Can the world prevent 8 million people from dying of smoking each year?

The prevalence of smoking around the world is declining. But as the world population rises there are also more smokers. Can we slow down the number of deaths from smoking?

Attempts to end the use of tobacco smoking range from Pope Urban VII issuing the first anti-smoking edict in 1590 to the first modern anti-smoking campaign launched in Nazi Germany after German scientist Franz H. Müller became the first to link lung cancer with smoking. More recently, Bhutan became the only country in the world to ban tobacco and tobacco products, China banned public officials from smoking in public, and New York City banned smoking of electronic cigarettes in public.

There's a good reason that the fight against smoking has spanned generations, cultures, and ideologies. The use of tobacco is the leading preventable cause of death in the world. An estimated five million people die each year from smoking-related diseases. Meanwhile, economies lose billions of dollars a year in lost worker productivity from smokers: $278 billion in the U.S. alone.

But in the United States it could be a lot worse if not for tobacco control measures. According to a new study from The Journal of the American Medical Association (JAMA), researchers estimate that tobacco control in the U.S. has lead to eight million fewer people dying from smoking between 1964 (when the U.S. surgeon general first issued a report on smoking laying out its negative impacts on human health) and 2012. During that time there have been an estimated 17.7 million smoking-attributable deaths.

Around the world, the prevalence of daily tobacco smoking has also gone down (25 percent for men and 42 percent for women) from 1980-2012. But, with a growing population, the total number of smokers rose (41 percent for males and 7 percent for females) over the same time period, according to another study in latest issue of JAMA. In large countries like Bangladesh, China, Indonesia and Russia, the number of smokers has been on the rise since 2006.

So how will the world prevent the number of annual smoking deaths from rising to its current projection of eight million by 2030? On a large scale, the World Health Organization suggests six main tactics:
  • Increasing tobacco taxes by 10 percent can reduce tobacco consumption by four percent in high-income countries and eight percent in low to middle-income countries. One study estimates that tripling cigarette taxes would prevent 200 million deaths this century.
  • Banning tobacco advertising, promotions, and sponsorships can lead to a decrease in tobacco consumption by an average of about 7 percent, WHO says.
  • Using graphic picture warning labels and advertisements -- only 30 countries meet "best practices" for picture warning labels.
  • Covering the costs of counseling and medication and through national comprehensive cessation services -- only 21 countries offer this.
  • Collecting data on tobacco use to implement the most effective policies.
  • Protecting people from second-hand smoke with smoke-free laws.
For individuals who want to stop smoking, there's a billion-dollar industry ready to cash-in on people trying to quit. That means pushing everything from hypnosis and acupuncture to smartphone apps to nicotine sprays. But the most controversial products are e-cigarettes, which vaporize a mixture of nicotine and other chemicals to the user. Proponents say they are a safer alternative to cigarettes and that they are a solution to wean people from nicotine. Others say their safety and effectiveness hasn't been sufficiently demonstrated

But as those arguments play out on local, national, and international stages, there is still more innovative thinking to be done as to how to best reduce smoking deaths. As researchers of the earlier study on U.S. smoking trends write in JAMA, "Tobacco control has been a great public health success story but requires continued efforts to eliminate tobacco-related morbidity and mortality."

Photo: Flickr/multisanti

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