One of Biggest Public Health Threats – Smoking in Developing Countries


SEATTLE — Tobacco kills over seven million people every year. While the prevalence of tobacco use is declining in many high-income countries due to increased tobacco control laws, smoking in developing countries is still on the rise.

The Tobacco Epidemic

The WHO defines the tobacco epidemic as “one of the biggest public health threats the world has ever faced.” Over six million people die annually from direct tobacco consumption and hundreds of thousands more die from the effects of second-hand smoke exposure. Smokers are at a significantly higher risk of heart disease, stroke and lung cancer.

To counter this global health epidemic, the WHO established the Framework Convention on Tobacco Control (FCTC) in 2005. The 180 parties within the convention have committed to implementing comprehensive measures in order to reduce tobacco consumption. Among others, the convention encourages price and tax increases, regulations of smoking in public places, limitations of tobacco advertisement and warning labels on packaging.

Although there is progress in the implementation of some of these measures in member countries, the FCTC 2016 Global Progress Report concluded that “the pace of implementation needs to be accelerated.” The countries that were unable to implement the convention’s measures cited a lack of resources, interference of the tobacco industry as well as a lack of legislative enforcement and political support.

Many high-income countries have achieved progress with their anti-smoking campaigns in recent years. The number of smokers in wealthy countries has declined, such as in the U.S., Australia and the UK.

Growing Revenue or Fostering Health

In their search for new markets, big tobacco companies have shifted their attention toward developing countries. As their populations are growing and living standards are rising, smoking in developing countries promises growing revenue. A 2015 study found that people in lower-income countries were exposed to 80 percent more tobacco ads than people in high-income countries – ads that often specifically targeted young people.

Additionally, tobacco companies continue to fight governments’ efforts to implement regulations and anti-smoking policies. Dr. Vinayak Prasad, head of the WHO tobacco control program, explains that they use intimidating practices and threats, domestic and international trade litigation and myths about their contribution to the economy to thwart anti-smoking policies.

Thus, the increase of smoking in developing countries negates the decline of tobacco consumption in some parts of the world. In 2014, China consumed the highest number of cigarettes per person – more cigarettes than the next 29 countries on the list combined. But the biggest growth rate of tobacco consumption occured in the WHO Eastern Mediterranean region, where consumption increased by one third between 2000 and 2014.

The World Lung foundation warns that “Africa presents the greatest risk in terms of future growth in tobacco use” due to their population and economic growth, and calls for appropriate prevention policies in order to forestall hundreds of millions of deaths in the 21st century.

Ending Tobacco Ads  

After a five-year legal battle, the World Trade Organization ruled in May that Australia’s laws restricting the use of logos and distinctive colors on tobacco packaging were a legitimate public health measure. The decision was a landmark victory that could give green light to similar laws in other countries. “We have a number of developing countries which have now picked up warning labels,” Prasad said.

Despite this small victory, more needs to be done in order to reduce the influence of big tobacco, contain the tobacco epidemic and inhibit millions of preventable deaths.

Lena Riebl
Photo: Flickr


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