Rationale for tobacco use as a risk factor for chronic disease

Introduction

The questions in this module measure: History of tobacco use Current type of tobacco use Current frequency of tobacco use

Research findings

Some research findings related to tobacco use are as follows: About 1.3 billion people worldwide smoke and the number of smokers continues to rise. Among these, about 84% live in developing and transitional economy countries.1 Tobacco is the fourth most common risk factor for disease and the second major cause of death worldwide. It is currently responsible for the death of one in ten adults worldwide (about 4.9 million deaths each year).2 If the current smoking pattern continues, it is estimated that deaths from tobacco consumption will be about 10 million people per year by 2020.2 Smokers have markedly increased risk of multiple cancers, particularly lung cancer, and are at far greater risk of heart disease, stroke, Chronic Obstructive Pulmonary 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 birth weight babies are known outcomes of smoking during pregnancy.3 A 2000 report estimated that productive assets equal to 1% or more of global GDP are lost each year due to smoking.4 Applying this result to global GDP for 2005 suggests that over US$ 600 thousand million in productive assets may be lost annually.5 Many studies have shown that in the poorest households in some low-income countries as much as 10% of total household expenditure is on tobacco. In addition to its direct health effects, tobacco leads to malnutrition, increased health care costs and premature death.6, 7, 8 It has also been shown that non-smokers exposed to second hand smoke have a 25 to 35% increased risk of suffering acute coronary diseases, and increased frequency of chronic respiratory conditions.9 Small 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).10 The World Bank estimates that in high-income countries, smoking-related healthcare accounts for between 6 and 15 percent of all annual health-care costs.11

Reference

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

use. Economics of Tobacco control paper No 6. Health, Nutrition and Population 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 Health Organization, 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/factbook 6. 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 Exposure to Environmental Tobacco Smoke. September 1997 11. Curbing the epidemic. Governments and the Economics of Tobacco Control. Washington DC, The World Bank, 1999.