The sixth edition of The Tobacco Atlas and its companion website TobaccoAtlas.org finds the tobacco industry is increasingly targeting vulnerable populations in emerging markets, such as Africa, Asia, and the Middle East, where people are not protected by strong tobacco control regulations. The report was released at the 17th World Congress on Tobacco OR Health in Cape Town, South Africa.
The Atlas, co-authored by ACS and Vital Strategies, graphically details the scale of the tobacco epidemic around the globe. It shows where progress has been made in tobacco control, and describes the latest products and tactics being deployed by the tobacco industry to grow its profits and delay or derail tobacco control efforts. In response to an evolving tobacco control landscape, the Sixth Edition includes new chapters on regulating novel products, partnerships, tobacco industry tactics and countering the industry.
In 2016 alone, tobacco use caused more than 7.1 million deaths worldwide (5.1 million in men, 2.0 million in women). Most of these deaths were attributable to cigarette smoking, while 884,000 were related to secondhand smoke. The increase in tobacco-related disease and death has been outpaced by the increase in industry profits. The combined profits of the world's biggest tobacco companies exceeded $62.27 billion in 2015, the last year on record for all the major companies. This is equivalent to $9,730 for the death of each smoker, an increase of 39% since the last Atlas was published in 2015, when the figure stood at $7,000.
"Every death from tobacco is preventable, and every government has the power reduce the human and economic toll of the tobacco epidemic," said Jeffrey Drope, PhD, co-editor and author of The Atlas and our vice president, Economic and Health Policy Research. "It starts by resisting the influence of the industry and implementing proven tobacco control policies." (Jeffrey is pictured in the top image.)
"Tobacco causes harm at every stage of its life cycle, from cultivation to disposal," said Dr. Neil Schluger, Vital Strategies' senior advisor for science and co-editor and author of The Atlas. "It is linked to an ever-increasing list of diseases, burdens health systems, and exacerbates poverty, especially when a breadwinner falls ill and dies from tobacco use. . . The only way to avert this harm is for all governments to vigorously implement the Framework Convention on Tobacco Control and to enforce the proven strategies that reduce tobacco use."
Tobacco use and exposure to secondhand smoke costs the global economy more than two trillion dollars every year – equivalent to almost 2% of the world's total economic output. Low- and middle-income countries represent more than 80% of tobacco users and tobacco-related deaths, placing an increased share of tobacco-related costs on those who can least afford it. A growing proportion of that burden will fall on countries across Africa in the future, if governments do not implement tobacco control policies now.
Africa is at a tipping point
The Sixth Edition of The Tobacco Atlas reveals that the tobacco industry deliberately targets countries that lack tobacco control laws and exploits governments, farmers, and vulnerable populations across Africa. In Sub-Saharan Africa alone, consumption increased by 52% between 1980 and 2016 (from 164 billion to 250 billion sticks). This is being driven by population growth and aggressive tobacco marketing in countries like Lesotho, where prevalence is estimated to have increased from 15% in 2004 to 54% in 2015. Economic growth has increased consumers' ability to afford tobacco products and there is a lack of tobacco control interventions to deter tobacco use. Furthermore, in countries like Ethiopia, Nigeria, and Senegal, smoking is now more common among youth than adults – potentially increasing the future health and economic burden of tobacco in these countries.
Yet Africa has seen real successes recently. Ghana and Madagascar have introduced comprehensive bans on tobacco advertising, promotion, and sponsorship. Burkina Faso, Djibouti, Kenya, and Madagascar have implemented graphic warnings on cigarettes, an important intervention in countries with multiple dialects and for citizens in those countries who have low levels of literacy. South Africa has implemented consecutive tobacco tax increases to deter consumption, and Kenya has implemented a highly effective track-and-trace system to track and reduce illicit trade. These countries are setting an example to others across the world.
Other examples of effective tobacco control policies
In spite of the tobacco industry's efforts to impede progress, global cigarette consumption and tobacco use prevalence have declined recently thanks to an overall increase in the adoption of proven and innovative tobacco control measures. Tobacco taxes alone could deliver a 30% relative reduction in smoking prevalence by 2025. This would save 38 million lives and $16.9 trillion, just from former smokers becoming healthier.
- In 2013, the Philippines implemented one of the largest tobacco tax increases in a low- and middle-income country, leading more than 1 million smokers to quit.
- Turkey's comprehensive tobacco control strategy reduced smoking prevalence from 39.3% in 2000 to 25.9% in 2015.
- Analysis by Australia's government found that plain packaging alone resulted in 108,228 fewer smokers between December 2012 and September 2015.
- Brazil has banned all tobacco additives such as flavors used to attract children. WHO predicts that there will be 3 million fewer smokers in Brazil between 2015 and 2025.
Tobacco Atlas - Tobacco Use in Africa
Tobacco Atlas - Tobacco Industry's Actions
Tobacco Atlas - Successful Policies
Photos courtesy of Photo©Marcus Rose/The Union