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SMOKING PREVALENCE AND CIGARETTE CONSUMPTION IN 187 COUNTRIES, 1980-2012

Friday, 10th of January 2014

SMOKING PREVALENCE AND CIGARETTE CONSUMPTION IN 187 COUNTRIES, 1980-2012

Marie Ng, PhD1; Michael K. Freeman, MPH1; Thomas D. Fleming, BS1; Margaret Robinson, BA1; Laura Dwyer-Lindgren, MPH1; Blake Thomson, BA1; Alexandra Wollum, BA1; Ella Sanman, BS1; Sarah Wulf, MPH1; Alan D. Lopez, PhD2; Christopher J. L. Murray, MD, DPhil1; Emmanuela Gakidou, PhD1

[+-] Author Affiliations

1Institute for Health Metrics and Evaluation, University of Washington, Seattle 
2School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia

JAMA. 2014;311(2):183-192. doi:10.1001/jama.2013.284692. January 8, 2014, Vol 311, No. 2 >

ABSTRACT; full text available to subscribers.

See also video at http://jama.jamanetwork.com/multimediaPlayer.aspx?interactiveid=6358516

Importance  Tobacco is a leading global disease risk factor. Understanding national trends in prevalence and consumption is critical for prioritizing action and evaluating tobacco control progress.

Objective  To estimate the prevalence of daily smoking by age and sex and the number of cigarettes per smoker per day for 187 countries from 1980 to 2012.

Design  Nationally representative sources that measured tobacco use (n = 2102 country-years of data) were systematically identified. Survey data that did not report daily tobacco smoking were adjusted using the average relationship between different definitions. Age-sex-country-year observations (n = 38 315) were synthesized using spatial-temporal gaussian process regression to model prevalence estimates by age, sex, country, and year. Data on consumption of cigarettes were used to generate estimates of cigarettes per smoker per day.

Main Outcomes and Measures  Modeled age-standardized prevalence of daily tobacco smoking by age, sex, country, and year; cigarettes per smoker per day by country and year.

Results  Global modeled age-standardized prevalence of daily tobacco smoking in the population older than 15 years decreased from 41.2% (95% uncertainty interval [UI], 40.0%-42.6%) in 1980 to 31.1% (95% UI, 30.2%-32.0%; P < .001) in 2012 for men and from 10.6% (95% UI, 10.2%-11.1%) to 6.2% (95% UI, 6.0%-6.4%; P < .001) for women. Global modeled prevalence declined at a faster rate from 1996 to 2006 (mean annualized rate of decline, 1.7%; 95% UI, 1.5%-1.9%) compared with the subsequent period (mean annualized rate of decline, 0.9%; 95% UI, 0.5%-1.3%; P = .003). Despite the decline in modeled prevalence, the number of daily smokers increased from 721 million (95% UI, 700 million–742 million) in 1980 to 967 million (95% UI, 944 million–989 million; P < .001) in 2012. Modeled prevalence rates exhibited substantial variation across age, sex, and countries, with rates below 5% for women in some African countries to more than 55% for men in Timor-Leste and Indonesia. The number of cigarettes per smoker per day also varied widely across countries and was not correlated with modeled prevalence.

Conclusions and Relevance  Since 1980, large reductions in the estimated prevalence of daily smoking were observed at the global level for both men and women, but because of population growth, the number of smokers increased significantly. As tobacco remains a threat to the health of the worlds population, intensified efforts to control its use are needed.