of cessation remaining elusive worldwide, the tobacco epidemic will continue for years to come unless countries can dramatically reduce the number of new smokers starting each year,” Reitsma told The Guardian.
The study estimated the prevalence of smoking in 204 countries, with 113 of them seeing an increase of smokers since 1990.
The study also said smoking was likely to increase over the next decades, and tobacco control policies were needed to increase life expectancy and decrease health care costs.
New tobacco control policies have been introduced over the past few years. The Biden administration announced a plan in April to ban menthol cigarettes and flavored cigars.
"Banning menthol – the last allowable flavor – in cigarettes and banning all flavors in cigars will help save lives, particularly among those disproportionately affected by these deadly products," Dr. Janet Woodcock, acting head of the Food and Drug Administration, said in a statement. "With these actions, the FDA will help significantly reduce youth initiation, increase the chances of smoking cessation among current smokers, and address health disparities experienced by communities of color, low-income populations, and LGBTQ+ individuals, all of whom are far more likely to use these tobacco products."
And in 2019, President Donald Trump signed legislation to raise the federal minimum age for the sale of tobacco products from 18 to 21.
Despite the "unsurprising" trends found in the study, Rizzo said, tobacco use will decrease with government and societal pressure and effort.
"We can't relax our efforts despite any numbers or studies. We need to do everything we can to decrease the smoking prevalence."
Tobacco sector ready to lead the way on recovery
Years of battling adversity – and a strong domestic performance during the pandemic – has put the tobacco sector in a good position to help as travel retail rebuilds
The travel retail tobacco sector is no stranger to adversity.
After years battling against challenges ranging from packaging restrictions to in-store space, the tobacco industry’s travel retail players are used to adapting and recovering.
That skill is going to be more important than ever as the market seeks to bounce back from the pandemic.
“This crisis has shown us once again how resilient the tobacco category is,” says Antonio Vencesla, World Wide Duty Free Corporate Affairs & Communications Director for JTI.
“The tobacco conversion rate, which has always been the highest among all categories, continues driving store footfall and, according to our key retail partners, this is even more evident now.”