Smoking a major global killer

Most people have an approximate understanding of the dimensions of health problems associated with cigarette smoking. But mortality statistics make the issue clearly. It is a major killer generally and by far the major preventable cause of death in the world today with 100 million killed in the twentieth century and perhaps 1 billion to die over the next 100 years. Most of the deaths to occur will do so in China and India. In these numerical terms smoking is a much more significant cause of death than war.

The WHO Framework Convention on Tobacco Control meetings occur next week and I will monitor this event. A new report on global tobacco policies has already been released which shows the overall incidence of tough anti-smoking policies globally. The MPOWER policy package proposed includes:

• Monitor tobacco use and prevention policies
• Protect people from tobacco smoke
• Offer help to quit tobacco use
• Warn about the dangers of tobacco
• Enforce bans on tobacco advertising, promotion and sponsorship
• Raise taxes on tobacco.

Key findings in the report include:

• Only 5% of the global population is protected by comprehensive national smoke-free legislation and 40% of countries still allow smoking in hospitals and schools.
• Only 5% of the world’s population lives in countries with comprehensive national bans on tobacco advertising and promotion.
• Just 15 countries, representing 6% of the global population, mandate pictorial warnings on tobacco packaging.
• Services to treat tobacco dependence are fully available in only nine countries, covering 5% of the world’s people.
• Tobacco tax revenues are more than 4000X greater than spending on tobacco control in middle-income countries and more than 9000X greater in lower-income countries.
• High- income countries collect about 340X more money in tobacco taxes than they spend on tobacco control.

My own view is that the most interesting aspects of the smoking catastrophe are about to unfold in developing countries and that this is where effort for control has the biggest potential payoffs.

BTW this is an interesting article from 2007 that I omitted to cite on industry concentration in global tobacco markets. The tobacco industry is under sustained global regulatory attack but that makes entry into the industry difficult and means that opportunities exist for market concentration to create good profits. The big prize for such global firms is, again, the Chinese tobacco market is opened up to international competition a market of 350 million is delivered.

Update: This NYT editorial sets out the policy issues confronting LDC's in clear terms.