Global tobacco survey draws deadly conclusions

Aug 20, 2012

The largest look at global tobacco use has its origins at the University at Buffalo. The study, which surveyed 3 billion tobacco users in 16 different countries, was conducted by an international team led  by Gary Giovino, chair of the University at Buffalo's  Department of Community Health and Health Behavior.

Among the study's most daunting conclusions: one billion could die prematurely in this century if tobacco use trends aren't curtailed.

Two nations with fast-growing economies, China and India, combine for over a half-billion tobacco users.

In China, the government owns and promotes the tobacco industry, Giovino says, and with that, some disturbing realities are evolving among the nation's 300 million smokers.

"In addition to the very high prevalence of smoking among men, very few of the men who have ever smoked daily have quit. It's ten percent. While the prevalence of smoking among Chinese men is 50 percent, only ten percent of men who've ever smoked daily have quit," Giovino told WBFO and AM970 News.   

"We haven't seen numbers like that or percentages like that in the United States since the 1950's."

The survey shows India with nearly 280 million tobacco users, including one of the world's largest populations of smokeless- tobacco users. The numbers rival China, but Giovino says the cause appears different.

"What many observers are noticing in India is a lot of people in India smoke simply because they're hungry. They smoke or use tobacco to take the edge off that gnawing sense of needing to eat. There's a lot of hungry people in India and a lot of people use tobacco just to stave off the sense of being hungry."

Though the survey shows troubling worldwide trends, some countries  offer hopeful signs.

"In Brazil and Uruguay, they've instituted fairly substantial tobacco control strategies over the years. Focusing on helping people to quit, on protecting non-smokers, on warning people with very strong warning labels and raising prices. So tobacco control has been instituted in those countries and they're seeing the benefits now," Giovino said.

"It points out what can be done."

When asked for a simple solution to the complex realities of widespread global tobacco use, Giovino offers quick answer.

"Raising taxes."

Giovino argues that when taxes elevate tobacco prices, usage drops.

It's been a successful strategy in parts of the United States, though it has been allowed to wane in certain instances.

Giovino sits on the New York State Tobacco Use Prevention and Control Program Advisory Board which has had its budget cut by 50 percent despite the state having some of the highest tobacco taxes in the nation.

"For example, the trends in youth smoking were declining rapidly and then states started cutting programs and those trends leveled off. Why did they start cutting programs? Unfortunately, the evidence shows the programs that are effective often get cut," Giovino said.

"That's a political issue. That's politics winning. The influence of the tobacco industry winning and not public health-common sense winning."

The study is published in the recent issue of  The Lancet.

Professor Giovino discussed his findings in an interview with WBFO and AM970 News. That interview is posted here.