Společnost pro léčbu závislosti na tabáku

Tobacco use falling: WHO urges countries to invest in helping more people to quit tobacco

World Health Organization 16 November 2021 News release

The fourth WHO global tobacco trends report released today, shows that there are 1.30 billion tobacco users globally compared to 1.32 billion in 2015. This number is expected to drop to 1.27 billion by 2025.  

Sixty countries are now on track to achieving the voluntary global target of a 30% reduction in tobacco use between 2010 and 2025:  two years ago only 32 countries were on track. Millions of lives have been saved by effective and comprehensive tobacco control policies under the WHO Framework Convention on Tobacco Control (WHO FCTC) and MPOWER – a great achievement in the fight against the tobacco epidemic

“It is very encouraging to see fewer people using  tobacco each year, and more countries on track to meet global targets,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “We still have a long way to go, and tobacco companies will continue to use every trick in the book to defend the gigantic profits they make from peddling their deadly wares. We encourage all countries to make better use of the many effective tools available for helping people to quit, and saving lives.”

The report also urges countries to accelerate implementation of the measures outlined in the WHO FCTC in an effort to further reduce the number of people at risk of becoming ill and dying from a tobacco-related disease.

“It is clear that tobacco control is effective, and we have a moral obligation to our people to move aggressively in order to achieve the Sustainable Development Goals,” says Dr Ruediger Krech, Director of WHO Department of Health Promotion. “We are seeing great progress in many countries, which is the result of implementing tobacco control measures that are in line with the WHO FCTC, but this success is fragile. We still need to push ahead.”

A new WHO  Global Investment Case for Tobacco Cessation, highlights that investing US$ 1.68 per capita each year in evidence-based cessation interventions such as brief advice, national toll-free quit lines, and SMS-based cessation support, could help 152 million tobacco users successfully quit by 2030, saving millions of lives and contributing to countries’ long-term economic growth. To facilitate this process, WHO has established a tobacco cessation consortium, which will bring together partners to support countries in scaling up tobacco cessation. The report and the investment case  are released right after of the ninth session of the Conference of the Parties (COP9) and during the second session of the Meeting of the Parties (MOP2) to the Protocol to Eliminate Illicit Trade in Tobacco Products.

Delegates meet to counter the ambitions of the tobacco industry to keep millions hooked on its products, , as recent evidence also show that the tobacco industry used the COVID-19 pandemic to build influence with governments in 80 countries.  

Key findings of the WHO global report on trends in prevalence of tobacco use 2000–2025: 

In 2020, 22.3% of the global population used tobacco, 36.7% of all men and 7.8% of the world’s women.

Target: Currently, 60 countries are on track to achieve the tobacco use reduction target by 2025. Since the last report two years ago, two other regions – the African and South-East Asian regions - have now joined the Americas region on-track to achieve a 30% reduction.

Children: Approximately 38 million children (aged 13-15) currently use tobacco (13 million girls and 25 million boys).  In most countries it is illegal for minors to purchase tobacco products. The goal is to achieve zero child tobacco users.

Women: The number of women using tobacco in 2020 was 231 million. The age group with the highest prevalence rate among women  for tobacco use  is 55-64.

Regional trends:

Trends in the Americas: Of all WHO regions, the steepest decline in prevalence rates over time is seen in the Americas Region. The average rate of tobacco use has gone from 21% in 2010 down to 16% in 2020.

WHO’s African Region trend: this region has the lowest average rate of tobacco use at 10% in 2020, down from 15% in 2010.

WHO’s European Region trend: in Europe 18% of women still use tobacco – substantially more than in any other region. Women in Europe are the slowest in the world to cut tobacco use.  All other WHO regions are on track to reduce tobacco use rates among women by at least 30% by 2025.

WHO’s Eastern-Mediterranean Region trend: Pakistan is the only country in this region that’s  on track to reach the tobacco reduction target. Four of the six countries in the world where tobacco use is increasing are in this region.

WHO’s South East Asian Region trend: The region currently has the highest rates of tobacco use, with around 432 million users, or 29% of its population. But this  is also the region where tobacco use is declining fastest.  The region is likely to reach tobacco use rates similar to the European Region and the Western Pacific Region by 2025.

WHO’s Western Pacific Region trend: This is projected to become the region with the highest tobacco use rate among men, with more than 45% of men still using tobacco in 2025.

Policy action: One in three countries are likely to achieve the 30% reduction target, and low-income countries are currently achieving the most progress against tobacco.  Upper middle-income countries are, on average, making the slowest progress in reducing tobacco use. In some 29 countries, data quality is low or insufficient to know the trend, so more monitoring is needed.

The data behind these estimates are from 1728 national surveys run by countries between 1990 and 2020, which together asked 97% of the world’s population about their tobacco use. Article 20 of the WHO FCTC underlines the importance of running surveys to obtain evidence of the tobacco epidemic, and now 190 countries have run at least one national survey - up from 140 in 2004 when the treaty was not yet in force.  WHO and partners have made a large contribution to filling the data gaps in low- and middle-income countries via the Global Tobacco Surveillance System surveys, the STEPS survey and the World Health Survey.

Highlights from the Global Investment Case for Tobacco Cessation

To meet global targets in reducing tobacco use, cessation services need to be scaled up, along with strengthening tobacco control measures. Offering cessation services can accelerate the downward trend in tobacco use prevalence, saving more lives and protecting the health of more people.

Population-level cessation interventions include brief advice, national toll-free quit lines, and mCessation (support through mobile phone text messaging). These interventions cost very little yet deliver significant returns on investment within 10 years. Pharmacologic interventions including nicotine replacement therapy (NRT), Bupropion, and Varenicline are more expensive but are proving effective.

Data from 124 low- and middle-income countries are used to generate the analysis. 

Editors notes

The WHO report covers use of smoked tobacco (cigarettes, pipes, cigars, waterpipes, cheroots, bidis, kretek, heated tobacco products, etc) and smokeless tobacco products (oral and nasal tobacco). Use of electronic cigarettes is not analysed in the report.

The report supports the monitoring of Sustainable Development Goal (SDG) target 3.a, which calls for strengthening implementation of the WHO Framework Convention on Tobacco Control (WHO FCTC). 

The WHO “MPOWER” measures measures are in line with the WHO FCTC and have been shown to save lives and reduce costs from averted healthcare expenditure, including:

Monitoring tobacco use and prevention policies.

Protecting people from tobacco smoke.

Offering help to quit tobacco use.

Warning people about the dangers of tobacco.

Enforcing bans on tobacco advertising, promotion and sponsorship.

Raising taxes on tobacco.

All these measures are highly cost-effective, impactful and provide significant return on investment and therefore WHO recommends adopting the MPOWER package comprehensively.