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Global trends and projections for tobacco use, 1990–2025: an analysis of smoking indicators from the WHO Comprehensive Information Systems for Tobacco Control [1]

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Date: 2015-03-14  

Tobacco control is a global health priority. The WHO Framework Convention on Tobacco Control, which entered into force in 2005, formalised global commitment,1 and so far has been ratified by 180 parties.2 However, country-specific progress varies substantially, with very high prevalence of smoking among both men and women in many countries.3 WHO estimates that about 6 million people worldwide die each year from causes attributed to smoking, with most of these deaths occurring in low-income and middle-income countries.4 The 2011 UN political declaration on non-communicable diseases provided additional impetus both for urgent and sustained control of tobacco use and for preventive action against other risk factors for non-communicable diseases.5 In 2013, the World Health Assembly endorsed the WHO global monitoring framework for non-communicable diseases and an associated voluntary global target of a 30% relative reduction in tobacco use worldwide among people aged 15 years or older by 2025 (with 2010 levels as baseline). This target was officially agreed on by WHO member states on the basis of experience from countries that had successfully implemented at the highest level of achievement at least three of the demand reduction measures outlined in the WHO Framework Convention, and will account for varying initial starting points for tobacco control in assessment of national progress.6 This target was endorsed at the Sixth Meeting of the Convention of Parties in Moscow in October, 2014.7 Monitoring of progress towards these targets will be of enormous benefit to individual countries because it will assist them in taking necessary corrections or new actions to reduce consumption of tobacco products.

Although some country-specific estimates of prevalence and trends in tobacco smoking are available, a comprehensive and consistent set of estimates—combining historical trends and the most up-to-date data with projections of the future burden of tobacco use—is needed for as many countries as possible. The WHO Reports on the Global Tobacco Epidemic regularly provide specific-year estimates for smoking prevalence, but do not provide changes over time or levels of uncertainty around estimates.3 The Institute for Health Metrics and Evaluation recently estimated prevalence trends from 1980 to 2012, but only for one measure, daily smoking.8 Neither of these studies projected trends in smoking prevalence nor assessed target achievement.3, 8

The tobacco epidemic proceeds through distinct stages,9 which can be affected by policy interventions;10 because many countries with mature tobacco epidemics have now implemented extensive control policies under the 2003 Framework Convention,3 trends from the past 10 years can serve as a useful guide for future strategies. Synthesis of existing trend data by region and country, with projections, can provide a useful instrument to assist development for tobacco control. We aimed to provide a comprehensive and consistent set of trend estimates for four tobacco use indicators from 2000 to 2010, and projections to 2025, with target achievement probabilities under the WHO global monitoring framework, using the most comprehensive and up-to-date nationally representative data available.

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[1] Url: https://www.sciencedirect.com/science/article/pii/S0140673615602641

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