Key info
- Tobacco kills as much as half of its customers who don’t give up (1–3).
- Tobacco kills greater than 7 million folks annually, together with an estimated 1.6 million non-smokers who’re uncovered to second-hand smoke (4).
- Round 80% of the world’s 1.3 billion tobacco customers reside in low- and middle-income international locations.
- To deal with the tobacco epidemic, WHO Member States adopted the WHO Framework Conference on Tobacco Management (WHO FCTC) in 2003. At the moment 183 international locations are Events to this treaty.
- The WHO MPOWER measures are according to the WHO FCTC and have been proven to avoid wasting lives and scale back prices from averted healthcare expenditure.
Overview
The tobacco epidemic is likely one of the largest public well being threats the world has ever confronted, chargeable for over 7 million deaths yearly in addition to incapacity and long-term affected by tobacco-related illnesses (4).
All types of tobacco use are dangerous, and there’s no protected degree of publicity to tobacco. Cigarette smoking is the most typical type of tobacco use worldwide. Different tobacco merchandise embrace waterpipe tobacco, cigars, cigarillos, heated tobacco, roll-your-own tobacco, pipe tobacco, bidis and kreteks, and smokeless tobacco merchandise.
Round 80% of the 1.3 billion tobacco users worldwide reside in low- and middle-income international locations, the place the burden of tobacco-related sickness and dying is heaviest. Tobacco use contributes to poverty by diverting family spending from fundamental wants comparable to meals and shelter to tobacco. This spending behaviour is tough to curb as a result of tobacco is so addictive.
The financial prices of tobacco use are substantial and embrace vital well being care prices for treating the illnesses attributable to tobacco use in addition to the misplaced human capital that outcomes from tobacco-attributable morbidity and mortality.
Key measures to cut back the demand for tobacco
Surveillance is essential
Good monitoring tracks the extent and character of the tobacco epidemic and signifies how greatest to tailor insurance policies. Nearly half of the world’s inhabitants are recurrently requested about their tobacco use in nationally consultant surveys amongst adults and adolescents.
More on monitoring tobacco use
Second-hand smoke kills
Second-hand smoke is the smoke that fills eating places, workplaces, houses, or different enclosed areas when folks smoke tobacco merchandise. There isn’t any protected degree of publicity to second-hand tobacco smoke. Second-hand smoke causes critical cardiovascular and respiratory illnesses, together with coronary coronary heart illness and lung most cancers, and kills round 1.6 million folks prematurely yearly.
Over third of the world’s inhabitants dwelling in 79 international locations are protected by complete nationwide smoke-free legal guidelines.
Tobacco customers need assistance to give up
Amongst people who smoke who’re conscious of the hazards of tobacco, most wish to give up. Counselling and drugs can greater than double a tobacco consumer’s probability of profitable quitting.
Nationwide complete cessation companies with full or partial cost-coverage can be found to help tobacco customers to give up in solely 31 international locations, representing a 3rd of the world’s inhabitants.
Pictorial well being warnings work
Laborious-hitting anti-tobacco mass media campaigns and pictorial well being warnings stop kids and different susceptible teams from taking over tobacco use, and improve the variety of tobacco customers who give up.
In the present day 62% of the world’s inhabitants reside within the 110 international locations that meet greatest follow for graphic well being warnings, which incorporates amongst different standards, giant (50% or extra of the primary areas of the package deal) pictorial well being warnings displayed within the nationwide language and rotating recurrently.
2.9 billion folks reside within the 36 international locations which have aired at the least one robust anti-tobacco mass media marketing campaign throughout the final 2 years.
More on tobacco health warnings
Bans on tobacco promoting decrease consumption
Tobacco promoting promotion and sponsorship (TAPS) will increase and sustains tobacco use by successfully recruiting new tobacco customers and discouraging tobacco customers from quitting.
Multiple third of nations (68), representing over 1 / 4 of the world’s inhabitants, have fully banned all types of TAPS.
More on tobacco advertising bans
Taxes are efficient in decreasing tobacco use
Tobacco taxes are probably the most cost-effective option to scale back tobacco use, particularly amongst youth and low-income teams. A tax improve that will increase tobacco costs by 10% decreases tobacco consumption by about 4% in high-income international locations and about 5% in low- and middle-income international locations.
Even so, excessive tobacco taxes are hardly ever applied. Solely 41 international locations, with 12% of the world’s inhabitants, have launched taxes on tobacco merchandise in order that at the least 75% of the retail value is tax.
Illicit commerce of tobacco merchandise have to be stopped
The illicit commerce in tobacco merchandise poses main well being, financial and safety issues world wide. It’s estimated that 1 in each 10 cigarettes and tobacco merchandise consumed globally is illicit.
Expertise from many international locations demonstrates that illicit commerce could be efficiently addressed even when tobacco taxes and costs are raised, leading to elevated tax revenues and decreased tobacco use.
The WHO FCTC Protocol to Remove the Illicit Commerce of Tobacco Merchandise (ITP) is the important thing provide facet coverage to cut back tobacco use and its well being and financial penalties.
More on eliminating the illicit trade of tobacco products
Newer nicotine and tobacco merchandise
Heated tobacco merchandise (HTPs) are tobacco merchandise that produce aerosols containing nicotine and poisonous chemical compounds upon heating of the tobacco, or activation of a tool containing the tobacco. They comprise the extremely addictive substance nicotine, non-tobacco components and are sometimes flavoured.
Regardless of claims of “threat discount”, there isn’t any proof to display that HTPs are much less dangerous than typical tobacco merchandise. Many toxicants present in tobacco smoke are at considerably decrease ranges in HTP aerosol however HTP aerosol incorporates different toxicants discovered typically at increased ranges than in tobacco smoke, comparable to glycidol, pyridine, dimethyl trisulfide, acetoin and methylglyoxal.
Additional, some toxicants present in HTP aerosols should not present in typical cigarette smoke and should have related well being results. Moreover, these merchandise are extremely variable and a number of the toxicants discovered within the emissions of those merchandise are carcinogens.
More on heated tobacco products
Digital cigarettes (or e-cigarettes) are the most typical type of digital nicotine supply methods (ENDS) and digital non-nicotine supply methods (ENNDS) however there are others, comparable to e-cigars and e-pipes. ENDS comprise various quantities of nicotine and dangerous emissions. Use of ENDS/ENNDS merchandise is colloquially known as ‘vaping’. Nevertheless this doesn’t imply that they’re innocent or emit water vapour.
E-cigarette emissions usually comprise nicotine and different poisonous substances which can be dangerous to customers and non-users who’re uncovered to the aerosols second-hand. Some merchandise claiming to be nicotine-free have been discovered to comprise nicotine.
Proof reveals that these merchandise are dangerous to well being and should not protected. Nevertheless, it’s too early to supply a transparent reply on the long-term impacts of utilizing them or being uncovered to them. Some latest research counsel that ENDS use can improve the chance of coronary heart illness and lung problems. Nicotine publicity in pregnant girls can have unfavourable well being penalties on the fetus, and nicotine, which is a extremely addictive substance is damaging for mind growth.
Nicotine pouches are pre-portioned pouches that comprise nicotine and are much like conventional smokeless tobacco merchandise comparable to snus in some respects together with look, inclusion of nicotine and method of use (inserting them between the gum and lip). They’re usually promoted, as “tobacco-free”, which can be utilized wherever and in some jurisdictions, such because the USA, they’re known as “white pouches”.
WHO response
There’s a elementary and irreconcilable battle between the tobacco trade’s pursuits and public well being coverage pursuits. The tobacco trade produces and promotes a product that has been confirmed scientifically to be addictive, to trigger illness and dying and to provide rise to quite a lot of social ills, together with elevated poverty.
The dimensions of the human and financial tragedy that tobacco imposes is surprising, and in addition preventable. The tobacco trade is preventing to make sure the hazards of their merchandise are hid, however we’re preventing again.
The WHO FCTC is a milestone within the promotion of public well being. It’s an evidence-based treaty that reaffirms the correct of individuals to the best commonplace of well being, gives authorized dimensions for worldwide well being cooperation and units excessive requirements for compliance. Since its entry into drive in 2005, the WHO FCTC has 182 Events masking greater than 90% of the world’s inhabitants.
In 2007, WHO launched a sensible, cost-effective initiative to scale up implementation of the demand discount provisions of the WHO FCTC, referred to as MPOWER.
The 6 MPOWER measures are:
- Monitor tobacco use and prevention insurance policies.
- Defend folks from tobacco use.
- Provide assist to give up tobacco use.
- Warn in regards to the risks of tobacco.
- Implement bans on tobacco promoting, promotion and sponsorship.
- Increase taxes on tobacco.
WHO has been monitoring MPOWER measures since 2007. For extra particulars on progress made for tobacco management at world, regional and nation degree, please discuss with the sequence of WHO reports on the global tobacco epidemic.
References
(1) Doll R, Peto R, Boreham J, Sutherland I. Mortality in relation to smoking: 50 years’ observations on male British medical doctors. BMJ. 2004 Jun 26;328(7455):1519.
(2) Banks, E., Joshy, G., Weber, M.F. et al. Tobacco smoking and all-cause mortality in a big Australian cohort examine: findings from a mature epidemic with present low smoking prevalence. BMC Med 13, 38 (2015).
(3) Siddiqi, Okay., Husain, S., Vidyasagaran, A. et al. International burden of illness attributable to smokeless tobacco consumption in adults: an up to date evaluation of knowledge from 127 international locations. BMC Med 18, 222 (2020).
(4) International Burden of Illness 2023. [online application]. Seattle: Institute for Well being Metrics and Analysis; 2025 (https:// vizhub.healthdata.org/gbd-compare/).[to be published July 2025]
(5) WHO global report on trends in prevalence of tobacco use 2000-2030. WHO, Geneva, 2024
