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| Stages of worldwide tobacco epidemic. Adapted from Lopez et al. A descriptive model of the cigarette epidemic in developed countries. Tobacco Control 1994;3:242-7 |
Who smokes tobacco?
Cigarette smoking first became a mass phenomenon in the United Kingdom and other more affluent countries in the early 20th century after the introduction of cheap, mass produced, manufactured cigarettes. Typically, a “smoking epidemic” in a population develops in four stages: a rise and then decline in smoking prevalence, followed two to three decades later by a similar trend in smoking related diseases. Usually, the uptake and consequent adverse effects of smoking occur earlier and to a greater degree among men.
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| Prevalence of smoking of manufactured cigarettes in Great Britain. Data from Tobacco Advisory Council (1948-70) and general household survey (1972-2001) |
In the United Kingdom there are about 13 million smokers, and worldwide an estimated 1.2 billion. Half of these smokers will die prematurely of a disease caused by their smoking, losing an average of eight years of life; this currently represents four million smokers each year worldwide. Deaths from smoking are projected to increase to more than 10 million a year by 2030, by which time 70% of deaths will be in developing countries.
The prevalence of smoking among adults in the United Kingdom has declined steadily from peaks in the 1940s in men and the late 1960s in women. However, this reduction in overall prevalence during stage 4 of the epidemic disguises relatively static levels of smoking among socioeconomically disadvantaged groups, making smoking one of the most important determinants of social inequalities in health in the developed world. Smoking has also declined much more slowly among young adults in the United Kingdom. The decline in smoking in the United Kingdom and some other developed countries may now be coming to an end. For example, since 1994 the prevalence of smoking in UK adults has remained at about 28%.
The prevalence of smoking among adults in the United Kingdom has declined steadily from peaks in the 1940s in men and the late 1960s in women. However, this reduction in overall prevalence during stage 4 of the epidemic disguises relatively static levels of smoking among socioeconomically disadvantaged groups, making smoking one of the most important determinants of social inequalities in health in the developed world. Smoking has also declined much more slowly among young adults in the United Kingdom. The decline in smoking in the United Kingdom and some other developed countries may now be coming to an end. For example, since 1994 the prevalence of smoking in UK adults has remained at about 28%.
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| Cigarette smoking by deprivation level in Great Britain. Data from general household survey |
Whereas countries in western Europe, Australasia, and the United States may be in stage 4 of the smoking epidemic, in
many developing countries the epidemic is just beginning.
Smoking in low and middle income countries is increasing
rapidly—for example, the prevalence of smoking among male in populous Asian countries is now far higher than in Western countries—45% in India, 53% in Japan, 63% in China, 69% in Indonesia, and 73% in Vietnam.
many developing countries the epidemic is just beginning.
Smoking in low and middle income countries is increasing
rapidly—for example, the prevalence of smoking among male in populous Asian countries is now far higher than in Western countries—45% in India, 53% in Japan, 63% in China, 69% in Indonesia, and 73% in Vietnam.
