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Rationale for tobacco use as a risk factor for chronic disease

Introduction The questions in this module measure:

History of tobacco useCurrent type of tobacco useCurrent frequency of tobacco use

Research

findingsSome research findings related to tobacco use are as follows:

About 1.3 billion people worldwide smoke and the number of smokerscontinues to rise. Among these, about 84% live in developing and transitionaleconomy countries.1

Tobacco is the fourth most common risk factor for disease and the secondmajor cause of death worldwide. It is currently responsible for the death of onein ten adults worldwide (about 4.9 million deaths each year).

2

If the current smoking pattern continues, it is estimated that deaths fromtobacco consumption will be about 10 million people per year by 2020.2

Smokers have markedly increased risk of multiple cancers, particularly lungcancer, and are at far greater risk of heart disease, stroke, Chronic ObstructivePulmonary Disease (COPD), diabetes, and other fatal and non-fatal diseases.People who chew tobacco risk cancer of the lip, tongue and mouth.

3

Intra Uterine Growth Retardation, spontaneous miscarriages and low birthweight babies are known outcomes of smoking during pregnancy.3

A 2000 report estimated that productive assets equal to 1% or more of globalGDP are lost each year due to smoking.4Applying this result to global GDP for2005 suggests that over US$ 600 thousand million in productive assets may belost annually.5

Many studies have shown that in the poorest households in some low-incomecountries as much as 10% of total household expenditure is on tobacco. Inaddition to its direct health effects, tobacco leads to malnutrition, increasedhealth care costs and premature death.

6, 7, 8

It has also been shown that non-smokers exposed to second hand smoke have a25 to 35% increased risk of suffering acute coronary diseases, and increasedfrequency of chronic respiratory conditions.

9Small children whose parents

smoke at home have an increased risk of suffering lower tract respiratory

infections, middle ear infection and Sudden Infant Death Syndrome (SIDS).10The World Bank estimates that in high-income countries, smoking-related

healthcare accounts for between 6 and 15 percent of all annual health-carecosts.11

Reference 1. Guindon G E, Boisclair D. Past, Current and Future trends in Tobacco

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use. Economics of Tobacco control paper No 6. Health, Nutrition andPopulation discussion paper. 2003.

2. The World Health Report 2002: Reducing risks, promoting healthy life.Geneva, World Health Organization, 2002.

3. Building blocks for Tobacco control, A handbook. Geneva, World HealthOrganization, 2004.4. "Estimating the costs of tobacco use". In Chaloupka, F. and P. Jha, eds.,Tobacco control in developing countries. Oxford University Press. p. 97

5. CIA World Fact Book. www.cia.gov/cia/publications/factbook6. Tobacco and Poverty: A vicious cycle. World Health Organization, 2004.7. Karki Y B et al. A study on the economics of tobacco in Nepal. HNP

Discussion Paper, Economics of tobacco control. Paper no: 13, 2003.8. Sesma-Vazquez S et al. Tobacco demand in Mexico:1992-1998. Salud

Public de Mexico. Vol 44(1), 2002:S82-S92.9. He, J.; Vupputuri, S.; Allen, K.; et al. Passive Smoking and the Risk of

Coronary Heart Disease-A Meta-Analysis of Epidemiologic Studies. New

England Journal of Medicine 1999; 340: 920-6.10.California Environmental Protection Agency. Health Effects of Exposureto Environmental Tobacco Smoke. September 1997

11.Curbing the epidemic. Governments and the Economics of TobaccoControl. Washington DC, The World Bank, 1999.

http://www.cia.gov/cia/publications/factbookhttp://www.cia.gov/cia/publications/factbook