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GTSS

Global Tobacco Surveillance System

The GATS Atlas


Global Adult Tobacco Survey
Acknowledgments
Funding for the Global Adult Tobacco Survey (GATS) is provided by
Bloomberg Philanthropies and Bill & Melinda Gates Foundation, through
the CDC Foundation.
Governments of Brazil, Greece, India, Malaysia, Panama, Qatar, Thailand,
and Turkey contributed funding to the GATS implementation.
We thank the thousands of field workers for their contributions as well as
the thousands of respondents for their cooperation, without whom this work
would not have been realized.
GTSS
Finally, we are grateful to Linda Andes, Rizwan Bashir, Johanna Birckmayer, Global Tobacco Surveillance System
Glenda Blutcher-Nelson, Rebecca Bunnell, Joanna Cohen, Jennifer Ellis,
Michael Eriksen, Gary Giovino, Prakash Gupta, Kelly Henning,
Muhammad Jami Husain, William Kalsbeek, Deliana Kostova,
Cynthia Lewis, Ahmed Mandil, Lazarous Mbulo, Sandra Mullin,
and Jean Paullin for their expert reviews to improve the quality
of The GATS Atlas.

The GATS Atlas


Global Adult Tobacco Survey

Samira Asma, Judith Mackay, Sophia Yang Song,


Luhua Zhao, Jeremy Morton, Krishna Mohan Palipudi
Douglas Bettcher, Lubna Bhatti, Roberta Caixeta, Rachna Chandora,
Rula Cavacos Dias, Vera Luiza da Costa e Silva, Heba Fouad,
Jason Hsia, Muhammad Jami Husain, Timothy McAfee,
Nivo Ramanandraibe, James Rarick, Dhirendra Sinha,
Brandon Talley, Edouard Tursan dEspaignet,
on behalf of the GATS Collaborative Group
First published by the CDC Foundation in 2015
Contents
Foreword 7
Preface 9
GATS Collaborative Group 10
Photo Credits 13
Disclaimer
The CDC Foundation is an independent, nonprofit organization that helps the Centers for Disease Control and Prevention do
more, faster by forging effective partnerships between CDC and individuals, foundations and
corporations to fight threats to health and safety.
Part One INTRODUCTION 14
Any reuse of this publication should not imply that WHO endorses any specific organisation or products. The use of the 1 Tobacco Products 16
WHO name and logo is not permitted without written permission from WHO.
2 The WHO FCTC 18
The designations employed and the presentation of the material in this publication do not imply the expression of any 3 MPOWER 20
opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city 4 GTSS Overview: GYTS and GATS 22
or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent
approximate border lines for which there may not yet be full agreement.
5 GTSS Overview: TQS 24
6 GATS Coverage 26
The mention of specific companies or of certain manufacturers products does not imply that they are endorsed or
recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors
and omissions excepted, the names of proprietary products are distinguished by initial capital letters.
All reasonable precautions have been taken by the World Health Organization to verify the information contained in this
publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. Part Two MONITOR USE AND POLICIES 28
The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health
Organization be liable for damages arising from its use. 7 Tobacco Use: Prevalence 30
8 Tobacco Use: Number 32
Materials prepared by employees of the United States Government as part of their official duties are a work of the United 9 Tobacco Use: Age 34
States Government and are thus in the public domain.
10 Smoking: Prevalence 36
Maps, graphics and original concept copyright Myriad Editions 2015 11 Smokeless: Prevalence 38
12 Dual Use: Smoking and Smokeless 40
ISBN (pbk): 978-0-9964232-0-5 13 Daily Smoking: Age of Initiation 42
ISBN (ebk): 978-0-9964232-1-2 14 Former Daily Smokers: Quit Ratio 44
15 Cigarettes Smoked 46
Produced for the CDC Foundation by
Myriad Editions
59 Lansdowne Place
Brighton BN3 1FL, UK
www.myriadeditions.com
Part Three PROTECT FROM SECONDHAND SMOKE 48
Edited and coordinated by Jannet King and Candida Lacey
Design, maps and graphics by Isabelle Lewis 16 Exposure to Smoke: Public Places 50
17 Exposure to Smoke: Workplace 52
Printed on paper produced from sustainable sources. 18 Exposure to Smoke: Home 54
Printed and bound in Hong Kong through Lion Production
under the supervision of Bob Cassels, The Hanway Press, London.

10 9 8 7 6 5 4 3 2 1

The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views
Part Four OFFER HELP TO QUIT 56
of the United States Government. The authors alone are responsible for the views expressed in this publication and they do 19 Tobacco Use: First of the Day 58
not necessarily represent the decisions or policies of the World Health Organization
20 Intention to Quit 60
or the Centers for Disease Control and Prevention (CDC).
21 Attempts to Quit 62
Suggested citation: 22 Advice from Health Professionals 64
Asma S, Mackay J, Song SY, Zhao L, Morton J, Palipudi KM, et al.,
The GATS Atlas. 2015. CDC Foundation, Atlanta, GA.
Part Five WARN OF DANGERS 66
Foreword
23 Beliefs about Dangers 68
If you cant measure it, you cant manage it.
24 Impact of Health Warnings 70
25 Impact of Anti-Cigarette Advertising 72 The global tobacco epidemic has now assumed pandemic proportions, with about 1.3
billion tobacco users and 6 million annual deaths from tobacco use. The epidemic also
involves substantial healthcare, social, and economic costs across high-, middle-, and
low-income countries.

In a marked advance over the last few decades, about 90 per cent of countries now
Part Six ENFORCE MARKETING BANS 74
collect data on the tobacco epidemic and are increasingly using systematic, comparable
26 Cigarette Advertising 76 data-collection systems thanks in no small part to the Global Tobacco Surveillance
27 Cigarette Promotion 78 System (GTSS).

Prior to the initiation of the GTSS in 1999, there were no international, standardized
surveys on the tobacco epidemic. Countries, in collaboration with the World Health
Organization (WHO) and the U.S. Centers for Disease Control and Prevention, have
undertaken surveys to monitor tobacco use and tobacco control measures among youth
Part Seven RAISE PRICES 80
and adults.
28 Cost and Affordability of Cigarettes 82
This Atlas highlights the findings from the Global Adult Tobacco Survey (GATS). It reflects
29 Expenditure on Cigarettes 84
the impact of the select demand-reduction strategies of the WHO Framework Convention
on Tobacco Control (WHO FCTC), which are badged by WHO as MPOWER:

Monitor tobacco use and prevention policies


Protect people from tobacco smoke
Part Eight TRACKING PROGRESS 86 Offer help to quit tobacco use
Warn about the dangers of tobacco
30 GATS Tracking Progress: Thailand 88
Enforce bans on tobacco advertising, promotion, and sponsorship
31 GATS Tracking Progress: Turkey 90
Raise taxes on tobacco
32 Integrating TQS: Sustainable Surveillance 92
33 NCDs: Global Voluntary Tobacco Targets 94 In the seven years since the publication of the first GTSS Atlas, enormous strides have
been made in adult tobacco surveillance and monitoring. In 2007, GATS was in the
planning stages, but by 2014 it has amassed data from 58 per cent of the worlds adult
population. Repeat surveys are already indicating trends in adult tobacco-use behavior,
and there are plans for the next few years to include new countries and undertake more
Part Nine REGIONAL HIGHLIGHTS 96 repeat surveys.
34 Regional Highlights: Africa 98 The Atlas outlines the many resources available for countries wishing to participate in
Regional Highlights: Eastern Mediterranean 99 such surveys. It will be an invaluable resource for governments, policy makers, public
35 Regional Highlights: Americas 100 health practitioners, scholars, and students interested in tobacco control. Several
36 Regional Highlights: Europe 102 publications have drawn upon the data, and it has been widely reported in the media.
37 Regional Highlights: South-East Asia 104 Most importantly, it has been utilized in the GATS countries themselves as a tool for
informing and influencing decision makers, the general population, and the local media.
38 Regional Highlights: Western Pacific 106
The surveys and the Atlas are successful examples of bringing a wide array of partners 7
together: governments, researchers, donors, and international organizations. Only
through this kind of cooperation and commitment can we overcome this epidemic.

Part Ten DISSEMINATION 108


39 Data Dissemination 110


40 Timeline 112

GATS Data 114 Michael Bloomberg Thomas R. Frieden Margaret Chan


GATS Publications 124 Founder, Bloomberg Director Director General
Philanthropies and Bloomberg Centers for Disease World Health Organization
GATS Manuals 125
LP, and Mayor, New York City Control and Prevention
References 125
20022013
Index 128
Preface
The Global Adult Tobacco Survey (GATS) is part of the Global Tobacco Surveillance
System (GTSS), the largest global public health surveillance system ever developed
and maintained.

It is the ongoing, systematic collection, analysis, and interpretation of data, and


is essential to the tracking of the epidemic, and the planning, implementation and
evaluation of control measures.

The GATS Atlas paints an important landscape of tobacco use and of select tobacco
control measures stipulated by the WHO Framework Convention on Tobacco Control,
and badged by WHO under the acronym MPOWER. It includes an introduction to the
GTSS, which, over 15 years, has facilitated the development, implementation, and
evaluation of tobacco control programs and policies in countries around the world. This
publication is an expansion of The GTSS Atlas, published in 2009, which focused on
youth data from the Global Youth Tobacco Survey.

The GATS, supported by the Bloomberg Initiative to Reduce Tobacco Use, began in
2007 to systematically monitor adult tobacco use and key tobacco control measures,
initially in 14 countries. It has already been expanded to 36 countries. The GATS Atlas
covers the 22 countries for which data had been publicly released by the end of 2013.
Two countries, Thailand and Turkey, have conducted the survey twice, providing trend
data and thus the ability to evaluate progress. The GATS Atlas therefore illustrates the
dynamics of tobacco use and tobacco control policies in countries representing 3 billion
of the 5 billion adult population worldwide.

The Tobacco Questions for Surveys (TQS), a subset of key questions from GATS,
was initiated in 2010 to generate comparable data by integrating a smaller number
of standard tobacco questions into other national and subnational surveys. Examples
from countries that have successfully integrated these questions, demonstrating a
commitment to monitoring progress towards the global voluntary tobacco targets of a
30 per cent relative reduction by 2025, are presented in these pages.

This Atlas combines data and visuals to guide and encourage decision makers and
public health practitioners to accelerate tobacco control. It aims to generate inquiry
by not only providing a portrait of each countrys progress, but also enabling rigorous
global and regional comparisons to be made. The central objective of this atlas is
to make data visualization both simpler and more friendly, which we hope we have
accomplished.

We thank the contributors, reviewers, and publishers for their tireless support and
advice. Our sincere appreciation goes to the GATS Collaborative Group for their
commitment and invaluable contributions to the initiative. We would also like to
express our gratitude to country collaborators, interviewers, and respondents for being 9
an integral and indispensable part of this initiative. Finally, this would not be possible
without the support of Bloomberg Philanthropies and Bill & Melinda Gates Foundation.

The authors
January 2015
GATS Collaborative Group
National Collaborators

Argentina Ministry of Health (MoH), Instituto Nacional de Bruno Linetzky (MoH), Daniel Ferrante (MoH), Jonatan Turkey Ministry of Health (MoH), Turkish Statistical Turan Buzgan, Hasan Irmak, Hseyin lter, Bekir Keskinkl
Estadistica y Censos (INDEC) Konfino (MoH), Dolores Ondarsuhu (INDEC) Institute (TurkStat), Hacetteppe University (HU) (MoH), Sertac Polat, Gnl ulha (MoH), Enver Tasti,
Ramazan Celikkaya, Guzin Erdogan, Ylmaz Ersahin,
Bangladesh Ministry of Health and Family Welfare (MoHFW), A.F.M. Ruhal Haque (MoHFW), Md. Amirul Hasan Ayse Toprak, Cengiz Erdogan, Mehmet zmen, Ramazan
National Institute of Preventive & Social Medicine (NIPSOM), Durgapada Bhattachariya (BBS), Ahsanul Alam Celikkaya (Turkstat), Nazmi Bilir, Hilal zcebe (HU)
(NIPSOM), Bangladesh Bureau of Statistics (BBS) (NIPORT)
National Institute of Population, Research & Ukraine Ministry of Health (MoH), Kiev International Alla Grygorenko, Konstantin Krasovsky (MoH), Natalia
Training (NIPORT) Institute of Sociology (KIIS), School of Public Kharchenko, Volodymyr Paniotto (KIIS), Tatiana Andreeva
Health, National University of Kyiv-Mohyla (SPH)
Brazil Ministry of Health-Secretariat of Health Deborah Carvalho Malta (MoH-SVS), Eduardo Pereira Academy (SPH)
Surveillance (SVS), Brazilian Institute of Geography Nunes, Marcia Quintslr, Cimar Azeredo, Wasmlia Bivar
& Statistics (IBGE), National Cancer Institute (IBGE), Maria Lucia Pereira (IBGE), Liz Maria de Almeida Uruguay Ministry of Health (MoH), National Statistics Winston Abascal, Ana Lorenzo (MoH), Franco Gonzlez
(INCA), The National Health Surveillance Agency (INCA), Humberto Martins (ANVISA), Ana Cludia Andrade Institute (INE) Mora (INE)
(ANVISA) (ANVISA)
Viet Nam Ministry of Health (MoH), Vietnam Standing Office Phan Thi Hai (MoH), Nguyen The Quan (GSO), Hoang Van
China Ministry of Health (MoH), Chinese Center for Qi Shi (MoH), Gonghuan Yang, Yan Yang, Lin Xiao, Qiang Li on Smoking and Health (VINACOSH), General Minh (HMU), Kim Bao Giang (HMU)
Disease Control (China CDC) (China CDC) Statistics Office (GSO), Hanoi Medical University
(HMU)
Egypt Ministry of Health (MoH), Central Agency for Sahar Latif Labib (MoH), Awatef Hussein (CAPMAS)
Public Mobilization & Statistics (CAPMAS)
Greece National School of Public Health (NSPH), MRB Anastasia Barbouni (NSPH), Eleni Antoniadou (NSPH) International Collaborators
Heallas, University of Thessally
India Ministry of Health & Family Welfare (MoHFW) Anuradha Vemuri, Jagdish Kaur (MoHFW), F. Ram, Sulabha World Health Organization (WHO) Tobacco Free Initiative CDC Foundation
Government of India, International Institute for Parasuraman, SK Singh (IIPS) Headquarters: Douglas Bettcher, Lubna Bhatti, Rachna Chandora, Connie Granoff, William Parra, Brandon Talley
Population Sciences (IIPS) Edouard Tursan dEspaignet, Sameer Pujari, Ayda Yurekli
Indonesia National Institute of Health Research and Soewarta Kosen (NIHRD), Kadarmanto (BPS), Salvator AFRO: A.E. Ogwell Ouma, Nivo Ramanandraibe Johns Hopkins Bloomberg School of Public Health
Development (NIHRD), Badan Pusat Statistik- Happy Hardjo (BPS) Country Offices: Nigeria: Emmanuel Musa Rajeev Cherukupalli, Joanna Cohen
Statistics Indonesia (BPS) AMRO-PAHO: Adriana Blanco, Roberta de Betania Caixeta
Country Offices: Argentina: Humberto Montiel; Brazil: Enrique Gil; Campaign for Tobacco Free Kids
Malaysia Ministry of Health (MoH), Institute of Public Health Helen Tee Guat Hiong (IPH), Sukhvinder Singh (TCU)
Mexico: Carlos Gamez; Panama: Dra Claudina Cayetano;
(IPH) within MoH, Tobacco Control Unit (TCU)
Uruguay: Julio Vignolo
within MoH RTI International
EMRO: Fatimah El Awa, Heba Fouad
Steve Litavecz, David Plotner
Mexico Ministry of Health (MoH), National Institute of Mauricio Hernandez Avila (MoH), Country Office Egypt: Randa Abou El Naga (former)
Public Health (INSP) Luz Miriam Reynales-Shigematsu (INSP) EURO: Kristina Mauer-Stender, Rula Cavacos Dias
Country Offices: Poland: Paulina Mikiewicz, Dorota Kaleta University of North Carolina, Chapel Hill
Nigeria Federal Ministry of Health (FMoH), National Bureau Michael Anibueze (FMoH), Ogbonna Nwokocha (FMoH), Mike Bowling, William Kalsbeek
(former), Anna Koziel (former); Romania: Victor Stefan;
of Statistics (NBS) Isiaka Olarewaju (NBS)
Russian Federation: Luigi Migliorini, Oleg Storozhenko (former);
Panama Ministry of Health (MoH), Gorgas Memorial Reina Roa (MoH), Beatriz Gomez (IGCES), Bernardo Iran Turkey: Toker Ergder; Ukraine: Nataliya Korol Experts & Scientific Advisors
Institute for Health Studies (IGCES), National Gonzalez (INEC), Victor Hugo Herrera (IGCES), Cecilio Nio SEARO: Khalil Rahman (former), Dhirendra N. Sinha Questionnaire Review Committee
Institute of Statistics and Census (INEC) (ICGES) Country Offices: Bangladesh: Sohel Choudhury, Ron Borland, Gary Giovino (chair), Prakash C. Gupta,
M. Mostafa Zaman; India: Vineet Munish Gill; Jeremy Morton
Philippines Department of Health (DoH), National Statistics Agnes Segarra (DoH), Glenn Barcenas, Benedicta Yabut Indonesia: Wibisana Widyastuti;
Office (NSO) (NSO) Sample Review Committee
Thailand: Chai Kritiyapichatkul
Rizwan Bashir, Michael Bowling, Jason Hsia,
Poland Ministry of Health (MoH), Maria Skodowska- Przemysaw Biliski, Adam Fronczak, Wojciech WPRO: Susan Mercado (former), Carmen Audera-Lopez,
William Kalsbeek (chair), Krishna Mohan Palipudi, Tarun K. Roy
Curie Cancer Center Institute of Oncology, Kosiski, Tadeusz Parchimowicz (MOH), Witold James Rarick
Medical University of Warsaw, Pentor Research Scientific Advisors
Zatonski, Krzysztof Przewozniak, Jakub obaszewski Country Offices: China: Sarah England (former), Angela Pratt;
International (Pentor Research International (CCI), Bolesaw Samoliski, Filip Raciborski (WUM), Malaysia: Paul Chun Soo; Philippines: Marina Miguel-Baquilod Neeraj Bhalla, Frank Chaloupka, Prabhat Jha, Jay Levinsohn,
merged with TNS OBOP and at present functions Krzysztof Siekierski (Pentor) (former), Florante Trinidad; Viet Nam: Pham Thi Quynh Nga, Judith Mackay, Ahmed Mandil, Marina Miguel-Baquilod,
10 as TNS Polska) Pham Huyen Khanh, Nguyen Tuan Lam Sir Richard Peto, Jonathan Samet, Gajalakshmi Vendhan, 11
Witold Zatonski
Qatar Supreme Council of Health (SCH), Ministry of Al Anoud Al Thanni (SCH), Kholood El Mutawa (SCH), WHO FCTC Secretariat
Development, Planning and Statistics (MDPS) Amani Elkhatim (SCH), Nasser El Mahadi (MDPS), Vera Luiza da Costa e Silva, Tibor Szilagyi
National Institutes of Health National Cancer Institute
Mansoor El Malki (MDPS)
Mark Parascandola
Romania Ministry of Health (MoH), National Institute of Amalia Canton (MoH), Sorina Irimie (NIPH), Raluca Teodoru U.S. Centers for Disease Control and Prevention (CDC)
Public Health, Regional Centre of Public Health (TCI), Sofica Musat (INS), Andreea Cambir (INS) Global Tobacco Control Branch, Office on Smoking and
Health (OSH) Bloomberg Philanthropies Bloomberg Initiative to Reduce
Cluj (NIPH), National Statistics Training Centre Tobacco Use
(INS), Totem Communication Inc. (TCI) Linda Andes, Samira Asma, Lauren Bartell, Rizwan Bashir,
Glenda Blutcher-Nelson, Rebecca Bunnell, Martine Chaussard, Jennifer Ellis, Kelly Henning
Russian Ministry of Health & Social Development (MoHSD), Maria Shevireva, Natalya Kostenko, (MoHSD), Vadim John Chiosi, Lorna English, Thomas R. Frieden, Jason Hsia,
Federation Federal State Statistics of Russia (RosStat), Nesterov, Tamara Chernisheva, Tatiana Konik (RosStat), Muhammad Jami Husain, Candace Kirksey-Jones, Bill & Melinda Gates Foundation
Pulmonary Research Institute (PRI) Galina Sakharova (PRI) Deliana Kostova, Kyung Ah Lee, Ronney Lindsey, Marcella Lottie, Jean Paullin, Cynthia Lewis
Lazarous Mbulo, Timothy McAfee, Jeremy Morton, Mai Nguyen,
Thailand Ministry of Public Health (MoPH), National Sarunya Benjakul (MoPH), Lakkhana Termsirikulchai,
Krishna Mohan Palipudi, Chelsealya Payne, Terry Pechacek,
Statistical Office (NSO), Mondha Kengganpanich (TRC), Areerat Lohtongmongkol,
Sheila Porter, Eugene Pun, Edward Rainey, Emily Ridgway,
Tobacco Control Research & Knowledge Hataichanok Puckcharern, Chitrlada Touchchai (NSO)
Simone Salandy, Sophia Y. Song, Luhua Zhao
Management Center (TRC) at Mahidol University
Photo Credits
Page 16: kreteks: FunkyPix/iStockphoto, electronic cigarette: Vladmir/iStockphoto; snus: gbrundin/
iStockphoto
Page 26 (top): CDC; (middle): CDC; (bottom): Krishna Mohan Palipudi/CDC
Page 32: CDC
Page 34: 2003 Mukunda Bogati/courtesy of Photoshare
Page 35: izusek/iStockphoto
Page 68 (left): Mark Harmel/Alamy Images; (right): Alamy Images
Page 70 (top): Commonwealth of Australia; (bottom left): Adriana Blanco/Roberta Caixeta/PAHO;
(bottom middle): Tobacco Pack Surveillance System; (bottom right): Tobacco Pack Surveillance
System
Page 71 (left): Tobacco Pack Surveillance System; (left middle): Tobacco Pack Surveillance System; (right
middle): Tobacco Pack Surveillance System; (right): Tobacco Pack Surveillance System
Page 72 (top left): Quit Victoria; (top right): Cancer Institute (NSW) 2013; (bottom): WLF 2013
Page 84: Yuri/iStock/Getty Images
Page 88 (left): Ministry of Public Health, Thailand; (middle): Ministry of Public Health, Thailand; (right):
Ministry of Public Health, Thailand
Page 90: Ministry of Health, Turkey
Page 98: Krishna Mohan Palipudi/CDC
Page 99: CDC
Page 102: Toker Erguder/WHO Turkey Country Office
Page 103 (left): Krishna Mohan Palipudi/CDC; (right): Krishna Mohan Palipudi/CDC
Page 104 (top): Krishna Mohan Palipudi/CDC; (bottom): Krishna Mohan Palipudi/CDC
Page 105: Krishna Mohan Palipudi/CDC
Page 106: CDC

13
Part One
INTRODUCTION

Preamble

The Parties to this Convention recogniz[e]


that the spread of the tobacco epidemic is a
global problem with serious consequences for
public health that calls for the widest possible
international cooperation and the participation
of all countries in an effective, appropriate and
comprehensive international response.

14 15
1 Tobacco Products
SMOKING SMOKELESS
Tobacco smoking is the combustion of the tobacco leaves Smokeless tobacco is consumed through the mouth or
and inhaling of the smoke. nose, without combustion or burning.

Manufactured cigarettes, addictive by design, Cigars are made of air-cured, fermented Chewing tobacco varieties include Snus is usually made from ground
are the predominant form of tobacco products tobacco wrapped in a tobacco leaf. They betel quid, chimo, gutkha, loose-leaf, tobacco. After water and salt are
used globally. They consist of shredded or are available in many sizes and shapes, from plug, toombak, twist. These products added, the tobacco meal is heated at
reconstituted tobacco, processed with chemicals cigarette-sized cigarillos, double coronas, are placed in the mouth, cheek, or inner high temperatures and high humidity for
and flavors and rolled into a paper. cheroots, stumpen, chuttas, and dhumtis. lip and chewed or sucked, or, in the case of 24 to 36 hours. The heating is reported
Most prevalent: Most prevalent: powders, applied to the gums or teeth. Betel quid to kill the bacteria originally present in the
Worldwide Worldwide consists of tobacco, areca nut, slaked lime, and tobacco, which appears to reduce the
flavorings wrapped in a betel leaf. Varieties of chewing formation of nitrite and TSNAs markedly. In
tobacco also include gundi, hogesoppu, kadapam, Sweden, smokeless tobacco manufacturers
Kreteks are clove-flavored cigarettes, kaddipudi, khiwam, mishri, patiwala, and zarda. adhere to the Gothiatek standard, which required the
originally from Indonesia and available Most prevalent: removal of TSNAs from snus. Flavors are added in the
Pipes are smoking devices made of briar,
internationally. The clove contains eugenol, an America, Africa, South East Asia (Bangladesh, India, finishing stage of production. Snus is typically taken
slate, or clay. Tobacco flakes
anesthetic to lessen harshness of tobacco. Kreteks Maldives, Myanmar, Nepal, Pakistan, Sri Lanka, either as a pinch that is placed in the vestibular area of
are placed in the wider
also contain special flavoring called sauces, which are Thailand), Western Pacific (Cambodia, Federal States of the upper jaw or in pre-packaged, portion-sized
opening of the pipe and burned,
unique to each brand. Micronesia, Lao, Malaysia, Palau, Viet Nam) quantities (sachets).
with the smoke passed through the stem and
Most prevalent: Most prevalent:
inhaled through the narrower opening.
Indonesia Denmark, Finland, Iceland, Norway,
Most prevalent:
Moist snuff is usually South Africa, Sweden
Worldwide
made from a mixture
Roll-your-own (RYO) of fire-and-air-cured Dry snuff is finely powdered fire-cured
INTRODUCTION

cigarettes are hand-rolled using dark tobaccos. The tobacco that is inhaled through the nose
Electronic nicotine delivery
loose tobacco and a cigarette cured tobacco is aged for at or taken by mouth.
systems (ENDS)/electronic
paper. least one year before being Most prevalent:
non-nicotine delivery systems
Most prevalent: taken for production. Moist snuff Brazil, Europe, South and Central Asia, Nigeria,
(ENNDS), of which electronic
Asia, Europe, New Zealand consumed in the American market is made from fine-cut South Africa, USA
cigarettes are the most common
tobacco, and the cutting sizes fine, coarse or long cut
prototype (also named vape pens,
result in different types of products. After cutting, the
vape pipes, hookah pens, electronic
Bidis are cigarettes consisting of tobacco is mixed with water and other ingredients and Dissolvables contain tobacco and numerous other
hookahs, etc.), are devices that do not
sun-dried tobacco flakes rolled in a allowed to ferment in closed vessels at controlled pH and agents that dissolve in the mouth and deliver nicotine via
burn or use tobacco leaves but instead
temburni or tendu leaf, and tied with a temperature for several weeks. After fermentation, further mucosal absorption. They are often brand
vaporize a solution the user then
string at one end. additives are mixed with the snuff to make it stable and to extensions of popular
inhales. The main constituent of the
Most prevalent: impart a desired flavor. Moist snuff is used in the USA cigarette brands.
solution, in addition to nicotine when
South Asia (Bangladesh, India) mainly by placing it between the lower lip and teeth. An They are advertised
nicotine is present, are propylene
alternative is available in the form of sachets (like a tea for use in any situation
n
glycol, with or without glycerol and
bag), where moist snuff is packed into porous paper-like where the user cannott
16 flavoring agents. ENDS/ENNDS 17
Waterpipes, also known as shisha, narghile, material. Other local moist products and varieties are smoke.
solutions and emissions contain other
hookah, or hubble-bubble, are smoked using iqmik (commonly used in Alaska), khaini, nass or naswar, Most prevalent:
chemicals, some of them considered to
an apparatus containing a basin of water, a and shammah. USA
be toxicants.
hose, and a mouthpiece. Flavored tobacco is Most prevalent:
Most Prevalent:
burned on a charcoal in a smoking bowl. South-East Asia, Saudi Arabia, South Africa, USA
Europe, USA, now spreading globally
The smoke is filtered through the water basin
and inhaled through the hose and
mouthpiece.
Most prevalent:
Mediterranean region, north Africa Tobacco: deadly in any form or disguise
and parts of Asia, now spreading globally
WHO, 2006
2 The WHO FCTC WHO FRAMEWORK
CONVENTION ON
TOBACCO CONTROL
As of December 2014, 180 World Health Organization The Global Tobacco Surveillance System aims to build THE WHO FCTC IS ONE OF THE MOST RAPIDLY as of 4 December 2014
(WHO) member states are parties to the WHO country capacity to monitor, develop, implement, and RATIFIED UN TREATIES OF ALL TIME
Framework Convention on Tobacco Control (WHO evaluate WHO FCTC and, in particular, select
ratified or acceded
FCTC). The Conference of the Parties (COP) is the demand-reduction measures badged by WHO under the
governing body of the WHO FCTC and is comprised of acronym of MPOWER. signed only
all Parties to the Convention. It keeps under regular ICELAND
neither signed nor ratified
review the implementation of the Convention, takes the SWEDEN FINLAND

decisions necessary to promote its effective NORWAY not applicable


implementation, and may also adopt protocols, annexes ESTONIA

and amendments to the Convention. Regular sessions of UNITED DENMARK


LATVIA
LITHUANIA

COP are now held at two-year intervals. IRELAND


KINGDOM

NETHERLANDS BELARUS
GREENLAND
Article 20.2 of the WHO FCTC states:
GERMANY POLAND
BELGIUM UKRAINE
The Parties shall establish, as appropriate,
CZECH
REPUBLIC SLOVAKIA REPUBLIC OF
LUXEMBOURG LIECHTENSTEIN MOLDOVA
programmes for national, regional and global FRANCE
AUSTRIA
SWITZ. SLOVENIA
HUNGARY
ROMANIA
RUSSIAN FEDERATION
surveillance of the magnitude, patterns, C A N A D A S. MARINO
CROATIA
BOSNIA AND HERZEGOVINA
SERBIA

determinants and consequences of tobacco


BULGARIA
MONTENEGO
MONACO
PORTUGAL ANDORRA FORMER YUGOSLAV
consumption and exposure to tobacco smoke.
ALBANIA
REPUBLIC OF
SPAIN MACEDONIA
ITALY
Towards this end, the Parties should integrate GREECE
KAZAKHSTAN
tobacco surveillance programmes into national, MONGOLIA

regional and global health surveillance programmes DEMOCRATIC PEOPLE'S


U S A
so that data are comparable and can be analysed UZBEKISTAN KYRGYZSTAN
GEORGIA REPUBLIC OF KOREA
See inset above JAPAN
AZERBAIJAN
TURKEY REPUBLIC
at the regional and international levels, as
TURKMENISTAN TAJIKISTAN
ARMENIA OF KOREA
CYPRUS SYRIAN ARAB
appropriate. TUNISIA
MALTA
LEBANON
ISRAEL
REP.
IRAQ
IRAN
(ISLAMIC
REPUBLIC OF)
AFGHANISTAN CHINA
MARSHALL ISLANDS
MOROCCO FED. STATES

The WHO Report on the Global Tobacco Epidemic, 2013


JORDAN MICRONESIA
BAHAMAS KUWAIT PAKISTAN BHUTAN KIRIBATI
CUBA DOMINICAN NEPAL NAURU
ALGERIA LIBYA
states:
MEXICO REP.
BAHRAIN
PUERTO RICO (ASSOCIATED) WESTERN EGYPT QATAR UNITED ARAB
HAITI SAHARA EMIRATES
Monitoring tobacco use and tobacco control JAMAICA
ST KITTS & NEVIS
ANTIGUA & BARBUDA
CABO
SAUDI ARABIA INDIA
BANGLADESH
MYANMAR LAO PEOPLE`S
TUVALU

measures is critical to effectively addressing the


BELIZE DOMINICA OMAN DEMOCRATIC REPUBLIC SAMOA
INTRODUCTION

VERDE MAURITANIA MALI


GUATEMALA HONDURAS ST VINCENT & THE GRENADINES ST LUCIA VANUATU COOK

epidemic and assessing the effects of global BARBADOS NIGER SUDAN THAILAND VIET NAM FIJI ISLANDS
GRENADA SENEGAL ERITREA YEMEN
EL SALVADOR
NICARAGUA TRINIDAD & TOBAGO GAMBIA CHAD
BOLIVARIAN
tobacco control. More than a quarter of countries,
BURKINA CAMBODIA TONGA NIUE
REPUBLIC OF GUINEA- FASO DJIBOUTI
COSTA RICA GUINEA
VENEZUELA BISSAU NIGERIA

BENIN
with 40% of the worlds population, regularly PHILIPPINES

GHANA
TOGO
PANAMA CTE SOUTH ETHIOPIA SRI LANKA BRUNEI
GUYANA SIERRA LEONE DIVOIRE CENTRAL PALAU
SUDAN DARUSSALAM
monitor tobacco use among adults and youth using
SURINAME LIBERIA AFRICAN REP.
COLOMBIA
FRENCH GUIANA (FR) SOMALIA MALDIVES
EQUATORIAL CAMEROON DEM. REP. UGANDA
MALAYSIA

nationally representative surveys, an increase of 14 ECUADOR


GUINEA
GABON
CONGO
KENYA SINGAPORE

countries (5% of world population) since 2007.


SO TOM
RWANDA
& PRINCIPE
CONGO
BURUNDI SEYCHELLES
UNITED REP. PAPUA
PERU OF TANZANIA I N D O N E S I A NEW
BRAZIL COMOROS
GUINEA
TIMOR-LESTE
ANGOLA SOLOMON
MALAWI
ZAMBIA ISLANDS
BOLIVIA MADAGASCAR
(PLURINATIONAL ZIMBABWE MAURITIUS
STATE OF)
NAMIBIA BOTSWANA

Main provisions
PARAGUAY MOZAMBIQUE
CHILE

AUSTRALIA
Research, surveillance and exchange of information
SWAZILAND
SOUTH
LESOTHO
Protection against interference by tobacco industry URUGUAY
AFRICA

18 Regulation of: ARGENTINA


19
B contents, packaging, and labeling of tobacco products
B prohibition of sales to and by minors
B illicit trade in tobacco products NEW
ZEALAND

B smoking at work and in public places


Reduction in consumer demand by:
B price and tax measures
B comprehensive ban on tobacco advertising, promotion and sponsorship Disclaimer
B education, training, raising public awareness and assistance with quitting The boundaries and names shown and the designations used on this map
do not imply the expression of any opinion whatsoever on the part of the
B support for economically viable alternative activities
World Health Organization concerning the legal status of any country,
B legislative action to deal with liability
territory, city or area or of its authorities, or concerning the delimitation of
Protection of the environment and the health of persons its frontiers or boundaries. Dotted and dashed lines on maps represent
approximate border lines for which there may not yet be full agreement.
3 MPOWER
In 2008, WHO identified six evidence-based tobacco
control measures that are the most effective in reducing
tobacco use. Known as MPOWER, they assist in the
country-level implementation of effective measures to
GATS TRACKING MPOWER 2.8 BILLION PEOPLE IN 54 COUNTRIES ARE COVERED MONITORING
Estimates for adults age 15 and above BY EFFECTIVE TOBACCO USE SURVEILLANCE
reduce the demand for tobacco as contained in the in 22 countries that have completed GATS
TOBACCO USE
WHO FCTC. The six proven measures are: Highest achieving countries
200813
2012
(m: million; bn: billion)
879m
Monitor tobacco use and prevention policies
Obtain nationally representative and
population-based periodic data on key indicators
Current
of tobacco use for youth and adults tobacco use

Protect people from tobacco smoke 1.2bn


Completely smoke-free environments in all indoor
public spaces and workplaces, including Exposure to
restaurants and bars, or at least 90% of the secondhand
smoke in
population covered by complete subnational
public
smoke-free legislation places
BARBADOS

Offer help to quit tobacco use


National quit-line, and both nicotine replacement 205m
Made an attempt to quit
therapy and some cessation services
smoking in the past
cost-covered 12 months
MAURITIUS
NIUE

Warn about the dangers of tobacco 241m


Large graphic health warnings on all tobacco Current smokers considering
packaging showing, in rotation, the harmful quitting because of health
warnings on cigarette
effects of tobacco use on health packaging

Enforce bans on tobacco advertising,


774m
Awareness of MONITORING OF TOBACCO USE AND TOBACCO
promotion and sponsorship tobacco
CONTROL POLICY ACHIEVEMENTS IS CENTRAL TO
Ban on all forms of tobacco advertising, advertising,
sponsorship or UNDERSTANDING AND REVERSING THE EPIDEMIC
promotion and sponsorship promotion

20 21
Raise taxes on tobacco products Average
Increase the price of tobacco products through Purchasing Power
International $2.7
Parity (PPP) cost
higher tax (at least 75% of the retail price),
paid per 20
making tobacco products progressively less manufactured
affordable cigarettes

GATS IS AN IMPORTANT TOOL TO STRENGTHEN


MONITORING, AND IS A GOLD STANDARD FOR
CONDUCTING HIGH-QUALITY SURVEILLANCE
4 GTSS Overview: GYTS and GATS
The Global Tobacco Surveillance System (GTSS)
is a global standard to monitor youth and adult GTSS Plan Repeat survey
tobacco use and key tobacco control policies. Data to Action every 3 5 years
GTSS comprises Global Youth Tobacco Survey Survey
B use of GTSS data to
(GYTS), Global Adult Tobacco Survey (GATS) Implementation
inform evidence-based
B questionnaire Conduct Data National
and Tobacco Questions for Surveys: A Subset of Data tobacco control policies
B sampling Survey Release tobacco control Track, evaluate and
Key Questions from GATS (TQS). Analysis and interventions and Implement
procedures B data analysis programs/policies interventions modify programs
enhance program
B survey
B report writing capacity
administration

GLOBAL YOUTH
GYTS Questionnaire Topics GATS
TOBACCO SURVEY
as of November 2014
Methodology B background characteristics Methodology Limitations GLOBAL ADULT
implemented original GYTS Nationally representative school-based survey of B tobacco use (smoking and smokeless) Nationally representative household Self-reported TOBACCO SURVEY
protocol 19992011 students aged 13 to 15 years. B cessation survey of persons age 15 years and Samples restricted to persons as of November 2014
also implementing revised Multistage sample design with schools selected B secondhand smoke above. living in non-institutionalized
GYTS protocol 201214 survey complete
proportional to enrollment size. B media Multistage, geographically clustered, households (military barracks,
only implementing revised Self-administered and anonymous. knowledge, attitudes, and perceptions probability-based sample design for dormitories excluded).
B now implementing
GYTS protocol 201214 cross-sectional estimates by gender
B economics
Limitations and residence.
no survey conducted school policy (GYTS only) no survey conducted
Self-reported
B
Face-to-face electronic data
not applicable Samples restricted to students in schools collection. not applicable

FINLAND
INTRODUCTION

ESTONIA
LATVIA
UNITED LITHUANIA
KINGDOM
BELARUS
POLAND
CZECH
REPUBLIC SLOVAKIA REPUBLIC OF RUSSIAN FEDERATION
RUSSIAN FEDERATION
MOLDOVA
SLOVENIA HUNGARY NORTH. MARIANA IS.
ROMANIA FED. ST. MICRONESIA
S. MARINO SERBIA
CROATIA MARSHALL IS.
BULGARIA POLAND
KAZAKHSTAN KIRIBATI UKRAINE KAZAKHSTAN
BOSNIA AND MONTENEGO UKRAINE
UK MONGOLIA
HERZEGOVINA ALBANIA GUAM
ITALY UZBEKISTAN PALAU
ROMANIA
U S A PORTUGAL FORMER YUGOSLAV GEORGIA KYRGYZSTAN
AZERBAIJAN TUVALU
REPUBLIC OF MACEDONIA TURKEY
GREECE
ARMENIA
TURKMENISTAN TAJIKISTAN REPUBLIC TOKELAU TURKEY
CYPRUS
CY SYRIAN ARAB IRAN C H I N A
OF KOREA
AMERICAN SAMOA GREECE C H I N A
TUNISIA
LEB. REP. (ISLAMIC AFGHANISTAN
ISRAEL I R A Q REPUBLIC OF) SAMOA
BAHAMAS MOROCCO
DOMINICAN Gaza Strip JORDAN
KUWAIT VANUATU UNITED
CUBA REPUBLIC ALGERIA West Bank
PAKISTAN
NEPAL
BHUTAN
ARAB PAKISTAN
LIBYA FIJI QATAR
PUERTO RICO (associated) BAHRAIN EMIRATES
MEXICO HAITI QATAR
COOK ISLANDS MEXICO EGYPT INDIA
JAMAICA BRITISH VIRGIN IS. EGYPT
SAUDI UNITED ARAB BANGLADESH SAUDI
US. VIRGIN IS. EMIRATES LAO PEOPLE`S NEW CALEDONIA
BELIZE ST KITTS & NEVIS ANTIGUA & BARBUDA ARABIA INDIA DEMOCRATIC REPUBLIC
ARABIA OMAN BANGLADESH
GUATEMALA MONTSERRAT DOMINICA CABO VERDE MAURITANIA MALI OMAN MYANMAR TONGA
HONDURAS ST LUCIA VIET NAM
EL SALVADOR ST VINCENT & SENEGAL NIGER ERITREA YEMEN THAILAND SOLOMON ISLANDS
NICARAGUA THE GRENADINES BARBADOS GAMBIA CHAD SUDAN VIET NAM SENEGAL
BURKINA
CAMBODIA NIUE PHILIPPINES
COSTA RICA GRENADA TRINIDAD & TOBAGO GUINEA-BISSAU
GUINEA
FASO DJIBOUTI PHILIPPINES COSTA RICA
NIGERIA NIGERIA
BENIN
GHANA
TOGO

CTE THAILAND
PANAMA BOLIVARIAN GUYANA ETHIOPIA BRUNEI PANAMA
22 23
SIERRA LEONE DIVOIRE SRI LANKA ETHIOPIA
REPUBLIC OF CENTRAL DARUSSALAM
AFRICAN REP.
VENEZUELA SURINAME LIBERIA COLOMBIA CAMEROON
COLOMBIA EQUATORIAL CAMEROON SOMALIA MALDIVES MALAYSIA MALAYSIA
GUINEA DEM. REP. UGANDA UGANDA
CONGO KENYA
ECUADOR SO TOME GABON SINGAPORE KENYA
& PRINCIPE RWANDA
CONGO BURUNDI
UNITED REPUBLIC SEYCHELLES INDONESIA
PAPUA UNITED REPUBLIC
PERU
OF TANZANIA NEW INDONESIA
BRAZIL GUINEA OF TANZANIA
COMOROS BRAZIL
ANGOLA TIMOR-LESTE
MALAWI
ZAMBIA
BOLIVIA
(PLURINATIONAL MADAGASCAR
STATE OF) NAMIBIA ZIMBABWE
MAURITIUS
BOTSWANA
MOZAMBIQUE BOTSWANA
PARAGUAY
CHILE

SWAZILAND
SOUTH
AFRICA LESOTHO
URUGUAY URUGUAY
ARGENTINA
ARGENTINA

NEW
ZEALAND
sobre Perguntas sobre Perguntas sobre Perguntas
sobre Tabaco para Pesquisas Preguntas sobre Tabaco para Pesquisas Preguntas sobre Tabaco para Pesquisas Preguntas
estas tabaco destinadas a encuestas tabaco destinadas a encuestas tabaco destinadas a encu

5 GTSS Overview: TQS


rveys Tobacco Questions for Surveys Tobacco Questions for Surveys Tobacco Questions for Su

INTEGRATION OF TQS
ans les Questions sur le tabagisme utiliser dans les Questions sur le tabagisme utiliser dans les Questions sur le tabagisme utiliser da
enqutes enqutes enqutes
as of November 2014

sobre Perguntas sobre Perguntas sobre Perguntas
sobre TQS (Tobacco Questions
Tabaco para Pesquisas Preguntas sobre for Surveys)
Tabaco para Pesquisas Preguntas sobreis a list of 22
Tabaco para survey
Pesquisas Preguntas completed
estas tabaco destinadas questions, grouped
a encuestas tabacoaccording
destinadas to a the MPOWER
encuestas tabacomeasures
destinadas a encu
not integrated
derived from GATS. They can be included in national,
rveys Tobacco Questions sub-national,
for Surveysand international
Tobacco Questions surveys
for Surveys to promote
Tobacco dataQuestions for Su
not applicable
comparability within and across countries over time.
ans les Questions sur le tabagisme utiliser dans les Questions sur le tabagisme utiliser dans les Questions sur le tabagisme utiliser da
enqutes enqutes enqutes

The three tobacco-smoking
prevalence questions
should

sobre be Perguntas
included for
sobre all surveys that Perguntas
measure tobacco
sobre use.
Perguntas
sobre
Additional questions
Tabaco para Pesquisas Preguntas sobre
can then be selected to cover key
Tabaco para Pesquisas Preguntas sobre Tabaco para Pesquisas Preguntas
estas tabaco destinadas a encuestas tabaco destinadas a encuestas tabaco destinadas a encu R U S S I A N F E D E R AT I O N
topics, or all the questions can be incorporated, as
rveys
appropriate. TQS is available in Arabic, Chinese, English,
Tobacco Questions for Surveys Tobacco Questions for Surveys Tobacco Questions for Su
ans les French,
Questions sur le tabagisme Russian,
utiliser Spanish,
dans les Questions and Portuguese.
sur le tabagisme utiliser dans les Questions sur le tabagisme utiliser da
enqutes enqutes enqutes
The informationobtained
from
the tobacco questions can
CZECH REPUBLIC
SLOVAKIA KAZAKHSTAN
be used to evaluate
and
monitor existingtobacco-control

SLOVENIA HUNGARY
MOLDOVA MONGOLIA
sobre Perguntas sobre Perguntas sobre Perguntas
sobre policies and programs,
Tabaco para Pesquisas Preguntas sobre Tabaco para as well Preguntas
Pesquisas as to inform development
sobre Tabaco para Pesquisas Preguntas
CROATIA GEORGIA
UZBEKISTAN
KYRGYZSTAN
estas tabaco destinadas and implementation
a encuestas tabaco of destinadas
new interventions
a encuestasat tabaco
community,destinadas a encu TURKEY TURKMENISTAN

sub-national and national levels. BERMUDA


ARMENIA
CHINA
rveys Tobacco Questions for Surveys Tobacco Questions for Surveys Tobacco Questions for Su
ans les Questions sur le tabagisme utiliser dans les Questions sur le tabagisme utiliser dans les Questions sur le tabagisme utiliser da BHUTAN
KUWAIT PAKISTAN
enqutes AS OF 2014, 47 COUNTRIES HAVE INTEGRATED
enqutes enqutes
EGYPT
NEPAL
QATAR

TQS. THE TARGET IS TO APPLY TQS IN 70

CAYMAN ISLANDS SAUDI
ARABIA
SAMOA
LAO PEOPLE`S
sobre COUNTRIES
Perguntas BY 2016
sobre Perguntas sobre Perguntas
BANGLADESH
MYANMAR
DEMOCRATIC REPUBLIC
sobre Tabaco para Pesquisas Preguntas sobre Tabaco para Pesquisas Preguntas sobre Tabaco para Pesquisas Preguntas COOK ISLANDS
ST VINCENT & THAILAND
estas tabaco destinadas a encuestas tabaco destinadas a encuestas tabaco destinadas a encu EL SALVADOR THE GRENADINES BURKINA
FASO TONGA

rveys Tobacco Questions for Surveys Tobacco Questions for Surveys Tobacco Questions for Su
ans les Questions sur le tabagisme utiliser dans les Questions sur le tabagisme utiliser dans les Questions sur le tabagisme utiliser da SRI LANKA
GHANA CAMEROON
enqutes

enqutes
enqutes


enqutes
enqut MALDIVES


UGANDA



RWANDA
INTRODUCTION

sobre Perguntas ssobre


obre Perguntas sobre

Perguntas
sobre Tabaco para Pesquisas Preguntas ssobre
obre Tabaco para Pesquisas Preguntas sobre co para Pesquisas Preguntas
Tabac
Tabaco
BRAZIL
estas tabaco destinadas a estas
encuestas tabaco destinadas a encuestas tabac
co
tabaco destinadas a encu
TIMOR-LESTE

rveys Tobacco Questions for Surveys rveys Tobacco Questions GTSS for Surveys Toba
Tobacco
acc Questions for Su
ans les ans les
Questions sur le tabagisme utiliser dans Questions surGLOBAL
le tabagisme utiliser dans les
TOBACCO SURVEILLANCE SYSTEM
Questtion sur le tabagisme utiliser da
Questions
enqutes
enqutes enqutes
enqu
tes BOTWANA





SOUTH
AFRICA
sobre Perguntas ssobre
obre Perguntas sobre

Perguntas
LESOTHO
sobre Tabaco para Pesquisas Preguntas ssobre
obre Tabaco para Pesquisas Preguntas sobre co para Pesquisas Preguntas
Tabac
Tabaco
estas tabaco destinadas a estas
encuestas tabaco destinadas a encuestas tabac
co
tabaco destinadas a encu
ARGENTINA

rveys Tobacco Questions for Surveys rveys


Tobacco Tobacco
Questions forQuestions
Surveys for Surveys Toba Tobacco
acc Questions for Su
ans les A Subset
ans les
Questions sur le tabagisme utiliser dans of Key Questions
Questions sur lefrom the GlobalAdult
tabagisme Tobacco
utiliser dansSurvey
les (GATS)
Quest tion sur le tabagisme utiliser da
Questions
2 Edition

enqutes enqu
nd

enqutes enqutes
tes






sobre Perguntas ssobre
obre Perguntas sobre

Perguntas
sobre 24
Tabaco para Pesquisas Preguntas ssobre
obre Tabaco para Pesquisas Preguntas sobre co para Pesquisas Preguntas
Tabac
Tabaco 25
estas tabaco destinadas a estas
encuestas tabaco destinadas a encuestas tabac
co
tabaco destinadas a encu
TQS GLOBAL ALLIANCE AIMS TO PROMOTE THE
rveys Tobacco Questions for Surveys Tobacco Questions for Surveys Tobacco Questions for Su
INTEGRATION OF TQS INTO SURVEYS
ans les Questions sur le tabagisme utiliser dans les Questions sur le tabagisme utiliser dans les Questions sur le tabagisme utiliser da
enqutes enqutes enqutes

















Perguntas sobre Perguntas sobre Perguntas
TQS GLOBAL ALLIANCE:
sobre
6 GATS Coverage GLOBAL ADULT TOBACCO
SURVEY CONDUCTED
as of November 2014

22 GATS COUNTRIES data released


data not released as of November 2014
B 3 billion adults represented
year survey completed 2008
B 380,400 household interviews
B 3,200 handheld devices used 2009
number of interviews 0,000
92%
B 3,300 fieldworkers trained RUSSIAN FEDERATION response rate %
B 2,000 fieldwork days 2010
POLAND
INDIA
69,296 2010 2014
UKRAINE KAZAKHSTAN 85%
2011
ROMANIA MALAYSIA
2012
4,250
2013 2008 2010
94% GREECE TURKEY C H I N A
2014
2013 70%
2009 2009 PAKISTAN
QATAR GREECE
MEXICO EGYPT 2016
2015 2010 4,359
SAUDI 2010
ARABIA UNITED INDIA 2009 2009
ARAB VIET NAM
PANAMA 2015 EMIRATES BANGLADESH PHILIPPINES
2011
BRAZIL 2013 SENEGAL 2016
39,425 COSTA RICA 2012 2009 89%
OMAN
2015 2016
NIGERIA THAILAND
2015 2014 ETHIOPIA ROMANIA
2011
97% CAMEROON 4,517
COLOMBIA MALAYSIA
2013 2014
UGANDA KENYA 2011
2016 95%
2008 INDONESIA
INTRODUCTION

TANZANIA
EGYPT BRAZIL URUGUAY
20,924 5,581

94% 2016
BOTWANA 74%
ARGENTINA
6,645
2009

2012 URUGUAY 65%


POLAND
THAILAND ARGENTINA 7,840
20,566

88% 76% UKRAINE


8,158

PANAMA
26 16,962
27
94%
INDONESIA
83% 8,305

MEXICO 99%
13,617 QATAR
96% 8,398
PHILIPPINES
VIET NAM NIGERIA 9,701 91%
9,925 9,765
98% TURKEY
CHINA
94% 9,030
13,354

RUSSIAN FEDERATION 95% BANGLADESH


93% 89% 9,629
11,406
Part Two
MONITOR
USE AND POLICIES 68
8

M
IL
LIO
N
PEOPL E S M
OK
EI
N2
2G
AT
SC

OU
Article 20: Research, surveillance and

NT
exchange of information

RIES
Parties undertake to develop and promote
national research and to coordinate research
programmes at the regional and international
levels in the field of tobacco control
Each Party shall promote and encourage
research that addresses the determinants and
consequences of tobacco consumption and
exposure to tobacco smoke.

28 29
7 Tobacco Use: Prevalence PREVALENCE OF CURRENT
TOBACCO USE
Among adults
Current tobacco use refers to the use of any tobacco age 15 and above
product, smoking or smokeless. Overall, current tobacco 200813
use prevalence ranges from 43% in Bangladesh to 6% in MEXICO
Panama and Nigeria among GATS countries to date. 35.0% or more
R U S S I A N F E D E R AT I O N
Prevalence is much higher among men than women. For 25.0% 34.9%
men, 12 countries have a prevalence of 40% or above. 15.0% 24.9%
For women, eight countries have a prevalence lower than PANAMA
POLAND
less than 15.0%
5%. The men-to-women ratio of prevalence of tobacco ROMANIA
UKRAINE

use was highest in Egypt (38:1) and in Asian countries


such as Malaysia (22:1) and China (27:1), and was lowest TURKEY Estimates for Turkey are for
BRAZIL
GREECE CHINA current tobacco smoking only,
in Argentina, Brazil, Greece, Poland, and Uruguay (all
as Turkey did not measure
were less than 2:1). smokeless tobacco use.
EGYPT
People who use tobacco daily make up the majority of QATAR INDIA

users in all countries except Mexico. BANGLADESH VIET NAM

URUGUAY PHILIPPINES
NIGERIA THAILAND
ARGENTINA
MEXICO SHOWS THE GREATEST DIFFERENCE BETWEEN MALAYSIA

MALE CURRENT AND DAILY TOBACCO USERS


INDONESIA

67% TOBACCO USE


61%
AMONG MALES AND FEMALES
58% Age 15 and above
200813
57% 53%
55% 51% 50% Prevalence of current tobacco use
53% 49% 48% 48% 48%
50% 46%
44% male
45% 45% female
44%
38% 37% 37%
40% 41% 40% 40%
39% Prevalence of daily tobacco use
36% 35% 31%
MONITOR

34% 29%
25%
22% 21%
25%
22%
19%
17%
10% 10%
12%
8%
4%

INDONESIA RUSSIAN BANGLADESH CHINA GREECE UKRAINE PHILIPPINES TURKEY INDIA VIET NAM THAILAND MALAYSIA EGYPT ROMANIA POLAND URUGUAY ARGENTINA MEXICO BRAZIL QATAR NIGERIA PANAMA
30 FEDERATION 31

29%
26%
24%
27% 22%
24% 20% 20%
21% 17% 16% 15%
17% 13%
16% 16% 11%
14% 10% 9%
13% 12% 8%
12%
9% 8% 8% 4% 4% 3% 3% 2% 2% 1%
4% 2% 2% 1%
3% 3% 1% 1% 1% 1%
BANGLADESH GREECE POLAND RUSSIAN INDIA URUGUAY ROMANIA ARGENTINA TURKEY BRAZIL UKRAINE PHILIPPINES THAILAND MEXICO INDONESIA VIET NAM QATAR PANAMA CHINA MALAYSIA NIGERIA EGYPT
FEDERATION
8 Tobacco Use: Number
545m 524m

NUMBER OF ADULTS
WHO USE TOBACCO
Age 15 and above
There are 879 million current tobacco users, including 200813
721 million men and 158 million women in the 22 288m
countries. Egypt has the highest ratio of men to women male users
tobacco users at 61:1. China has the largest number of female users
tobacco users, with 288 million men and 13 million
women, followed by India with 197 million men and total male population
78 million women. Estimates for Turkey are for current total female population
tobacco smoking only, as Turkey did not measure
smokeless tobacco use.
61m
51m

Wor 15m 17m


ld ad u 13m 31m
users in 22 GATS Adu lt p
bacco coun lt p opu
lt to opu 5.8m 4.1m 13m
Adu trie
s la t io
l at i
on
nc 5. 1 POLAND CHINA
ov
ere bi l
l io 8.8m 9.4m RUSSIAN FEDERATION
db n 18m 22m
yG 3.3m
A 1.6m 2.5m
9.1m 31m 33m

TS
3.0
ROMANIA
UKRAINE

bi l
15m

l io
4.6m 4.7m 1.2m

n
25m 26m
33m 36m
2.3m 1.2m VIET NAM
879m 12m
GREECE
2.9m 4.0m 31m
31m
30% 8.2m 25m 24m
of total GATS population TURKEY
15m
3.1m
MEXICO 9.6m 0.2m 0.2m
0.2m
0.05m 0.01m
EGYPT PHILIPPINES
1.3m 1.3m QATAR
0.1m Scale is double that
0.04m
41m 41m of other circles
PANAMA
MONITOR

4.1m 47m 48m


69m 74m
0.5m
28m
NIGERIA 14m

15m 411m
384m BANGLADESH 11m 10m
9.9m
4.6m
BRAZIL 0.2m
26m 27m
32 MALAYSIA 33
12m 2.5m
197m

THAILAND
13m 14m
86m 86m
2.3m 78m
3.9m 58m
ARGENTINA

1.2m 1.3m
0.4m 0.3m 3.8m
URUGUAY INDIA INDONESIA
 Interviewers on a boat en route to conduct fieldwork in Bangladesh.
9 Tobacco Use: Age AGE OF CURRENT
TOBACCO USERS
Percentage in each age group
The prevalence of tobacco use (smoking and smokeless) who use tobacco
generally increases into young adulthood or middle age 40%
49% 50% 200813
34%
and then declines, mainly due to tobacco users quitting 27% 38%
or dying. However, this trend is less obvious in Asian 18% 34% 15 17 years
31%
countries, particularly India, Bangladesh, and Thailand,
9% 19% 22% 23% 18 24 years
where prevalence is highest among adults age 65 15%
and above. 25 44 years
UKRAINE 4%
45 64 years
RUSSIAN FEDERATION CHINA 65 years or more
36% 38%
35%
29% Estimates for Turkey are for
26% 28%
current tobacco smoking only,
14% as Turkey did not measure
11% 12%
8% smokeless tobacco use.

ROMANIA POLAND
IN MOST ASIAN COUNTRIES A HIGHER
51% PROPORTION OF PEOPLE IN THE OLDER AGE
38%
43% GROUPS USE TOBACCO THAN IN THE
YOUNGER AGE GROUPS
14% 15%
8% 8%
15% 2% 31%
29%
7% 24%
QATAR 18%
GREECE
3%

40% VIET NAM


29% 29%
33% 34% 32%
13% 26%
7% 7% 10%
3% 5% 5%
12%
PANAMA TURKEY
MONITOR

20%
17% 16% 47% 48% PHILIPPINES
10% 8% 40%
37%
23%
18% 27% 29%
14% 14% 24%
MEXICO 21%
4% 12%
10% 10%
6% 8%
BRAZIL 1% 2%

NIGERIA INDIA THAILAND

34 29% 30% 29% 23%


26% 69% 71% 35
20% 29%
14% 23%
21%
14% 16%
8% 4%
45%
7%
EGYPT
URUGUAY
MALAYSIA
20%
38% 40% 38%
8% 32%
25% 27% 24%
BANGLADESH 15%
9% 9%

ARGENTINA INDONESIA
10 Smoking: Prevalence CURRENT TOBACCO SMOKING
Among adults
age 15 and above
Most of the tobacco consumed throughout the world is in 200813
the form of smoking tobacco, such as manufactured
cigarettes, hand-rolled cigarettes, cigars, pipes, MEXICO
30.0% or more
waterpipes, kreteks, and bidis. Overall, the prevalence of 20.0% 29.9%
current tobacco smoking ranges from 39% in Russian R U S S I A N F E D E R AT I O N
10.0% 19.9%
Federation to 4% in Nigeria. Among men, 11 GATS
countries have a prevalence of 40% or above. PANAMA
less than 10.0%
For women, 11 countries have a prevalence of more POLAND
UKRAINE
than 5%. ROMANIA

With the exception of Bangladesh and India, most BRAZIL


TURKEY
GREECE CHINA
smokers smoke cigarettes, particularly manufactured
cigarettes. Men commonly smoke bidis in India and
Bangladesh. The use of the waterpipe is relatively high in EGYPT
QATAR INDIA
Viet Nam, Egypt, Turkey, Russian Federation, and BANGLADESH VIET NAM
Ukraine.
URUGUAY PHILIPPINES
Prevalence of smoking is generally much higher for men NIGERIA THAILAND
than women in every GATS country. The male-to-female
ARGENTINA
MALAYSIA
prevalence ratio for smoking is highest in Egypt (76:1)
and lowest in Poland and Uruguay (both less than 2:1).
INDONESIA
The majority of current smokers are daily smokers in all
countries except for Mexico.
67% PREVALENCE OF SMOKING IS GENERALLY
MUCH HIGHER FOR MEN THAN WOMEN IN
60% EVERY GATS COUNTRY SMOKING AMONG
MALES AND FEMALES
57% 53% Age 15 and above
55% 51% 50%
48%
200813
48% 47% 46%
50% 45% 44% Current smoking
45% 45% 44% male
38% 37% 37%
39% 39%
41% 40% female
38%
36% 35% 31% Daily smoking
MONITOR

34% 29%
25% 24%
25% 22%
20%
22%
18% 19%
17%
9%
12% 7%

4% 6%

INDONESIA RUSSIAN CHINA GREECE UKRAINE TURKEY PHILIPPINES VIET NAM THAILAND BANGLADESH MALAYSIA EGYPT ROMANIA POLAND URUGUAY ARGENTINA MEXICO INDIA BRAZIL QATAR PANAMA NIGERIA
36 FEDERATION 37

26%
24%
22%
24% 20%
21% 17% 16% 15%
13%
16% 16% 11%
14% 13% 9%
12% 12% 8%
9%
7% 3% 3% 3% 3% 3% 2%
2% 2% 2% 2% 2% 2% 1% 1% 0.5% 0.4%
4% 1% 1% 1% 1% 0.5% 0.3%
GREECE POLAND RUSSIAN URUGUAY ROMANIA ARGENTINA TURKEY BRAZIL UKRAINE PHILIPPINES MEXICO INDIA INDONESIA QATAR THAILAND PANAMA CHINA BANGLADESH MALAYSIA VIET NAM EGYPT NIGERIA
FEDERATION
11 Smokeless: Prevalence CURRENT SMOKELESS
TOBACCO USE
Among adults
The overwhelming use of smokeless tobacco globally is age 15 and above
in India and Bangladesh. Across 21 countries (Turkey did 200813
not measure smokeless tobacco use), there are 248 MEXICO
million smokeless tobacco users, of which 232 million are 18.0% or more
from India and Bangladesh. In India, the prevalence is R U S S I A N F E D E R AT I O N
1.0% 6.5%
33% among men and 18% among women, compared
with 26% (men) and 28% (women) in Bangladesh. 0.0% 0.9%
PANAMA
POLAND
Smokeless tobacco use is also noticeable among UKRAINE Turkey did not measure
ROMANIA smokeless tobacco use.
Egyptian men and Thai women at 4% and 6%,
respectively. BRAZIL
TURKEY
GREECE CHINA

EGYPT QATAR
INDIA
BANGLADESH VIET NAM
THE OVERWHELMING USE OF TOBACCO BY WOMEN
IN LOW- AND MIDDLE-INCOME COUNTRIES IS OF URUGUAY
NIGERIA
PHILIPPINES
THAILAND
SMOKELESS TOBACCO IN INDIA AND BANGLADESH ARGENTINA
MALAYSIA

INDONESIA

NUMBER OF SMOKELESS

n
n

l io
il l io
TOBACCO USERS ess tobacco in 2
okel

bi l
m 2G

.1 b
s

3.0
33% Age 15 and above of AT

on 5

TS
2009

ers

Sc
GA
INDIA

t us

oun
u lat i

by

Adul

tries
26%

lt pop

red
cove
135m 248m

u
8%

World ad
BANGLADESH

lation
71m
of total GATS population

u
13m 13m

Adult pop
MONITOR

male female male female

4.1%
2.9% 2.7%
1.5% 1.3% 1.3% 1.0% 1.0% 1.0% 0.9% 0.7% 0.6% 0.5% 0.4% 0.3% 0.3% 0.2% 0.1%
0.0%
INDIA BANGLADESH EGYPT NIGERIA PHILIPPINES INDONESIA QATAR THAILAND PANAMA POLAND RUSSIAN MALAYSIA CHINA BRAZIL UKRAINE ROMANIA MEXICO VIET NAM GREECE ARGENTINA URUGUAY
FEDERATION

28%
38 39

SMOKELESS TOBACCO USE


18% AMONG MALES AND FEMALES
Age 15 and above
200813

male
6.3% female
2.3% 1.9% 1.2% 0.9% 0.6% 0.3% 0.3% 0.2%
0.5% 0.3% 0.2% 0.2% 0.2% 0.1%
0.0% 0.0% 0.0% 0.0%
BANGLADESH INDIA THAILAND VIET NAM INDONESIA PHILIPPINES NIGERIA MALAYSIA PANAMA BRAZIL EGYPT MEXICO ARGENTINA GREECE ROMANIA RUSSIAN POLAND CHINA QATAR UKRAINE URUGUAY
FEDERATION
12 Dual Use: Smoking and Smokeless PATTERN OF
TOBACCO USE
Among current tobacco users
Dual use refers to an individual using both smoking and age 15 and above
smokeless tobacco products on either a daily or less 200813
than daily basis. Dual use is highest among men who 0.2% 57 MILLION ADULTS ARE USERS OF BOTH SMOKING
use tobacco. It is highest in Bangladesh (22%), India
0.7% 0.1% AND SMOKELESS TOBACCO PRODUCTS
smoked only
(19%), and Egypt (9%). It is highest among women
smokeless only
who use tobacco in Egypt (25%), Nigeria (9%), and 99.1% 99.9%
Panama (9%). UKRAINE 0.7% 0.2% both smoked and smokeless (dual)
1.0% 0.7%

1.0% male
1.7% 0.3% 98.3% 99.1%
female
RUSSIAN FEDERATION
Due to rounding, data
97.2% 99.7% do not always add up
POLAND to 100%.

0.1% 1.2% 0.5%


1.0% 1.4% 1.2%
0.6% 0.6% 1.7%
2.5%
99.0% 98.8% 98.6% 98.3%

98.8% 95.8% ROMANIA CHINA


4.0%
MEXICO 0.4% 2.3%
0.6%
0.4%
93.7% 100% 0.2%
59.8%
99.6% 99.4% QATAR
3.5%
GREECE 99.4% 36.6%
VIET NAM
Turkey did not measure
2.4% smokeless tobacco use.
8.2% 3.1% 10.3%
TURKEY 2.5% 1.3%
7.6%
89.3% 83.0% 9.3%
PANAMA 94.4% 88.4%
PHILIPPINES
MONITOR

2.0% 1.7% 1.8%


0.8% 0.4% 1.0%
66.0%
49.3% 85.5%
97.2% 98.0% 3.5% 68.9% 97.1% 30.8% 3.3%
26.1%
BRAZIL 31.3% 19.4% THAILAND
21.9% 9.2% 5.3%
70.4% 9.2%
INDIA 0.2%
NIGERIA 1.8%
64.7%
1.2% 35.3%
40 9.5% 98.0% 41
18.9% 94.7%
23.0% MALAYSIA
89.3% 56% 25.1% 54.6% 22.5% 2.7%
0.1% 2.5%
0.5% EGYPT 0.1%
0.2% 0.8% BANGLADESH 2.1%
39.8%
99.7% 98.7% 97.8% 56.6% 3.7%
ARGENTINA INDONESIA

100% 100%
URUGUAY
13 Daily Smoking: Age of Initiation AVERAGE AGE AT WHICH
SMOKING STARTS
On a daily basis among
Age of daily smoking initiation reflects patterns of initiation 18.4 16.6 17.1 ever daily smokers age 20 to 34
16.9
among young adults. The average age at which people 200813
start smoking daily varies between men and women, with
women starting at a slightly older age than men. Smokers IN ALL GATS COUNTRIES THE AVERAGE 16.0 16.9 years
18.0
in Asia and Africa tend to start smoking daily at a later 17.6
AGE OF INITIATION IS UNDER 20 YEARS 17.0 17.9 years
age compared with those in Europe and Latin America.
18.0 18.9 years
19.0 19.5 years
WOMEN START SMOKING ON A DAILY BASIS AT
A SLIGHTLY OLDER AGE THAN MEN IN MOST RUSSIAN FEDERATION
18.0 UKRAINE
GATS COUNTRIES EXCEPT IN ARGENTINA, INDIA, 16.7
AND QATAR AVERAGE AGE AT WHICH
MALES AND FEMALES
POLAND
START DAILY SMOKING
200813
17.5 18.1
18.1 18.0
17.1 male
16.5 19.5
female
ROMANIA
* The data for women are not
reported in some countries due to
19.1
the small sample size.

16.7 17.4
GREECE
17.9 QATAR
MEXICO 16.7
* 19.2
CHINA 17.6

*
17.1 VIET NAM
18.3
17.2 17.4
PANAMA
MONITOR

17.1 17.3
TURKEY

PHILIPPINES

18.3 *
EGYPT
* 17.6
18.4
INDIA BANGLADESH

BRAZIL
42 43
16.5 16.7 17.6 17.2
16.1 16.3

*
NIGERIA

THAILAND

* *
ARGENTINA URUGUAY INDONESIA MALAYSIA
14 Former Daily Smokers: Quit Ratio ADULTS WHO
NO LONGER SMOKE
As a percentage of adults who have
Giving up smoking, even late in life, can result in THE QUIT RATIO TENDS TO BE HIGHER AMONG ever smoked daily
significant improvements in health and life expectancy. WOMEN THAN MEN IN MOST COUNTRIES 200813
Lifelong smokers lose, on average, 10 years of life, and
quitting by age 40, 50, or 60 results in average gains of 26% 25% 9.5% 19.9%
38%
9, 6, and 3 years of life, respectively. 20.0% 29.9%
34% QUIT RATIOS ARE LOWEST IN THREE OF THE FOUR
The quit ratio (the percentage of former daily smokers MOST POPULOUS COUNTRIES: CHINA, INDIA, 30.0% 39.9%
among ever daily smokers) is an important indicator of AND INDONESIA 40.0% or more
the impact of tobacco control policies and programs. In
seven countries (Bangladesh, China, Egypt, India,
Indonesia, Malaysia, and Russian Federation), the quit
UKR
UKRAIN
AINEE
UKRAINE
ratio is less than 20% for men. It exceeds 40% in Brazil 28% 27% MALE AND FEMALE
19%
and Uruguay for both men and women. 17%
FORMER DAILY SMOKERS
As a percentage
POL ND
POLAND of ever daily smokers
200813

SSIAN FEDERATI
RUSSIAN FEDERATION
male
ROMANI
ROM NIA
ROMANIAA female
33% 28%
32% 52%
25% 29%
24% 23% 17%
13% 23%

27%
31% 24%
CH A
CHINA

GREECE QAT
QATA
QATAR
VIET NAM
VIET AM 25%
MEX CO
MEXICO
21%
54%
48% 21% 16%
46% TURKEY
17% 12%
MONITOR

PANAM
PANAMA
41%
35%
PHI
PHILIP
LIPPIN
PINES
PHILIPPINESES
IND A
INDIA
EGYPT
EGYPT
34%
43% 28%
41% 17%

44 BRAZIL
BRA ZIL 23% 9% 10% 45
42% NIG
NIGERI
ERIA
NIGERIAA BAN
ANGLA
GLADES
DESH
BANGLADESH H
38%
9% MAL AYSIA
SIA
MALAYSIA
THA
THAILA
ILAND
ND
THAILAND

IND
NDONE
ONESIA
SIA
INDONESIA
URUGUAY
URUGUA
URU GUAY
Y

ARG
ARGENT
ENTINA
INA
ARGENTINA
15 Cigarettes Smoked HEAVY SMOKERS
Percentage of daily cigarette
smokers age 15 and above
People who smoke 20 or more cigarettes per day are who smoke 20 or more
usually considered heavy smokers. Overall, more than cigarettes per day
50% of daily cigarette smokers fall into this category in 200813
eight countries. In all countries except for India, there are
more heavy smokers among men than women. 50% or more

The average number of cigarettes smoked per day 25% 49%


ranges for men from 6 in India to 21 in Greece. For less than 25%
women, it ranges from 7 in Philippines and India to 17 in *
Greece.

RUSSIAN FEDERATION
NUMBER OF
CIGARETTES SMOKED
Average per day
among daily cigarette smokers POLAND
age 15 and above UKRAINE
ROMANIA
200813
male TURKEY
GREECE
female
CHINA
* The data for women
are not reported in
some countries due to the QATAR
small sample size. MEXICO INDIA
EGYPT
BANGLADESH
VIET NAM

PANAMA PHILIPPINES
NIGERIA THAILAND

MALAYSIA
MONITOR

INDONESIA

BRAZIL
IN MOST COUNTRIES MEN SMOKE MORE CIGARETTES *
DAILY THAN WOMEN; THE EXCEPTION IS INDIA

46 URUGUAY * 47

ARGENTINA

*
Part Three
PROTECT
FROM SECONDHAND SMOKE

1.2 BILLION ARE EXPOSED TO SECONDHAND SMOKE


IN PUBLIC PLACES IN 22 GATS COUNTRIES
Article 8: Protection from
exposure to tobacco smoke
Parties recognize that scientific evidence has
unequivocally established that exposure to
tobacco smoke causes death, disease
and disability.
Each Party shall adopt and implement
measures, providing for protection from
exposure to tobacco smoke in indoor
workplaces, public transport, indoor public
places and, as appropriate, other public
places.

48 49
16 Exposure to Smoke: Public Places PREVALENCE OF EXPOSURE
To secondhand smoke
in public places in the past 30 days
There is no safe level of secondhand smoke (SHS). 52% 200813
In all countries except for Argentina, Egypt, Philippines,
and Uruguay, exposure to SHS is highest in restaurants government buildings
79%
among the four public venues. The lowest exposure is healthcare facilities
87% 64%
found in healthcare facilities, except in Brazil, China, and 88%
Romania. 10% restaurants
8%
5%
public transportation
There is consistent evidence that smoking bans reduce
exposure in public places including in restaurants, pubs, 58%
and workplaces. POLAND 25%
18%
Implementing and enforcing comprehensive smoke-free 10% 17% 38%
7% 34%
10%
policies are the most effective strategies for reducing 21%
exposure and helping smokers quit. These policies offer
10% 9% 85%
the potential to influence social norms regarding smoking.
UKRAINE
RUSSIAN FEDERATION

ROMANIA 72%
26% CHINA
39%
14% 34%
8%
4%
30% 24%
24%
17%
18% QATAR
4%
7% 7% 55%

56% VIET NAM


MEXICO 12% 34%
9% 7% 8% GREECE 25%

8%
16%
PANAMA 11%
6% 48%
34%
34%
PHILIPPINES
PROTECT

26% 22%
32% TURKEY 17% 13%
29% 5%
18%
10% 9% 17%
9%
5% THAILAND
INDIA
80%
80% 71%
BRAZIL
73% 73%
NIGERIA
54% 85%
50 51
49% 43%
70%
7% 63%
4% 4% 5% 28%
24%
20%
9%
URUGUAY
24% 23%
17% 18%
9% BANGLADESH MALAYSIA
EXPOSURE TO SHS IN PUBLIC PLACES IS
EGYPT
LOWEST IN URUGUAY, THE ONLY COUNTRY
PROHIBITING SMOKING IN ALL PUBLIC
ARGENTINA PLACES AT THE TIME OF THE SURVEYS INDONESIA
17 Exposure to Smoke: Workplace NUMBER EXPOSED
To secondhand smoke in
the workplace in the past 30 days
63m 200813
In total, 392 million adults are exposed to secondhand
smoke (SHS) in their workplace.
CHINA HAS THE SMOKIEST WORKPLACES total in workplace 00m
In Bangladesh, China, and Egypt, 60% or more of adults
WITH A QUARTER OF A BILLION WORKERS total exposed
who work indoors have been exposed to SHS at their 00m
EXPOSED TO SECONDHAND SMOKE
workplace. 22m
388m
Smoking bans have been implemented in various
16m
settings to protect employees from the harmful effects of
SHS and assure both health and economic benefits. In
addition, smoke-free policies help facilitate smoking 13m
5.2m
cessation and assure economic benefit.
4.3m
246m
RUSSIAN FEDERATION
UKRAINE
5.8m
POLAND
3.0m 2.0m

1.6m
ROMANIA

GREECE 14m
15m
0.2m
0.03m 8.0m
14m QATAR
2.9m
50m 5.3m
VIET NAM
MEXICO
9.2m
16m 14m
0.7m TURKEY 5.5m
0.04m 10m
PANAMA 12m 4.5m

EGYPT
PROTECT

16m
PHILIPPINES
BANGLADESH
12m
BRAZIL 125m
2.7m
5.8m CHINA
3.3m
2.3m
NIGERIA

THAILAND
MALAYSIA
52 1.0m 53

0.2m 37m
URUGUAY
28m

15m

11m

3.4m

ARGENTINA INDIA INDONESIA


18 Exposure to Smoke: Home NUMBER EXPOSED
To secondhand smoke
in the home in the past 30 days
1.5 billion people are exposed to secondhand smoke 200813
40m
(SHS) at home in the 22 GATS countries. In China, nearly 112m
total population at home 00m
three-quarters of a billion people (717 million) are
exposed, almost equalling the combined number in the total exposed 00m
remaining 21 countries. Implementing smoke-free policies 9.4m
39m
helps facilitate cessation and adoption of voluntary rules
32m
for smoke-free homes that especially protect children. UKRAINE 1,066m
14m
ENCOURAGING VOLUNTARY ADOPTION OF RULES
FOR SMOKE-FREE HOMES COULD REDUCE 93m
RUSSIAN FEDERATION
18m
EXPOSURE AND HELP CURRENT SMOKERS QUIT POLAND 717m
51m
6.4m

9.2m ROMANIA
69m 64m
6.0m
47m
0.4m
GREECE BANGLADESH
0.1m
51m QATAR
12m
29m

143m VIET NAM


MEXICO 49m
30m
TURKEY 20m
2.7m
7.6m
0.1m 40m
PANAMA 79m
EGYPT MALAYSIA
782m

BRAZIL 52m
PROTECT

5.2m 60m
CHINA
17m
NIGERIA 33m

2.5m 313m THAILAND

0.8m PHILIPPINES
URUGUAY
54 170m 55
133m

28m

9.1m

ARGENTINA

INDIA INDONESIA
Part Four
OFFER HELP
TO QUIT 205 MILLION
PEOPLE
MADE AN ATTEMPT
TO QUIT SMOKING
IN THE PAST 12 MONTHS
IN 22 GATS COUNTRIES

Article 14: Demand reduction measures


concerning tobacco dependence
and cessation
Each Party shall develop and disseminate
appropriate, comprehensive and integrated
guidelines based on scientific evidence and
best practices, taking into account national
circumstances and priorities, and shall take
effective measures to promote cessation of
tobacco use and adequate treatment for
tobacco dependence.

56 57
19 Tobacco Use: First of the Day EARLY BIRD USERS
Percentage of current users
age 15 and above
The time to first tobacco use after waking up is indicative 64% who use tobacco
of nicotine dependence. In 12 countries, 50% or more of within 30 minutes of waking
200813
tobacco users use their first tobacco within 30 minutes of 51% 50% 50%
64%
waking. This ranges from 26% (Mexico) to 76% (Greece)
among men, and 17% (Malaysia) to 64% (Greece, 50% or more
Nigeria, Romania) among women. 62% 46% less than 50%
57%
More men than women use tobacco within 30 minutes of 64%
72%
waking up in most countries, except in Argentina, China, male
Egypt, Mexico, Nigeria, Qatar, and Romania.
female

UKRAINE CHINA

RUSSIAN FEDERATION
76%
66%
59%
64% POLAND 60%
33%
26% 42%
ROMANIA
60%

47%
MEXI
XICO
MEXICO
39%
32% 43%
36% QATAR
VIET NAM
GREECE
62%
OFFER HELP

55%

PANAMA PHILIPPINES

TURKEY

63%
42% 61%
56% 64% 40%
50%
54% 45%

35%
INDIA

58 59
BANGLADESH
38%
32% 48%
BRAZIL EGYPT 39% THAILAND
332%
% NIGERIA 30%
26%

17%

URUGUAY

ARGENTINA INDONESIA MALAYSIA


20 Intention to Quit QUITTING INTENTION
Percentage of current smokers
age 15 and above
Self-reported intention to quit smoking predicts future who intend to quit smoking
smoking abstinence. In 18 of the 21 GATS countries, the 74% 200813
majority of current smokers are interested in quitting. In 66%
71%
Argentina, Malaysia, Mexico, and Uruguay, more than 70% or more
70% of current smokers intend to quit smoking. 50% 69%
56%
Among men, quitting intention ranges from 42% (China, less than 50%
Egypt) to 77% (Uruguay). Among women, quitting 53%
intention ranges from 34% (China) to 83% (Malaysia). 48%
male
63% 63%
female
69%
* The data for women
were not reported in
75% 54%
54% some countries due to
71% the small sample size.
UKRAINE
58%
RUSSIAN Brazil data not available.
42% 68%
50% FEDERATION
POLAND 34%
72%

62%
%
ROMANIA 37% 60% 61%

QATAR
54% CHINA
51%
%
GREECE
MEXICO
47% VIET NAM
41%
%

PANAMA
OFFER HELP

PHILIPPINES

TURKEY
49%
46%
68% 42%
INDIA
35%

69%

77% 83%
74%
75% 60%
71% 70%
53%
60 61
EGYPT 37% INDONESIA

*
NIGERIA

BANGLADESH
THAILAND

URUGUAY
MALAYSIA
ARGENTINA
21 Attempts to Quit ATTEMPTED QUITTERS
Percentage of smokers
age 15 and above
Ukraine CESSATION AIDS The percentage of those who had attempted to quit who attempted to quit smoking
2%
Percentage of smokers smoking in the previous 12 months was measured 35% 36% in the past 12 months
3%
age 15 and above 200813
Egypt
among current smokers, and former smokers who had
who used smoking cessation aids quit in the previous 12 months. In only three countries 46%
2%
in the past 12 months 50% or more
4% (Mexico, Thailand, Viet Nam), 50% or more of smokers 39%
China 200813
tried to quit smoking during the past 12 months. 40% 49%
3%
pharmacotherapy less than 40%
3% Among men, the lowest percentages are found in China 38%
counseling/advice
India (14%), Greece (17%), Russian Federation (29%), and 41% POLAND
4% 29% male
* Bangladesh did not measure Indonesia (30%). Among women, the percentages range
9% 36%
36 %
pharmacotherapy. from 19% in China to 57% in Mexico. female
Argentina
4% Of those who attempt to quit, between 2% (Egypt, * The data for
3% UKRAINE women
Ukraine) and 26% (Indonesia) use pharmacotherapy as a 56%
Nigeria were not
5%
cessation aid, and between 2% (Romania, Turkey) and reported in
RUSSIAN FEDERATION
15% 16% (Qatar) seek counselling/advice. 44%
44% some
Philippines 47% countries due
44%
6% ROMANIA to the small
12% sample size.
Mexico 19%
6%
14%
3% 57%
Panama 23%
6% 47% 17%
48%
12%
44% CHINA VIET NAM
Brazil 54%
7% TURKEY
15% 47%
GREECE 41%
Romania 38%
9%
2%
Malaysia
9%
MEXICO
OFFER HELP

4%
Turkey PANAMA
9%
50% 48%
2%
QATAR PHILIPPINES
Thailand 43%
11% 46% 44% 32%
6% 41%
41
Greece 38% 39%
15%
3%
Uruguay
18%
12%
BANGLADESH
Russian Federation BRAZIL
20% *
62 6% NIGERIA EGYPT INDIA 63
49% 50%
Qatar 46% 47%
22%
16%
50% 48% 49%
Viet Nam 48% 45%
24%
3%
Poland 30%
30
0%
25%
3%
Indonesia
26% MALAYSIA THAILAND
7%
Bangladesh *
ARGENTINA URUGUAY INDONESIA
15%
22 Advice from Health Professionals INQUIRY AND ADVICE
Reported by current smokers and
recent quitters age 15 and above
Healthcare providers (HCP) inquiring about patients who visited a healthcare provider
tobacco use and advising tobacco users to quit can in the past 12 months
200813
increase cessation rates. Among smokers who have
visited a healthcare provider in the past 12 months, the 42%
31%
Percentage asked about
percentage of those who are asked about their smoking smoking status
status ranges from 35% in Viet Nam to 84% in Greece, 32%
and those who are advised to quit smoking ranges from 42% Percentage advised
17% in Mexico to 72% in Greece. 57% to quit smoking
POLAND UKRAINE
45%

82%
RUSSIAN FEDERATION

67%

ROMANIA

41% 34%
30%

17% 84% 49% 41% 35%

TURKEY CHINA VIET NAM

72%
74%
65% 60%
GREECE
MEXICO
PANAMA 52%
OFFER HELP

67%
77%

71% PHILIPPINES

QATAR
74% 53%
67%
57% 56%
71%

EGYPT
BANGLADESH
BRAZIL
64 61% 52% 65
70%

46% 60%
NIGERIA
80% THAILAND
61%

53%
53% 35%
INDIA
ARGENTINA 54% 68%
77%
40%
MALAYSIA
INDONESIA
URUGUAY
Part Five
WARN
OF DANGERS

Article 11: Packaging and labelling of


tobacco products
Each Party shall ensure that each unit
packet and package of tobacco products and
any outside packaging and labelling carry
health warnings describing the harmful effects
of tobacco use...

Article 12: Education, communication,


training and public awareness
Each Party shall promote and strengthen
public awareness of tobacco control issues,
using all available communication tools ...

66 67
241 MILLION ARE
CONSIDERING QUITTING BECAUSE OF
HEALTH WARNINGS ON
CIGARETTE PACKAGING
IN 22 GATS COUNTRIES
23 Beliefs about Dangers DANGERS OF SMOKING
Percentage of adults
age 15 and above
The percentage of those who believe that smoking ONLY 14% OF ADULTS IN CHINA BELIEVE THAT 94% OF ADULTS IN RUSSIAN FEDERATION KNOW who believe smoking causes
causes heart attack ranges from 39% in China to 95% LOW-TAR CIGARETTES ARE AS HARMFUL AS THAT CIGARETTES CAUSE AN ADDICTION specific conditions
200813
in Egypt, and for stroke from 27% in China to 89% in GENERAL CIGARETTES
Egypt and Romania. 91% 91%
78% 79% stroke
The majority of adults from all 22 countries are aware LESS THAN ONE-QUARTER OF ADULTS IN CHINA 67% 71%
BELIEVE THAT SMOKING CAUSES STROKE, HEART heart attack
that smoking causes lung cancer, ranging from 73% in 93%
Nigeria to 99% in Argentina. ATTACK, AND LUNG CANCER 80% lung cancer
62%
The majority in all 22 countries also believe that
secondhand smoke causes serious illness in
non-smokers. 98%
89% 90%
UKRAINE
UK
KRAINEE
KR RUSSIAN FEDERATION
USSI N FEDE
EERATION
R
96%

POLAND
PO
OLLLAND
D 70%
63%
78%
97%
94% 96%
80% 82%
China 64% 39%
60% ROMANIA
RO
OMANIA
M NIA
A 27%
Indonesia 74% VIETE NAM
VIIIET M

Nigeria 75%
97% 96% CHINA
C
91%
Poland 81% 84%
74% 77% 93%
MEXICO
MEXICO
O
Russian Federation 82% TURKEY
TU
URKEY
Y 79%
73%

India 83%

Greece 85%
94% 96%
Malaysia 86% PANAMA
PA
ANA
AMA
A GREECE
GREECEE
GR
80%
Ukraine 86% PHILIPPINES
PHIL
ILLIPPINE
NEES

Viet Nam 87%


96%
Panama 88% 87%
97%
WARN

92%
74% 77% 73%
82% 86% 80% 76%
Brazil 91%
51% QATAR
Q
QAATAR
TAR
Philippines 92%

Argentina 93%
95% 96%
Bangladesh 93% 89%
68 BRAZIL
B RAZILL NIGERIA
N A 85% 69
BANGLADESH
BANG
AN
NGLAD
DES
SH THA
HA
AILAN
ND
N
THAILANDD
Uruguay 94% 64%
49%
Romania 94%
DANGERS OF 99% 97% 94%
Qatar 95% SECONDHAND 91% 92%
81% 85% 81%
89%

SMOKE 74% 76%


Thailand 95% Percentage of adults EEGYPTT
age 15 and above IINDIA
NDIA 45%
Turkey 96% who believe secondhand
smoke causes
Mexico 96%
serious illness in
non-smokers
Egypt 96% INDONESIA
IND
DONESIA
D SIA
A
200813 AR
RGENTIN
R G NA
ARGENTINA URUGUAY
UR
RUGUA
R AY
AY MALAYSIA
MA
ALAYSIA
A IA
24 Impact of Health Warnings IMPACT OF HEALTH
WARNINGS
Percentage of current smokers
Effective health warnings on tobacco packaging deliver age 15 and above
important messages to both users and non-users. They considering quitting
can encourage users to think about quitting, prevent because of health warnings
relapse and deter non-users from initiating use by on cigarette packaging
increasing their awareness of the associated health risks. 200813

The percentage of current smokers in the 22 GATS less than 30%


countries who notice health warnings on cigarette
packaging and think about quitting as a result ranges RUSSIAN FEDERATION 30% 59%
from 15% in Greece to 67% in Thailand. 60% or more

POLAND country currently


UKRAINE has graphic
health warnings on
ROMANIA
16 GATS COUNTRIES HAVE GRAPHIC cigarette packaging
HEALTH WARNINGS ON THEIR PACKAGING TURKEY
GREECE
CHINA

MEXICO
EGYPT INDIA
QATAR
BANGLADESH
VIET NAM PHILIPPINES
PANAMA
THAILAND
NIGERIA

MALAYSIA

BRAZIL INDONESIA

AUSTRALIA IS THE ONLY COUNTRY


WARN

THAT HAS ADOPTED STANDARDIZED


URUGUAY
(PLAIN) PACKAGING
 Australia ARGENTINA

70 71

 Uruguay  Brazil  Egypt  Turkey  India  Indonesia  China


25 Impact of Anti-Cigarette Advertising IMPACT OF
COUNTER-ADVERTISING
Percentage of adults
Anti-tobacco messages in the mass media, either 59% age 15 and above
describing the dangers of smoking cigarettes or 46%
noticing anti-cigarette information
encouraging people to quit smoking, have proven to 39% 39% 200813
reduce smoking prevalence. 34%
28% 28%
25% 25% 25% in newspapers/magazines
In all 22 GATS countries, except Nigeria and Qatar,
14% on billboards
television is the media venue where the highest 11%
percentages of adults notice anti-cigarette messages in on television
the previous 30 days. Viet Nam, Turkey, and Malaysia 77%
on radio
have the highest percentages for television. Malaysia also 80%
has the highest for newspapers/magazines, billboards, POLAND UKRAINE RUSSIAN FEDERATION
and radio. 86%

45% 45% 35% 85%


26% 25%
31%
45%
43%
46% 31%
28%
22% 21%
36%
50% ROMANIA
47% 23% 6%
MEXICO 37%
27% 26%
CHINA VIET NAM
10% 6%
4%
TURKEY 60%

PANAMA GREECE 41% 40%


39%
34%
29% 31%
26%
36%

16%
10% 11%
64% 33%
QATAR PHILIPPINES
14% 16%
WARN

9% 36%
39% BANGLADESH
25%
30% 21% 74%
15%
19%
NIGERIA

52%
39%
INDIA 85% 33%
72 27% 73
BRAZIL
27% 69% 72%
67%
19%
58% 14%
52%
48%
43% 42% 40%
37%
29% 32% 30% THAILAND
EGYPT
11%
5%

 Mass media campaigns. ARGENTINA URUGUAY MALAYSIA INDONESIA


Part Six
ENFORCE
MARKETING BANS

774 M
CIGA ILLIO
N NO
RETT TICE
OR E A DVER
SPO TISIN
IN 2 NSO G
2 GA RSH
TS C IP
OUN
TRIE
S
Article 13: Tobacco advertising,
promotion and sponsorship
Parties recognize that a comprehensive ban on
advertising, promotion and sponsorship would
reduce the consumption of tobacco products.
Each Party shall, in accordance with its
constitution or constitutional principles,
undertake a comprehensive ban of all tobacco
advertising, promotion and sponsorship ... [or]
shall apply restrictions on all tobacco
advertising, promotion and sponsorship.

74 75
26 Cigarette Advertising IMPACT OF ADVERTISING
Percentage of adults
age 15 and above
Exposure to tobacco advertising, promotion and 14%
44% noticing cigarette advertising
sponsorship (TAPS) is associated with the initiation of 200813
21% 33%
tobacco use among young people and continuation of 2% 3%
15%
use among current tobacco users. Some or all forms of 11% 10% in newspapers/magazines
tobacco advertising are banned in many countries. on billboards
SINCE IMPLEMENTATION OF GATS, BRAZIL, EGYPT,
POLAND 11%
Only four countries, Egypt, Thailand, Turkey, and Viet Nam TURKEY, AND UKRAINE HAVE BANNED on television
have bans at the point of sale, and in these countries ADVERTISEMENTS IN STORES in stores
there are also relatively low levels of exposure to cigarette 27% UKRAINE
advertising in stores. The four major venues Data are not available for
(newspapers/magazines, billboards, television, stores) are RUSSIAN FEDERATION 7% all media channels in
2% 4% 4%
presented; additional data were also collected on posters, some countries as they
public transportation, and public walls. did not ask those
questions.
CHINA
IN FOUR COUNTRIES ARGENTINA, INDONESIA, ROMANIA
PHILIPPINES, AND RUSSIAN FEDERATION OVER
40% OF PEOPLE NOTICE POINT-OF-SALE CIGARETTE
ADVERTISING IN STORES 28%
54%
37% 11% 10%
10% 9%
3% 2% 0.7% 0.7% 2%
17% 17%
24%
QATAR
16% GREECE VIET NAM
13% 14%
9% 10%
6%
3% 3%
0.6% 0.3%
MEXICO

PANAMA TURKEY PHILIPPINES

7%
ENFORCE

30% 0.4% 0.2% 0.8%

6%
3% 3% 3% THAILAND
11%
5% 7% 6%
NIGERIA 33%

BRAZIL INDIA
66%
8%
76 6% 5% 77
0.5% 0.9% 0.7% 2%

46%
42%
EGYPT BANGLADESH 19% 40%
13% 14% 14%
25%
21% 21%
18%
13% 13%
10%
7%
MALAYSIA

ARGENTINA URUGUAY INDONESIA


27 Cigarette Promotion IMPACT OF CIGARETTE
PROMOTION
Percentage of adults
A comprehensive ban on all tobacco advertising, 21% age 15 and above
promotion and sponsorship (TAPS) activities significantly 6% noticing cigarette promotion
10%
reduces exposure to smoking cues. Cigarette promotion 0.8%
13% 200813
and sponsorship by the tobacco companies, through 2% 2% 7%
brand extensions, product placements, etc., circumvent branded clothing
government restrictions on TAPS. POLAND
free cigarette samples
UKRAINE
sponsorship of sporting events
RUSSIAN
FEDERATION
Data are not available
for all media channels
5% 4% 5% in some countries as
they did not ask those
questions.
4%
1% 0.5%
ROMANIA

CHINA

11% 11%
7% 3%
6% 5% 0.8% 0.9%
4% 4%
3% 1% 18%

VIET NAM 8%
MEXICO QATAR
GREECE 3%
3% 3% 3%
2% 1% 2%

PHILIPPINES

PANAMA TURKEY

7%
ENFORCE

8% 0.3% 1%
3%
6% 1% 1% 1%
2% THAILAND
0.7%

NIGERIA INDIA
7%
5%
BRAZIL
1%
2% 2%
0.4%

78 BANGLADESH 79
EGYPT
32%
8% 30%

3%
8%
4% 5% 5%
1% 2%
MALAYSIA
6%
ARGENTINA
URUGUAY
NEARLY ONE-THIRD OF ADULTS IN INDONESIA
NOTICE SPONSORSHIP OF SPORTING EVENTS BY
CIGARETTE COMPANIES INDONESIA
Part Seven
RAISE
PRICES

PPP $2.7
IS THE AVERAGE COST OF
Article 6: Price and tax measures to
reduce the demand for tobacco 20 MANUFACTURED CIGARETTES
Parties recognize that price and tax measures
are an effective and important means of
ACROSS 22 GATS COUNTRIES
reducing tobacco consumption.
Each Party should adopt or maintain
measures which may include: implementing
tax policies and, where appropriate, price
policies, on tobacco products so as to
contribute to reducing tobacco
consumption.

80 81
28 Cost and Affordability of Cigarettes AFFORDABILITY
Average cost of 2,000 manufactured
cigarettes as percentage of
Increasing the price of tobacco through tax increases is GDP per capita
the single most effective way to decrease tobacco use. 200813
Higher prices encourage current users to quit and
prevent youth from starting. After adjusting for 7.0% or more
differences in country-level purchasing powers, the 3.0% 6.9%
average cost of a pack of 20 manufactured cigarettes is
2.0% 2.9%
$2.7 among 22 GATS countries.
RUSSIAN FEDERATION less than 2.0%
Cigarette prices are still very low in countries with large
populations, such as Bangladesh, Brazil, China, Egypt,
Indonesia, Philippines, Russian Federation, and
POLAND
Viet Nam. The majority of the worlds population lives in UKRAINE
countries with affordable cigarette prices due to low ROMANIA
taxes on cigarettes.
TURKEY
GREECE
C H I N A

QATAR
MEXICO EGYPT INDIA
BANGLADESH
VIET NAM

PHILIPPINES

PANAMA THAILAND

NIGERIA MALAYSIA

COST OF CIGARETTES INDONESIA


Average cost of 20 manufactured BRAZIL
cigarettes among current smokers
RAISE PRICES

200813
The values are given in international or
Purchasing Power Parity dollars (PPP $),
which reflect the cost of living within each
country and enable cross-country
comparisons.

URUGUAY

$4.9 ARGENTINA
$4.8
CIGARETTES ARE HIGHLY AFFORDABLE IN
$4.3
$4.2 COUNTRIES WITH LARGE POPULATIONS OF
SMOKERS AND HIGH SMOKING PREVALENCE:
$3.8
BRAZIL, CHINA, AND RUSSIAN FEDERATION
$3.5
$3.3 $3.3
82 83
$2.9
$2.7 $2.7
$2.5 $2.4

$1.8 $1.8 $1.7 $1.7 $1.6


$1.3 $1.2 $1.1
$0.8

ROMANIA GREECE POLAND MALAYSIA PANAMA MEXICO URUGUAY TURKEY INDIA ARGENTINA THAILAND NIGERIA QATAR CHINA INDONESIA EGYPT BRAZIL UKRAINE RUSSIAN BANGLADESH VIET NAM PHILIPPINES
FEDERATION
29 Expenditure on Cigarettes PROPORTION OF GDP
SPENT ON CIGARETTES
Average monthly expenditure
The average monthly expenditure on manufactured on manufactured cigarettes
cigarettes among current smokers across 22 GATS as percentage of monthly GDP
countries is PPP $50.2. Monthly expenditure on per capita
cigarettes constitutes more than 5% of the monthly GDP 200813
per capita in 14 out of 22 GATS countries. It is more than
10% in Bangladesh, Nigeria, and Romania. 10.0% or more
RUSSIAN FEDERATION
5.0% 9.9%
less than 5.0%
POLAND
UKRAINE
ROMANIA

EXPENDITURE ON CIGARETTES TURKEY


Average monthly expenditure on GREECE
C H I N A
manufactured cigarettes
$146.2
200813
QATAR
The values are given in international or Purchasing
MEXICO EGYPT
Power Parity dollars (PPP $), which reflect the cost of INDIA
living within each country and enable comparisons to BANGLADESH
VIET NAM
be made between countries.
PHILIPPINES

PANAMA THAILAND
$116.2 NIGERIA MALAYSIA

INDONESIA
BRAZIL

$95.1
RAISE PRICES

$80.6

$74.4 URUGUAY
ARGENTINA
SMOKERS IN COUNTRIES WITH A RELATIVELY LOW
INCOME SPEND A HIGHER PROPORTION OF THEIR
$57.0
INCOME ON CIGARETTES
$56.9 $55.7
$52.1
$47.8

84 $39.6 85
$37.5
$34.3 $34.2 $33.7
$30.1
$28.8

$22.7
$18.9
$16.8
$13.9
$11.2

GREECE ROMANIA POLAND TURKEY MALAYSIA QATAR PANAMA URUGUAY ARGENTINA EGYPT CHINA UKRAINE THAILAND INDONESIA BRAZIL RUSSIAN MEXICO NIGERIA VIET NAM INDIA BANGLADESH PHILIPPINES
FEDERATION
Part Eight
Quotes from Country Partners
TRACKING
PROGRESS GATS assists countries to track tobacco control policies.
With this important tool, we can invest our resources
where most needed for saving lives
Brazil

We are eagerly looking forward to repeating GATS in 2015


China

GATS is a huge catalyst for guiding tobacco control


policies in India. It has provided us with vital data on all
aspects of tobacco control
India

We are proud to continue the systematic monitoring of tobacco


Article 20: Research, surveillance and
use by incorporating GATS/TQS questions into our National
exchange of information Health and Morbidity Survey in 2015
Parties should integrate tobacco surveillance Malaysia
programmes into national, regional and global
health surveillance programmes so that data
are comparable and can be analysed at the The capacity of the Romanian health system to implement
regional and international levels, as
appropriate. such surveys at a national scale was definitely improved after
GATS. We are sure to use this experience for other health
surveys as well
Romania

86 87
GATS is a best-practice project for transferring the body of
knowledge from global to local: think globally, act locally
Thailand

GATS is an integral part of tracking the NCD targets. It is very


important for Ukraine that GATS helped the country be a part of
a global network: the sum is greater than its parts
Ukraine
30 GATS Tracking Progress: Thailand
In Thailand, the Global Adult Tobacco Survey was first
conducted in 2009 and repeated in 2011. Both surveys PREVALENCE OF CURRENT SMOKING
used similar multistage stratified cluster sample designs 50
to produce nationally representative data. male 46.6%
45.6%
Thailand historically has had strong tobacco control laws
40
that were successful in reducing smoking prevalence.
Further reduction will only occur with strengthened
enforcement of current laws and with introduction of 30
stronger measures. overall
23.7% 24.0%
20
NO SIGNIFICANT CHANGES OCCURRED IN OVERALL
SMOKING PREVALENCE BETWEEN 2009 AND 2011
10

3.1%
female
2.6%
0
2009 2011
TRACKING PROGRESS

EDUCATION LEVEL
Percentage of current manufactured cigarette smokers
who purchased new inexpensive cigarette brand
2011

14.3% CURRENT SMOKERS WITH LESS EDUCATION ARE QUIT ATTEMPTS DECLINED FROM 49.8% IN 2009
10.5% 9.6% MORE LIKELY TO PURCHASE INEXPENSIVE TO 36.7% IN 2011
4.9% CIGARETTE BRANDS INTRODUCED BY THE THAILAND
TOBACCO MONOPOLY FOLLOWING A 2009 TOBACCO
TAX INCREASE QUIT ATTEMPTS AMONG SMOKERS
less than primary primary secondary university In the past 12 months
2009
2011
60.6%

49.8%
CURRENT SMOKERS WHO THOUGHT OF QUITTING BECAUSE OF GRAPHIC HEALTH WARNING ON PACKAGING 47.5%
DECREASED FROM 67.0% IN 2009 TO 62.6% IN 2011
42.6%
88
NOTICED CIGARETTE ADVERTISEMENTS 89
36.7% In stores where cigarettes were sold in the past 30 days
35.4%
among adults
TOP THREE MOST EFFECTIVE GRAPHIC HEALTH WARNINGS
Influencing current smokers to want to quit and non-smokers to not want to start 2009
2011 2011 24.5%

Smoking causes oral cancer Smoking causes laryngeal cancer Smoking causes lung cancer 18.2% 16.8%

11.6%
6.7% 5.5%

overall 1524 years 25+ years overall 1524 years 25+ years
31 GATS Tracking Progress: Turkey
In Turkey, GATS was first conducted in 2008 and
repeated in 2012. Both surveys used similar multistage PREVALENCE OF CURRENT SMOKING Surveillance and monitoring of tobacco use and
stratified cluster sample designs to produce nationally prevention policies are the key elements of tobacco
representative data. 50 control. GATS 2008 was the first national
47.9%
Turkey is the first country to attain the highest level of representative household survey in Turkey and
achievement in all six MPOWER measures, and is male
41.5% repeated in 2012. In four years, there is 13.4% relative
continuing its commitment to implement strong tobacco 40
control policies in order to further accelerate these decrease on tobacco use, which shows tobacco control
encouraging trends. 30 31.2% and MPOWER policies work in Turkey.
overall 27.1%
Dr Mehmet Muezzinoglu,
Minister of Health, Republic of Turkey
20
TURKEY IMPLEMENTED GRAPHIC HEALTH
15.2%
WARNINGS IN 2010 LEADING TO AN INCREASE female 113.1%
IN PEOPLE THINKING ABOUT QUITTING 10 THE REAL COST OF A PACK OF 20
MANUFACTURED CIGARETTES HAS
INCREASED SUBSTANTIALLY AND CIGARETTES
0 HAVE BECOME LESS AFFORDABLE
2008 2012
THINKING OF QUITTING
Because of noticing health warnings 5.7 TL
on cigarette packaging
4.0 TL
TRACKING PROGRESS

2008
1.2 MILLION FEWER PEOPLE IN TURKEY
2012
SMOKED CIGARETTES IN 2012 THAN IN 2008 AVERAGE AMOUNT 80.3%

57.5% PAID FOR 20


73.5%
53.0%
51.6% MANUFACTURED
CIGARETTES
46.3% 46.4% 46.3%
44.8% 46.0% QUIT ATTEMPTS And total tax as percentage
AMONG SMOKERS of retail price
In the past 12 months and
cessation methods used (in Turkish Lira, TL)
2008 2012
2008
2012

13.6%
9.3%
8.0%
EXPOSURE TO FEWER NON-SMOKERS ARE BEING EXPOSED TO
SECONDHAND SMOKE 56.3%
SECONDHAND SMOKE AFTER IMPLEMENTATION
55.9%
1.8% In the past 30 days IN 2009 OF A NATIONAL SMOKE-FREE LAW IN
RESTAURANTS, CAFES, AND BARS
overall male female quit attempts pharmacotherapy counseling/advice 2008
2012
90 38.3% 91
TOP THREE MOST EFFECTIVE GRAPHIC HEALTH WARNINGS 37.3%
Among current smokers
2012

Smoking causes fatal lung cancer Smoking when pregnant harms your baby Smokers die younger
15.6% 16.5%
12.9%
10.4% 11.3%
6.5%

homes workplace public transport government buildings restaurants


32 Integrating TQS: Sustainable Surveillance INTEGRATION OF TQS
as of November 2014

TQS (Tobacco Questions for Surveys) is a list of 22 TQS IS A COST-EFFECTIVE AND SUSTAINABLE OPTION 47.9%
completed
43.5%
survey questions grouped according to the MPOWER TO MONITOR THE TOBACCO EPIDEMIC
classification that ensures consistency in reporting results
TURKEY not integrated
Prevalence of tobacco smoking 31.2% 29.5%
with GATS. It offers flexibility through seamless integration among adults age 15 and above not applicable
into national and international surveys or as a standalone
module. Global Adult Tobacco 15.2% 16.0%
Survey, 2008
TQS also increases the pool of reliable results and quality National Health
estimates. Four countries have implemented GATS and Survey, 2010
TQS into their national surveys, demonstrating that the overall male female
results can be used to track trends and improve
comparability over time.
RUSSIAN FEDERATION
COUNTRY SURVEYS Prevalence of tobacco smoking 31.8%
among women age 15 to 44
INCORPORATING TQS RUSSIAN FEDERATION
23.7%
as of November 2014 Global Adult Tobacco
Survey, 2009
SLOVAKIA
Reproductive Health
CAMEROON GEORGIA CZECH REPUBLIC MOLDOVA
KAZAKHSTAN
Survey, 2011
MONGOLIA
Multiple Reproductive HUNGARY
Indicator Health Survey
SLOVENIA
GEORGIA
UZBEKISTAN
KYRGYZSTAN
ARGENTINA Cluster Survey (RHS) CROATIA

National Risk (MICS) TURKEY


ARMENIA
TURKMENISTAN
CHINA
TRACKING PROGRESS

Factor Survey BERMUDA C H I N A Prevalence of tobacco smoking


(NRFS)
CAYMAN GHANA KUWAIT
BHUTAN among adults age 18 and above
PAKISTAN NEPAL
ISLANDS Study on Global
WHO Ageing and Adult CAYMAN ISLANDS
EGYPT
SAUDI
QATAR
Global Adult
ARMENIA
Tobacco Survey, 2010
ARABIA
STEPS Health (SAGE) BANGLADESH LAO PEOPLES
WHO Health Wave 2 MYANMAR
DEMOCRATIC REPUBLIC
SAMOA
Systems SAINT VINCENT AND THAILAND COOK ISLANDS
Behavioral Risk Factor
SLOVENIA
Performance
CHINA
EL SALVADOR THE GRENADINES
European
BURKINA
TONGA Surveillance, 2011
Assessment FASO
BRFSS, Health Health
HUNGARY 55.8%
Literacy Survey, Interview 53.3%
European MALDIVES SRI LANKA
TQS in 14 Survey GHANA MALDIVES
Health WHO CAMEROON
Cities UGANDA
BANGLADESH Interview STEPS
RWANDA
WHO Survey SOUTH
STEPS COOK AFRICA
BRAZIL
ISLANDS Study on Global
KAZAKHSTAN MOLDOVA
WHO Ageing and Adult TIMOR-LESTE
TQS WHO
STEPS Health (SAGE)
BERMUDA Standalone STEPS
Wave 2
WHO in Almaty BOTWANA
STEPS CROATIA TURKEY
QATAR National Health 2.5% 2.5%
European MONGOLIA SRI SOUTH
Health KUWAIT WHO WHO LANKA Survey (NHS), AFRICA
BHUTAN Interview STEPS STEPS WHO Survey on Health LESOTHO male female
WHO
WHO Survey STEPS Promotion
STEPS
STEPS ARGENTINA

CZECH RUSSIAN
MYANMAR FEDERATION THAILAND
REPUBLIC WHO SAMOA 69.7% 70.0%
Cigarette
92 BOTSWANA
Countrywide
KYRGYZSTAN STEPS
Reproductive WHO Smoking and 93
Integrated Non- Health Survey STEPS TURKMENISTAN
WHO WHO STEPS (RHS) Alcohol Drinking WHO STEPS
communicable 54.3%
STEPS Behavior
Diseases 51.0%
NEPAL Survey
Intervention
WHO SAUDI
(CINDI) RWANDA
BRAZIL LAO STEPS ARABIA 39.1%
National PEOPLES
WHO Saudi Health TIMOR- UGANDA BANGLADESH 34.4%
STEPS Interview LESTE WHO
Health Survey EGYPT DEMOCRATIC
STEPS
Prevalence of tobacco use
(NHS) REPUBLIC Survey WHO
WHO PAKISTAN
STEPS among adults age 25 and above
STEPS WHO STEPS National Health SAINT
Behavior Survey VINCENT SLOVAKIA Global Adult Tobacco
BURKINA EL (NHBS), AND THE Tobacco and TONGA UZBEKISTAN Survey, 2009
FASO SALVADOR LESOTHO WHO STEPS GRENADINES Health WHO
WHO National WHO WHO STEPS Education
WHO NCD Risk Factor
STEPS STEPS
STEPS Population STEPS Survey Survey, 2010 overall male female
Health Survey COMPLETED
33 NCDs: Global Voluntary Tobacco Targets TARGETS FOR TOBACCO
USE PREVALENCE
2025
The four main non-communicable diseases (NCDs) The projections for 2025 are illustrated for four selected TARGET: A 30% RELATIVE REDUCTION IN TOBACCO
cancers, diabetes, and cardiovascular and chronic lung countries (Brazil, China, India, and Russian Federation) USE PREVALENCE BY 2025
diseases kill three out of every five people. based on the GATS 200810 data and United Nations number of non-tobacco users 00m
(UN) population estimates. number of tobacco users 00m
Tobacco use is the only single risk factor shared by the
lt p o p u la ti o n lt p o p u l a t i o n :
four major NCDs. adu :1 adu 11 number of averted tobacco users
tal 68m 1 tal 69m 00m
if target met

3m
To

To
In November 2012, WHO Member States agreed on a

2m
global monitoring framework which includes a set of 13m 30% target reduction in
voluntary global targets that will achieve the global NCD tobacco-use prevalence
39.3%
9.3%
% 31m
mortality reduction goal. A key target is to achieve a 30% Baseline data (200810)
relative reduction in current tobacco use among people reported from GATS.
of age 15 and above by 2025. 2025 country population data from
44m 27.5%
UN projections.
2009 RUSSIAN FEDERATION
FEDERATION 2025

u l t p o p u l a ti o n : 1
p o p u l a ti o n: ta l ad 144m 75
m
u lt To
a l ad 118m 14
3
ot
m
T

a dult population: 1,198m


Total
9m 861m
t p o pu l a t i o n : 1 , 0 6 9
Tot al ad ul m
TRACKING PROGRESS

21m 768m
17.5%
5%
%
12.3%
12.3
25m

2008 BRAZIL
B R 2025

tio n : 1 ,0 6 1 m
lt p o p ula
l a du 694m
ta 101m
To
o p ul atio n: 7 9
l a d u lt p 6
Tota m 28.1%
521m 236m

110m

94 34.6% 19.7%
19 7% 95
257m 301m

2010 CHINA
CH
HINA 2025

REGULAR MONITORING AND SURVEILLANCE IS


24.2%
24 2% ESSENTIAL TO ENSURE THAT TARGETS ARE ACHIEVED

275m

2010 INDIA
INDIIIA
A 2025
Part Nine
Quotes from Country Partners
REGIONAL
HIGHLIGHTS GATS was a breakthrough in providing the first nationally
representative tobacco figures, which supported the planning of
evidence-based national tobacco control strategies
Egypt

The GATS process allowed access to internationally renowned


experts in survey design and public health policy a unique
capacity building experience
Greece

GATS enriched our national data on tobacco to enable us


to update tobacco control policies
Indonesia

GATS allows comparisons between countries, and strengthens


Article 20: Research, surveillance and
exchange of information technical cooperation on tobacco control
Each Party shall promote and strengthen Panama
training and support for all those engaged in
tobacco control activities, including research,
implementation and evaluation.
GATS provided a baseline to help refine and accelerate our
tobacco control strategies
Qatar

GATS provided a clear picture of the country status and the


impact of tobacco control policies in different population
96
groups. Only by knowing our needs can we plan an 97
effective response
Uruguay

Strong partnerships were central to the successful


implementation of GATS in our country, and the data obtained
have been instrumental in the development of our national
tobacco control policy
Viet Nam
34 Regional Highlights: Africa Eastern Mediterranean
EGYPT
2009
19% of adults currently smoke tobacco

19%
men women
38% 0.5%

3% of adults are shisha smokers


NIGERIA 3%
men
6%
women
0.3%
2012
6% of adults use tobacco the lowest
prevalence among all 22 GATS countries  Survey interview in progress in Egypt. For cultural reasons, only A typical smoker in Egypt spends more than
WHO African Region female interviewers conducted surveys with female respondents.
6% men women 9% 9% of monthly GDP per capita on cigarettes
country has completed GATS
10% 1%
country implementing GATS
not applicable CIGARETTES CHEAPEST IN REGION EVEN THOUGH
29% of adults are exposed to secondhand CIGARETTE TAXES INCREASED SIGNIFICANTLY IN
29%
smoke in restaurants 2010 TO COMPRISE ABOUT 65% OF RETAIL SALE
REGIONAL HIGHLIGHTS

PRICE

17% of adults are exposed to secondhand


17% smoke in enclosed workplaces
PAKISTAN

CIGARETTES ARE CHEAP RELATIVE TO


BASIC NECESSITIES SAUDI ARABIA
UNITED ARAB
EMIRATES
WHO Eastern Mediterranean Region
OMAN
PREVENTION POLICIES ARE CRITICAL country has completed GATS
TO KEEP PREVALENCE LOW country implementing GATS
SENEGAL

other region
not applicable

CAMEROON

UGANDA

KENYA

NIGERIA HAS THE LOWEST PREVALENCE QATAR


OF TOBACCO USE AMONG ALL 22 GATS Self-funded GATS, 2013
COUNTRIES: 6% OVERALL 98%
98 99
The 98% response rate to the survey was the
 Survey interview in progress in Nigeria.
highest among 22 GATS countries

Of those who attempt to quit smoking, the


highest percentage seek counseling/advice
16% from healthcare professionals

BAN ON ELECTRONIC CIGARETTES IN PHARMACIES


AS OF 2012
35 Regional Highlights: Americas
MEXICO WHO Region of the Americas
2009 country has completed GATS
Only GATS country where fewer than half of male country implementing GATS
current tobacco users are daily users

Lowest percentage of current users BRAZIL


27% who use tobacco within Co-funded GATS, 2008
30 minutes of waking
65% Effective graphic health warnings on cigarette
packaging, with 65% of current smokers thinking
81%
about quitting as a result of seeing them
81% of adults are exposed to secondhand
smoke in bars and night clubs
46% Highest male quit ratio
MEXICO CITY ADOPTED SMOKE-FREE LEGISLATION IN 2008,
PROHIBITING SMOKING IN ALL ENCLOSED PUBLIC PLACES
AND WORKPLACES INCLUDING BARS AND RESTAURANTS
74%
Cigarette price increased 74% from 2006 to 2013,
SINCE GATS, THERE HAVE BEEN CONSECUTIVE following a 116% increase in excise tax per pack
TOBACCO TAX RAISES IN 2010 AND 2011
REGIONAL HIGHLIGHTS

FIRST COUNTRY TO BAN THE TERMS LIGHT AND MILD


FROM CIGARETTE PACKAGING
PANAMA
Self-funded GATS, 2013
GATS was integrated into the national health survey

Lowest percentage of male smokers


10% among 22 GATS countries COSTA RICA
URUGUAY
2009
64%
More than half of current smokers COLOMBIA

are thinking about quitting


Graphic health warnings cover
CURRENT COMPREHENSIVE LAW REQUIRES: SMOKE-FREE PUBLIC PLACES, BAN 80% of front and back of cigarette
ON TOBACCO ADVERTISING, PROMOTION, AND SPONSORSHIP, AND GRAPHIC packaging
HEALTH WARNINGS ON CIGARETTE PACKAGING

ARGENTINA Lowest percentage of adults exposed to


2012
secondhand smoke in all public places among
99%
22 GATS countries
100 99% of adults believe
101
76%
that smoking causes lung cancer Highest percentage of smokers
intending to quit smoking  President of Uruguay releasing
GATS results.
47% of non-smokers are exposed to THE 2011 NATIONAL TOBACCO CONTROL LAW
47% REQUIRES GRAPHIC HEALTH WARNINGS AND
secondhand smoke in indoor places
A COMPREHENSIVE BAN ON TOBACCO THE 2005 TOBACCO CONTROL LAW BANS SMOKING
ADVERTISING, PROMOTION, AND IN ALL PUBLIC PLACES, AND ALL FORMS OF TOBACCO
92% ADVERTISING, PROMOTION, AND SPONSORSHIP
92% of adults support national laws SPONSORSHIP
prohibiting smoking in all enclosed EXCEPT POINT-OF-SALE ADVERTISING AND DISPLAY
workplaces Not yet a party to the WHO FCTC OF THE PRODUCT
36 Regional Highlights: Europe
UKRAINE WHO European region
2010 country has completed GATS
64% SINCE GATS, LAWS HAVE BEEN PASSED TO FURTHER country implementing GATS
64% of adults are exposed to
secondhand smoke in restaurants RESTRICT TOBACCO ADVERTISING, PROMOTION, other region
or cafs AND SPONSORSHIP, AND TO BAN SMOKING IN not applicable
RESTAURANTS, CAFS, AND BARS
45% 45% of adults are exposed to cigarette
Between 2008 and 2010, tobacco tax increased
advertising, promotion, and sponsorship
more than five fold

POLAND
2010

Lowest male-to-female ratio


for smoking prevalence (1.5:1)

51% of non-smokers who visit KAZAKHSTAN


51% restaurants, coffee shops, and bistros
REGIONAL HIGHLIGHTS

are exposed to secondhand smoke


RUSSIAN FEDERATION
NEW LAW MANDATED HEALTH 2009
WARNINGS ON PACKAGING OF ALL 61% of adult men use tobacco, the
61%
SMOKING TOBACCO PRODUCTS SINCE second highest among 22 GATS
GATS TURKEY
2008, 2012 countries

First country in the world to achieve the highest level 59% 59% of adults are exposed to tobacco
of achievement in MPOWER measures advertising, promotion, and sponsorship
ROMANIA Repeated the GATS survey in 2012
2011 GREECE 73% 73% of current smokers support
prevalence of smoking of
Self-funded GATS, 2013 manufactured cigarettes The prevalence of manufactured comprehensive ban on tobacco
64% High percentage of women tobacco users
cigarette smoking declined by advertising, promotion, and sponsorship
using tobacco products within 30 minutes
Women smokers smoke an average of 15% from 2008 to 2012, following
of waking
17 cigarettes per day highest among 30% 26%
a 42% increase in cigarette
94% 22 GATS countries prices after a tax raise in 2010 GATS data were used to support the passage of a
94% who visit night clubs and bars are 2008 2012 comprehensive tobacco control law in 2013,
exposed to secondhand smoke 84% Highest percentage of smokers banning point-of-sale advertising and selling
72%
being asked about smoking status SINCE 2008, LAWS HAVE BEEN PASSED TO cigarettes in kiosks
57% (84%) and advised to quit (72%) PROHIBIT SMOKING IN PUBLIC PLACES,
by a healthcare professional FURTHER RESTRICT TOBACCO ADVERTISING,
102 57% support smoking ban in bars PROMOTION, AND SPONSORSHIP AND MANDATE 103
Highest female smoking GRAPHIC HEALTH WARNINGS ON PACKAGING OF
87% 26% prevalence (26%) TOBACCO PRODUCTS
87% of adults who visit restaurants are
exposed to SHS
Lowest percentage of smokers thinking
about quitting because of health
72% 16%
warnings on cigarette packaging
 Survey interviews in progress in Russia.
72% support smoking ban in restaurants 84% t Director General of WHO,
Dr. Margaret Chan, presenting the
Director Generals Special Recognition
84% of non-smokers support laws prohibiting Certificate to the Prime Minister of
smoking in restaurants Turkey, Recep Tayyib Erdoan.
37 Regional Highlights: South-East Asia
INDIA CURRENT TOBACCO USERS
2010 Percentage of people age 15 and above
JAMMU
AND KASHMIR in each state
200910
45.0% or more 15.0% 29.9%
THAILAND
HIMACHAL
PRADESH

30.0% 44.9% less than 15.0%


PUNJAB
CHANDIGARH UTTARANCHAL 2009, Co-funded GATS repeat survey, 2011
HARYANA
DELHI ARUNACHAL
PRADESH
SIKKIM 30% of men smoke manufactured
RAJASTHAN
cigarettes and 27% smoke hand-rolled
UTTAR
PRADESH ASSAM
NAGALAND 30% 27%
cigarettes
BIHAR MEGHALAYA
MANIPUR
JHARKHAND TRIPURA
MADHYA PRADESH WEST MIZORAM
85% A law to increase the size of the health
GUJARAT BENGAL

CHHATTISGARH
warning on the front of packaging from 50% of
DAMAN & DIU MAHARASHTRA ORISSA
area to 85% was passed in 2014
DADRA AND
NAGAR HAVELI

Has a comprehensive tobacco control law in place


ANDHRA
PRADESH
Tobacco taxes fund the tobacco control programs
GOA
Repeated the GATS survey in 2011
REGIONAL HIGHLIGHTS

KARNATAKA
ANDAMAN
AND NICOBAR
PONDICHERRY ISLANDS
LAKSHADWEEP TAMIL NADU

KERALA

Co-funded GATS WHO South-East Asia Region


Highest number of smokeless tobacco users country has completed GATS
(206 million) among 22 GATS countries other region
not applicable
Enforcement of the national comprehensive tobacco
control law needs further strengthening

National, regional, and state-specific estimates are


available  Survey interview in progress in India.

INDONESIA
2011
67%
Highest male smoking prevalence among
22 GATS countries
BANGLADESH
2009 78%
104 Highest percentage of adults exposed to 105
Highest tobacco use prevalence secondhand smoke at home
43% (43%) and smokeless tobacco use 27%
(27%) among 22 GATS countries
Highest percentage of adults noticing cigarette
Highest percentage of women company sponsorship of sporting events and
29% using tobacco (29%) cigarette advertisements on TV, billboards and in stores
predominantly smokeless
 Survey interview in progress in Bangladesh.
Since GATS, the 2012 legislation has restricted
FROM JUNE 2014, GRAPHIC HEALTH outdoor tobacco advertising and sponsorship
21% of men WARNINGS ARE REQUIRED TO COVER 40%
21% are bidi smokers OF CIGARETTE PACKAGING  Survey interview in progress in Indonesia. Not yet a party to the WHO FCTC
38 Regional Highlights: Western Pacific
CHINA PHILIPPINES WHO Western Pacific region
2010 2009, Will fund GATS repeat survey country has completed GATS
Largest number of tobacco users in the world other region
(301 million) Highest tobacco smoking prevalence among not applicable
9%
women in the region
Largest number of adults exposed to secondhand smoke at work
(246 million) and home (717 million) 71%
71% of adults are exposed to cigarette
advertising
64% Lowest percentage among 22 GATS countries of adults
aware of the harms of secondhand smoke
54% 54% of adults notice advertising in stores
where cigarettes are sold
REGULATIONS REQUIRE ALL HEALTHCARE
FACILITIES, PRIMARY, MIDDLE AND HIGH The 2012 Sin Tax Reform Act significantly increased
SCHOOLS, AND ENCLOSED PUBLIC PLACES tobacco taxes
TO BE SMOKE FREE. HOWEVER,
ENFORCEMENT IS A CHALLENGE

A NATIONAL TOBACCO CONTROL LAW


REGIONAL HIGHLIGHTS

FOCUSING ON PUBLIC PLACES AND A


REVISION OF NATIONAL ADVERTISEMENT
LAW ARE BEING DRAFTED AS OF JUNE 2014
 Survey interview in progress in China.

VIET NAM
2010

Highest percentage of men who smoke


waterpipe among 22 GATS countries
13%

85%
85% of adults are exposed to secondhand
smoke in restaurants MALAYSIA
2011

106 86% Highest percentages among 22 GATS countries of adults 107


Highest percentage of adults noticing anti-cigarette information on the radio, billboards
noticing anti-cigarette and in newspapers/magazines
information on TV
Lowest percentage of female tobacco users who use
55% Highest percentage of smokers tobacco within 30 minutes of waking up
who attempted to quit
83%
Highest quit intention
THE 2012 COMPREHENSIVE TOBACCO CONTROL LAW among women
BANS ALL FORMS OF DIRECT AND INDIRECT TOBACCO
ADVERTISING AND MANDATES GRAPHIC HEALTH Comprehensive ban on tobacco advertising, promotion and
WARNINGS TO COVER 50% OF CIGARETTE PACKAGING sponsorship
Part Ten
Quotes from Country Partners
DISSEMINATION
GATS assists countries to not only monitor, but
accurately monitor, tobacco control policies
Argentina

GATS has been a useful instrument in furthering the


activities on Tobacco Control
Bangladesh

GATS data were instrumental to the national


tobacco control policy
Mexico

Nigeria aims to use the findings to strengthen our national


tobacco control plan and for the eventual elimination of tobacco
Article 20: Research, surveillance and
exchange of information as a public health risk factor
Parties shall cooperate with the World Nigeria
Health Organization in the development of
general guidelines or procedures for defining
the collection, analysis and dissemination of Without GATS data we were shooting in the dark. We can now
tobacco-related surveillance data.
invest our resources where most needed for saving lives
Philippines

The information from GATS continues to increase the


effectiveness of health policies and to reduce the smoking
108 109
epidemic, thereby promoting the health of Poles
Poland

GATS findings were instrumental in justifying the adoption


of a new strong law on tobacco control, protecting people
from exposure to tobacco smoke and the consequences of
tobacco consumption
Russian Federation
39 Data Dissemination
FACT SHEETS DATA COORDINATING CENTER
Fact sheets provide data highlights Function
and key messages from the survey results.
CDC is the designated Data Coordinating Center (DCC)
and depository of the GTSS data, including GATS at an
international level. The DCC provides data management,
quality assurance, standardization, and data repository
functions, as well as data sharing, release, and
dissemination.

GATS Comprehensive Standard Protocol


COUNTRY REPORTS The standard guidelines, manuals, and technical
assistance are available to countries to ensure
Country reports document in detail
systematic GATS implementation.
the survey methodology, results,
policy context, and recommendations.
Public Use Datasets
All GATS data, with the exception of any confidential
information, are publicly available, along with the
codebook, one year after the release of the country
report by the national government.

COUNTRY OWNERSHIP AND RELEASES


The national governments provide leadership and coordination for data Interactive Web Application
releases. The data belong to the country, and the health ministries
disseminate the results to the press, public, policy makers, and Data can be accessed from various GTSS surveys. Data
advocates. The country releases aim to focus attention on the current can be tracked by country, region, and MPOWER
state of the policies, and recommend effective strategies. indicators at http://apps.nccd.cdc.gov/gtssdata

PUBLICATIONS
Approximately 40 peer-reviewed articles
have been published.
The full list is given on page 124.
110 111

WEBSITES
GATS comprehensive standard protocol, fact sheets,
country reports and datasets are available at
www.who.int and www.cdc.gov. Each WHO regional
website also hosts respective country information.
40 Timeline
The Global Adult Tobacco Survey started in 2007, as part
201213
of the Global Tobacco Surveillance System. As of 2014,
GYTS protocol
data are available covering 58% of the worlds population
revised and
in 22 countries.
launched in 74
countries

2005
WHO FCTC came 2012
into force, using GTSS Web
international law to Application 2014
reduce tobacco use launched GATS public
2009 2015
2013 use datasets
Tobacco The GATS Atlas
TQS second edition available for 23
Questions for published
launched and available countries
1999 2007 Surveys first
Global Adult in seven languages Brazil integrated
Global Youth edition launched
Tobacco Tobacco Survey 2011 TQS into their 2016
(GATS) TQS Global Alliance ongoing national TQS integrated
Survey (GYTS) The GTSS Atlas TQS integration
commenced founded health survey in 70 countries
commenced published commenced

1999 2005 2007 2009 2010 2011 2012 2013 2014 2015 2016

2009 2010 2012 2013 2014 2015 201416


GATS releases: GATS releases: China, GATS releases: GATS releases: GATS releases: GATS releases: Nine countries
Bangladesh, Egypt, India, Mexico, Argentina, Nigeria, Panama, Greece, Kenya, Cameroon, to repeat GATS
Brazil, Thailand, Philippines, Poland, Indonesia, Qatar Uganda Kazakhstan,
Turkey Russian Federation, Malaysia, Pakistan
Ukraine, Uruguay, Romania,
Viet Nam Thailand (repeat),
Turkey (repeat)

58% 58%
56%

51%
GATS TOTAL COVERAGE
As percentage of world population
age 15 and above
112 2014 113

7%
%

2009 2010 2012 2013 2014


GATS Data
GATS overview Monitor use and policies Monitor use and policies
Number Response Population of Prevalence of Number of Prevalence of daily Percentage distribution of current Number of Prevalence of Prevalence of
of rate adults age 15 current tobacco tobacco users tobacco use tobacco use by age group current tobacco current current
interviews (%) and above use (in millions) (%) (%) smokers tobacco smoking daily tobacco
(in millions) (%) (In millions) (%) smoking
(%)
Country Country
(survey year) overall overall overall male female overall male female overall male female overall male female (survey year) 15 17 18 24 25 44 45 64 65+ overall overall male female overall male female

Argentina (2012) 6,645 74.3 27.6 13.1 14.5 22.2 29.4 15.6 6.1 3.9 2.3 17.1 21.9 12.7 Argentina (2012) 8.6 25.4 27.1 24.0 8.8 6.1 22.1 29.4 15.6 17.1 21.9 12.7

Bangladesh (2009) 9,629 93.6 95.4 47.4 48.0 43.3 58.0 28.7 41.3 27.5 13.8 40.0 52.8 27.3 Bangladesh (2009) 8.2 20.4 44.8 68.8 70.8 21.9 23.0 44.7 1.5 20.9 40.7 1.3

Brazil (2008) 39,425 94.0 143.0 68.5 74.5 17.5 22.0 13.3 25.0 15.1 9.9 15.3 19.2 11.7 Brazil (2008) 4.1 13.7 18.4 23.1 14.5 24.6 17.2 21.6 13.1 15.1 18.9 11.5

China (2010) 13,354 96.0 1,068.8 544.5 524.3 28.1 52.9 2.4 300.8 288.1 12.7 24.1 45.4 2.0 China (2010) 4.0 22.1 31.0 33.6 22.7 300.7 28.1 52.9 2.4 24.1 45.4 2.0

Egypt (2009) 20,924 97.2 49.7 25.3 24.3 19.7 38.1 0.6 9.8 9.6 0.2 18.8 36.3 0.6 Egypt (2009) 4.1 13.7 23.3 25.8 20.5 9.7 19.4 37.6 0.5 18.5 35.8 0.5

Greece (2013) 4,359 69.6 9.3 4.6 4.7 38.2 51.2 25.7 3.5 2.3 1.2 36.6 49.7 23.9 Greece (2013) 6.8 38.4 50.7 43.2 15.3 3.5 38.2 51.2 25.7 36.6 49.7 23.9

India (2010) 69,296 91.8 795.5 411.1 384.4 34.6 47.9 20.3 274.9 197.0 77.9 29.1 40.8 16.7 India (2010) 9.6 21.4 37.3 47.1 47.8 111.2 14.0 24.3 2.9 10.7 18.3 2.4

Indonesia (2011) 8,305 94.3 172.1 85.9 86.2 35.7 67.1 4.4 61.4 57.6 3.8 29.8 56.8 3.0 Indonesia (2011) 15.4 31.6 38.0 40.5 37.5 59.9 34.8 67.0 2.7 29.2 56.7 1.8

Malaysia (2011) 4,250 85.3 20.5 10.6 10.0 23.4 44.0 1.6 4.8 4.6 0.2 21.1 39.9 1.2 Malaysia (2011) 7.2 20.7 29.4 23.1 16.1 4.7 23.1 43.9 1.0 20.9 39.9 0.7

Mexico (2009) 13,617 82.5 68.8 32.8 36.0 16.0 25.0 7.9 11.0 8.2 2.9 7.6 11.9 3.7 Mexico (2009) 10.2 20.2 17.1 15.8 8.1 10.9 15.9 24.8 7.8 7.6 11.8 3.7

Nigeria (2012) 9,765 89.1 81.7 40.9 40.8 5.5 9.9 1.1 4.5 4.1 0.5 4.2 7.6 0.8 Nigeria (2012) 1.0 1.8 6.0 10.4 12.3 3.1 3.9 7.3 0.4 2.9 5.6 0.3

Panama (2013) 16,962 88.4 2.7 1.3 1.3 6.3 9.6 3.0 0.2 0.1 0.04 2.9 4.5 1.3 Panama (2013) 2.8 4.6 7.2 7.4 5.0 0.2 6.1 9.4 2.8 2.8 4.4 1.2

Philippines (2009) 9,701 94.7 61.3 30.6 30.7 29.5 49.2 10.0 18.1 15.0 3.1 23.7 39.7 7.8 Philippines (2009) 12.3 25.7 32.9 33.5 32.0 17.3 28.2 47.6 9.0 22.5 38.2 6.9

Poland (2010) 7,840 65.1 32.3 15.4 16.9 30.5 37.3 24.4 9.9 5.8 4.1 27.0 33.6 21.0 Poland (2010) 11.2 28.5 35.2 37.8 11.8 9.8 30.3 36.9 24.4 27.0 33.5 21.0

Qatar (2013) 8,398 98.5 0.4 0.2 0.2 12.5 21.0 3.1 0.1 0.05 0.01 9.8 17.2 1.7 Qatar (2013) 2.4 8.4 14.3 15.0 8.4 0.1 12.1 20.2 3.1 9.5 16.5 1.7

Romania (2011) 4,517 89.1 18.2 8.8 9.4 26.7 37.4 16.7 4.8 3.3 1.6 24.3 34.9 14.5 Romania (2011) 14.4 25.5 36.3 28.0 7.6 4.8 26.7 37.4 16.7 24.3 34.9 14.5

Russian Federation (2009) 11,406 97.7 112.2 50.8 61.4 39.3 60.6 21.7 44.2 30.8 13.3 33.9 55.1 16.3 Russian Federation (2009) 18.9 48.6 49.7 38.2 14.9 43.9 39.1 60.2 21.7 33.8 55.0 16.3

Thailand (2009) 20,566 94.2 52.6 25.6 27.0 27.2 46.4 9.1 14.3 11.9 2.5 23.6 39.9 8.1 Thailand (2009) 8.0 23.8 26.9 28.7 39.8 12.5 23.7 45.6 3.1 20.3 39.2 2.4

Thailand (2011)* 20,606 96.3 54.2 26.3 27.9 26.9 47.2 7.6 14.6 12.4 2.1 24.3 42.6 6.9 Thailand (2011)* 15.9 24.3 26.7 28.6 31.8 13.0 24.0 46.6 2.6 21.5 42.0 2.1

Turkey (2008) 9,030 90.9 51.2 25.1 26.1 31.2 47.9 15.2 16.0 12.0 4.0 27.4 43.8 11.6 Turkey (2008) 13.0 29.3 39.9 29.5 10.3 16.0 31.2 47.9 15.2 27.4 43.8 11.6

Turkey (2012)* 9,851 90.1 54.5 26.9 27.7 27.1 41.5 13.1 14.8 11.1 3.6 23.8 37.3 10.7 Turkey (2012)* 9.7 25.2 35.7 25.9 8.8 14.8 27.1 41.5 13.1 23.8 37.3 10.7
114 Ukraine (2010) 8,158 76.1 40.0 18.2 21.8 28.9 50.1 11.3 11.6 9.1 2.5 25.5 45.5 8.9 Ukraine (2010) 17.6 34.1 40.1 27.0 8.5 11.5 28.9 50.0 11.3 25.5 45.5 8.9 115
Uruguay (2009) 5,581 95.2 2.5 1.2 1.3 25.0 30.7 19.8 0.6 0.4 0.3 20.4 24.8 16.4 Uruguay (2009) 14.0 29.5 30.4 28.6 8.1 0.6 25.0 30.7 19.8 20.4 24.8 16.4

Viet Nam (2010) 9,925 92.7 64.3 31.3 33.1 25.0 47.6 3.6 16.1 14.9 1.2 20.4 38.8 3.0 Viet Nam (2010) 2.8 17.8 29.0 30.8 24.5 15.3 23.8 47.4 1.4 19.5 38.7 1.2

: Data not available. : Data not available.


~: Indicates estimate based on less than 25 unweighted cases and has been suppressed. ~: Indicates estimate based on less than 25 unweighted cases and has been suppressed.
*: Thailand 2011 and Turkey 2012 data are only used for spreads 30 and 31. *: Thailand 2011 and Turkey 2012 data are only used for spreads 30 and 31.
For precision, the number of decimal places may vary, depending on the indicator and country. For precision, the number of decimal places may vary, depending on the indicator and country.
Monitor use and policies Monitor use and policies
Prevalence of current Pattern of tobacco use Average age of daily Percentage of former daily Average number of
smokeless tobacco use among current users (%) smoking initiation among smokers among ever daily cigarettes
(%) ever daily smokers smokers smoked per day
age 20 34 (%) among current daily
Smoked only Smokeless only Dual use smokers
Country Country
(survey year) overall male female overall male female overall male female overall male female (survey year) overall male female overall male female overall male female

Argentina (2012) 0.2 0.1 0.2 99.3 99.7 98.7 0.2 0.1 0.5 0.4 0.2 0.8 Argentina (2012) 16.3 16.5 16.1 39.5 37.5 42.5 15.2 16.6 13.0

Bangladesh (2009) 27.2 26.4 27.9 37.3 54.6 2.7 46.9 23.0 94.7 15.8 22.5 2.5 Bangladesh (2009) 17.4 17.4 ~ 17.8 16.6 41.3 8.6 8.7 ~

Brazil (2008) 0.4 0.6 0.3 97.5 97.2 98.0 1.9 2.0 1.7 0.6 0.8 0.4 Brazil (2008) 17.2 17.1 17.3 46.9 46.4 47.7 13.8 14.7 12.4

China (2010) 0.4 0.7 0.0 98.6 98.6 98.3 0.0 0.0 0.5 1.4 1.4 1.2 China (2010) 19.5 19.5 ~ 12.8 12.6 16.8 16.5 16.6 12.8

Egypt (2009) 2.2 4.1 0.3 88.8 89.3 56.0 1.5 1.2 18.9 9.7 9.5 25.1 Egypt (2009) 17.1 17.1 ~ 16.6 16.5 21.2 19.3 19.4 ~

Greece (2013) 0.2 0.2 0.2 99.5 99.6 99.4 0.0 0.0 0.0 0.5 0.4 0.6 Greece (2013) 17.7 17.5 18.1 24.0 24.5 23.1 19.8 21.3 16.8

India (2010) 25.9 32.9 18.4 25.1 31.3 9.2 59.5 49.3 85.5 15.4 19.4 5.3 India (2010) 18.3 18.3 17.2 12.6 12.1 16.2 6.2 6.1 7.0

Indonesia (2011) 1.7 1.5 1.9 95.2 97.8 56.6 2.5 0.1 39.8 2.2 2.1 3.7 Indonesia (2011) 17.6 17.6 ~ 9.5 9.0 23.2 12.8 13.0 8.1

Malaysia (2011) 0.7 0.9 0.6 96.9 98.0 64.7 1.3 0.2 35.3 1.7 1.8 0.0 Malaysia (2011) 17.2 17.2 ~ 9.5 9.4 10.0 13.9 14.0 ~

Mexico (2009) 0.3 0.3 0.3 98.0 98.8 95.8 0.9 0.6 1.7 1.1 0.6 2.5 Mexico (2009) 16.6 16.5 17.1 32.0 31.6 33.1 9.4 9.7 8.4

Nigeria (2012) 1.9 2.9 0.9 65.4 70.4 21.9 30.5 26.1 68.9 4.1 3.5 9.2 Nigeria (2012) 18.2 18.3 ~ 36.2 35.2 53.8 8.3 8.0 ~

Panama (2013) 0.8 1.0 0.5 87.8 89.3 83.0 3.7 2.4 7.6 8.5 8.2 9.3 Panama (2013) 16.9 16.7 17.4 37.0 30.6 52.3 14.8 16.3 10.1

Philippines (2009) 1.9 2.7 1.2 93.4 94.4 88.4 4.3 3.1 10.3 2.3 2.5 1.3 Philippines (2009) 17.7 17.6 19.2 21.5 20.9 25.0 10.6 11.3 6.9

Poland (2010) 0.5 1.0 0.1 98.3 97.2 99.7 0.6 1.0 0.0 1.1 1.7 0.3 Poland (2010) 17.7 17.6 18.0 36.5 38.3 33.7 17.2 18.3 15.5

Qatar (2013) 0.7 1.3 0.0 94.4 93.7 100.0 3.5 4.0 0.0 2.0 2.3 0.0 Qatar (2013) 18.1 18.1 18.0 27.3 27.6 24.7 17.2 17.6 10.9

Romania (2011) 0.3 0.4 0.2 98.9 99.0 98.8 0.0 0.1 0.0 1.0 1.0 1.2 Romania (2011) 17.1 16.7 18.0 28.0 28.2 27.5 16.6 17.7 14.1

Russian Federation (2009) 0.6 1.0 0.2 98.5 98.3 99.1 0.5 0.7 0.2 1.0 1.0 0.7 Russian Federation (2009) 16.7 16.6 17.1 18.3 18.8 17.1 17.0 18.5 12.7

Thailand (2009) 3.9 1.3 6.3 85.7 97.1 30.8 12.9 1.8 66.0 1.4 1.0 3.3 Thailand (2009) 17.6 17.6 18.4 28.8 28.4 34.4 12.6 12.9 8.6

Thailand (2011)* 3.2 1.1 5.2 88.0 97.7 31.4 10.8 1.4 65.8 1.2 0.9 2.8 Thailand (2011)* 17.4 17.3 19.0 27.2 26.8 33.8 12.5 12.6 9.3

Turkey (2008) Turkey (2008) 17.1 16.7 17.9 26.5 27.2 23.9 17.7 19.3 12.2

Turkey (2012)* Turkey (2012)* 17.2 16.9 18.1 27.2 26.9 28.3 19.2 20.3 15.3
116 Ukraine (2010) 0.2 0.5 0.0 99.3 99.1 99.9 0.2 0.2 0.0 0.6 0.7 0.1 Ukraine (2010) 17.3 16.9 18.4 25.9 26.1 25.0 16.9 18.1 11.8 117
Uruguay (2009) 0.0 0.0 0.0 100.0 100.0 100.0 0.00 0.00 0.00 0.02 0.04 0.00 Uruguay (2009) 16.5 16.3 16.7 42.0 42.8 41.0 15.4 17.6 12.5

Viet Nam (2010) 1.3 0.3 2.3 94.7 99.4 36.6 4.8 0.4 59.8 0.5 0.2 3.5 Viet Nam (2010) 19.0 19.1 ~ 23.5 23.3 28.6 13.5 13.6 10.9

: Data not available. : Data not available.


~: Indicates estimate based on less than 25 unweighted cases and has been suppressed. ~: Indicates estimate based on less than 25 unweighted cases and has been suppressed.
*: Thailand 2011 and Turkey 2012 data are only used for spreads 30 and 31. *: Thailand 2011 and Turkey 2012 data are only used for spreads 30 and 31.
For precision, the number of decimal places may vary, depending on the indicator and country. For precision, the number of decimal places may vary, depending on the indicator and country.
Monitor use and policies Protect from secondhand smoke
Percentage of adults exposed to smoke Exposure to smoke Exposure to smoke
Percentage distribution of cigarettes smoked per day
in public places (%) Number of adults at workplace in the home
among current daily smokers (%) (in millions) (in millions)
exposed to smoke
government healthcare public
in public places**
restaurants total total total total
1 10 11 19 20 or more buildings facilities transportation (in millions) workforce exposed at home exposed
Country Country
(survey year) overall male female overall male female overall male female (survey year) overall overall overall overall overall overall overall overall overall

Argentina (2012) 45.0 34.1 62.0 9.5 11.3 6.8 45.5 54.7 31.1 Argentina (2012) 24.5 8.8 23.2 16.6 6.8 10.7 3.4 27.5 9.1

Bangladesh (2009) 78.3 78.2 ~ 10.7 10.8 ~ 11.1 11.1 ~ Bangladesh (2009) 43.3 23.8 79.7 53.6 42.8 16.5 10.2 93.3 51.2

Brazil (2008) 52.2 48.6 57.8 12.4 12.8 11.8 35.3 38.6 30.3 Brazil (2008) 18.0 10.1 31.7 9.5 25.8 49.7 11.6 143.0 39.9

China (2010) 39.9 39.1 58.4 13.0 13.1 11.3 47.1 47.8 30.3 China (2010) 58.4 37.9 88.5 34.1 599.7 388.0 245.7 1,065.8 716.9

Egypt (2009) 11.8 11.5 ~ 2.2 2.2 ~ 86.0 86.2 ~ Egypt (2009) 72.7 49.2 72.7 79.6 34.4 9.2 5.5 48.5 30.3

Greece (2013) 21.2 15.9 32.0 21.3 19.8 24.4 57.5 64.3 43.5 Greece (2013) 18.2 6.8 72.2 6.9 3.8 3.0 1.6 9.2 6.0

India (2010) 88.4 88.9 82.1 6.7 6.3 12.0 4.9 4.8 6.0 India (2010) 26.2 16.8 47.8 33.9 228.4 125.0 37.3 782.4 313.0

Indonesia (2011) 37.5 36.4 72.9 46.9 47.7 20.4 15.6 15.9 6.7 Indonesia (2011) 63.4 17.9 85.4 70.0 78.7 28.4 14.6 170.0 133.3

Malaysia (2011) 48.6 48.0 ~ 17.9 18.1 ~ 33.6 33.9 ~ Malaysia (2011) 20.0 8.7 71.0 28.2 9.6 5.8 2.3 19.9 7.6

Mexico (2009) 77.1 75.4 81.9 6.0 6.8 3.8 16.9 17.8 14.3 Mexico (2009) 17.0 4.3 29.6 24.2 15.9 15.5 2.9 68.6 11.9

Nigeria (2012) 76.5 77.4 ~ 12.4 12.9 ~ 11.0 9.7 ~ Nigeria (2012) 16.7 5.3 29.3 9.4 13.1 15.8 2.7 78.9 5.2

Panama (2013) 49.7 44.0 66.9 13.3 10.1 23.0 37.0 45.9 10.2 Panama (2013) 8.6 7.3 12.4 8.2 0.4 0.7 0.04 2.7 0.1

Philippines (2009) 69.0 65.9 86.4 8.5 9.2 4.1 22.5 24.9 9.5 Philippines (2009) 25.5 7.6 33.6 55.3 33.7 13.7 4.5 60.4 32.9

Poland (2010) 29.4 25.2 35.5 19.2 16.7 22.7 51.4 58.0 41.8 Poland (2010) 10.0 4.6 52.0 8.4 6.7 12.9 4.3 31.8 14.1

Qatar (2013) 32.5 29.9 66.1 14.1 14.6 7.5 53.4 55.5 26.5 Qatar (2013) 7.8 4.3 25.9 14.0 0.1 0.2 0.03 0.4 0.1

Romania (2011) 34.2 27.5 49.4 14.6 14.3 15.3 51.1 58.2 35.3 Romania (2011) 20.7 10.4 86.6 8.9 5.9 5.8 2.0 18.1 6.4

Russian Federation (2009) 33.8 25.1 58.0 15.6 15.9 14.9 50.6 59.0 27.1 Russian Federation (2009) 17.0 10.2 78.6 24.9 39.3 62.9 21.9 111.6 38.7

Thailand (2009) 55.8 54.5 78.1 20.1 20.7 9.4 24.1 24.8 12.5 Thailand (2009) 13.0 4.8 34.4 21.6 9.2 12.1 3.3 52.4 17.4

Thailand (2011)* 57.9 57.0 76.3 18.0 18.4 9.3 24.1 24.6 14.4 Thailand (2011)* 14.7 7.3 46.9 25.6 16.5 13.8 4.2 54.2 19.5

Turkey (2008) 33.9 26.0 62.5 12.1 13.1 8.4 54.0 60.9 29.2 Turkey (2008) 11.3 6.0 55.9 16.5 16.1 14.2 5.3 50.5 28.5

Turkey (2012)* 29.6 23.7 49.5 12.2 12.3 11.7 58.2 64.0 38.8 Turkey (2012)* 6.5 3.8 12.9 10.4 7.5 15.6 2.4 54.4 20.8
118 Ukraine (2010) 32.8 25.5 63.9 16.1 17.6 9.9 51.1 57.0 26.2 Ukraine (2010) 10.1 6.6 64.1 17.5 11.9 15.7 5.2 39.8 9.4 119
Uruguay (2009) 47.6 38.8 59.3 15.5 15.2 15.9 36.9 46.0 24.7 Uruguay (2009) 6.9 3.8 4.4 5.4 0.2 1.0 0.2 2.5 0.8

Viet Nam (2010) 60.2 59.8 72.3 10.5 10.7 5.2 29.3 29.5 22.5 Viet Nam (2010) 38.7 23.6 84.9 34.4 20.9 14.3 8.0 64.0 46.8

: Data not available. : Data not available.


~: Indicates estimate based on less than 25 unweighted cases and has been suppressed. ~: Indicates estimate based on less than 25 unweighted cases and has been suppressed.
*: Thailand 2011 and Turkey 2012 data are only used for spreads 30 and 31. *: Thailand 2011 and Turkey 2012 data are only used for spreads 30 and 31.
For precision, the number of decimal places may vary, depending on the indicator and country. For precision, the number of decimal places may vary, depending on the indicator and country.
Offer help to quit Offer help to quit Warn of danger
Percentage of first Percentage of Percentage of Percentage of smokers Number of Percentage of current smokers and Percentage of adults Percentage of Number of current
tobacco use within current smokers smokers using attempting to quit in smokers recent quitters believing smoking adults believing smokers considering
30 minutes after intending to quit cessation aid in past past 12 months attempting to causes (%) secondhand smoke quitting because
quit in past asked about smoking advised to quit by causes serious health warnings on
waking (%) (%) 12 months (%)
by healthcare providers healthcare providers
(%) 12 months stroke heart lung illness among cigarette packaging
in past 12 months (%) in past 12 months (%) attack cancer non-smokers (%) (in millions)
(in millions)
Country Country
(survey year) overall male female overall male female pharmacology counselling/ overall male female overall (survey year) overall male female overall male female overall overall overall overall overall
advice

Argentina (2012) 28.5 26.1 32.3 73.6 74.9 71.3 4.1 2.5 48.6 47.9 49.6 3.3 Argentina (2012) 80.1 82.2 77.3 60.5 60.7 60.4 73.6 91.0 98.6 92.6 2.0

Bangladesh (2009) 41.7 42.3 40.3 68.0 69.1 36.9 14.9 47.3 47.8 31.5 10.7 Bangladesh (2009) 56.0 55.9 64.6 52.9 52.7 61.6 81.6 85.9 91.5 93.4 12.6

Brazil (2008) 60.0 62.8 55.8 6.7 15.2 45.6 43.0 49.5 12.1 Brazil (2008) 71.0 70.2 71.8 57.1 55.7 58.5 74.3 87.0 96.2 91.4 16.0

China (2010) 50.3 50.3 50.3 41.2 41.6 33.8 3.3 3.0 14.4 14.2 18.6 44.6 China (2010) 40.8 41.7 25.5 33.9 34.5 23.1 27.2 38.7 77.5 64.3 94.5

Egypt (2009) 35.2 35.1 44.7 42.2 42.3 35.3 2.0 4.0 41.1 41.1 44.4 4.1 Egypt (2009) 74.1 75.3 35.8 67.0 68.4 23.4 88.6 95.0 96.2 96.3 4.2

Greece (2013) 72.2 76.2 64.2 53.0 50.3 58.1 15.1 2.7 18.9 16.9 22.7 0.7 Greece (2013) 83.8 88.9 77.8 72.2 78.7 64.8 76.6 91.2 96.3 84.9 0.5

India (2010) 60.1 62.1 55.1 46.6 47.3 40.6 4.0 9.2 38.4 38.3 38.9 43.8 India (2010) 53.0 54.0 45.5 46.3 47.3 38.9 49.4 63.9 84.9 82.9 31.6

Indonesia (2011) 38.3 38.6 30.0 48.8 48.9 45.8 25.7 7.0 30.4 29.8 44.6 18.5 Indonesia (2011) 40.5 41.6 17.9 34.6 35.7 13.0 45.5 81.5 84.7 73.7 16.2

Malaysia (2011) 47.5 48.1 16.8 70.7 70.4 82.8 9.0 4.4 48.6 48.7 45.7 2.3 Malaysia (2011) 67.6 67.3 ~ 52.6 52.2 ~ 80.7 88.8 93.7 85.8 2.1

Mexico (2009) 27.4 25.7 32.6 72.1 71.0 75.5 6.2 2.9 49.9 47.2 57.4 6.1 Mexico (2009) 64.7 64.3 65.6 17.3 17.9 16.1 60.4 79.7 96.7 95.6 3.6

Nigeria (2012) 55.3 54.4 63.8 66.3 68.2 ~ 5.2 15.0 45.4 45.8 ~ 1.5 Nigeria (2012) 69.7 71.3 ~ 61.2 62.4 ~ 51.4 76.8 73.0 74.5 0.8

Panama (2013) 43.7 47.3 31.8 64.4 62.1 71.8 6.2 12.0 45.2 44.4 48.2 0.1 Panama (2013) 73.6 71.0 79.5 60.4 63.7 53.0 73.5 83.5 97.0 87.5 0.1

Philippines (2009) 56.6 59.7 39.4 60.4 60.3 60.5 5.9 12.3 47.9 46.7 53.9 8.7 Philippines (2009) 67.5 71.6 53.4 51.6 53.2 46.2 73.3 78.9 92.8 91.6 6.5

Poland (2010) 60.0 62.2 56.7 50.2 48.0 53.1 24.9 3.5 35.1 34.7 35.5 3.7 Poland (2010) 57.2 58.9 55.4 41.8 41.2 42.5 61.8 79.9 92.6 81.4 1.7

Qatar (2013) 43.3 41.9 59.2 66.8 68.6 53.5 21.6 15.9 38.2 37.7 41.3 0.02 Qatar (2013) 77.4 78.8 68.8 71.3 72.9 61.6 79.5 93.7 96.4 95.1 0.03

Romania (2011) 69.5 72.0 63.7 62.8 62.5 63.3 8.9 1.7 37.8 36.1 41.2 1.9 Romania (2011) 82.1 85.1 77.6 67.3 68.8 65.0 89.2 90.0 98.3 94.2 1.5

Russian Federation (2009) 59.0 63.6 45.8 60.3 55.8 70.7 20.1 5.7 32.1 29.4 38.1 14.6 Russian Federation (2009) 45.4 47.7 41.3 31.8 34.2 27.5 67.3 71.0 91.2 81.9 13.9

Thailand (2009) 58.8 60.7 50.0 60.0 60.5 52.9 10.6 5.8 49.8 49.9 47.4 6.4 Thailand (2009) 60.2 59.9 63.9 51.9 52.3 48.7 79.6 75.7 97.5 94.9 8.4

Thailand (2011)* 56.2 57.6 47.9 54.0 53.9 56.4 7.6 4.8 36.7 36.5 39.4 4.9 Thailand (2011)* 65.3 65.0 68.2 55.8 55.9 54.5 81.0 77.3 97.8 94.2 8.1

Turkey (2008) 41.1 42.6 35.5 53.0 53.6 51.1 9.3 1.8 44.8 44.1 46.9 7.7 Turkey (2008) 49.0 49.1 48.8 40.7 42.2 38.0 82.1 93.6 96.1 95.5 7.4

Turkey (2012)* 42.1 42.7 39.8 55.2 53.8 59.3 13.6 8.0 46.0 45.1 48.8 7.2 Turkey (2012)* 51.4 49.1 56.3 42.9 41.3 46.4 84.8 95.5 97.7 96.2 7.8
120 Ukraine (2010) 61.7 64.1 51.5 68.0 66.3 74.0 1.9 2.7 40.5 39.1 45.6 5.0 Ukraine (2010) 41.7 43.1 38.2 30.8 32.4 26.9 77.9 79.3 91.2 86.3 6.6 121
Uruguay (2009) 35.5 38.2 31.7 75.7 76.7 74.3 18.2 12.4 48.6 48.4 48.9 0.3 Uruguay (2009) 76.6 75.1 77.9 54.5 56.7 52.3 76.5 92.0 96.8 93.8 0.3

Viet Nam (2010) 66.2 66.4 60.2 67.5 68.4 36.8 24.5 3.0 55.3 55.6 44.4 8.9 Viet Nam (2010) 34.9 35.3 25.6 29.7 30.2 20.3 70.3 62.7 95.6 87.0 10.2

: Data not available. : Data not available.


~: Indicates estimate based on less than 25 unweighted cases and has been suppressed. ~: Indicates estimate based on less than 25 unweighted cases and has been suppressed.
*: Thailand 2011 and Turkey 2012 data are only used for spreads 30 and 31. *: Thailand 2011 and Turkey 2012 data are only used for spreads 30 and 31.
For precision, the number of decimal places may vary, depending on the indicator and country. For precision, the number of decimal places may vary, depending on the indicator and country.
Warn of danger Enforce market bans Enforce market bans Raise prices**
Percentage of current Percentage of adults noticing Number of Percentage of adults noticing Percentage of adults noticing Average monthly
Average Average cost Average monthly
smokers considering anti-cigarette information adults cigarette advertising various types of cigarette expenditure on
cost of 20 of 2,000 expenditure on
quitting because of (%) noticing (%) promotion (%) manufactured
manufactured manufactured manufactured
health warnings on cigarette cigarettes as % of
cigarettes cigarettes as % of cigarettes
cigarette packaging newspaper/ billboard television radio advertising newspaper/ billboard television store branded free cigarette sponsored monthly GDP
magazine magazine clothing samples sports events (international $) GDP per capita (%) (international $)
(%) (in millions) per capita (%)
Country Country
(survey year) overall male female overall overall overall overall overall overall overall overall overall (survey year) overall overall overall overall overall overall overall

Argentina (2012) 32.9 33.9 31.3 42.9 28.6 58.3 32.4 16.2 18.0 20.6 24.7 41.9 Argentina (2012) 8.4 1.2 3.9 2.75 1.5 52.1 3.4

Bangladesh (2009) 58.5 60.1 7.4 9.7 16.4 36.5 10.9 38.8 1.9 6.1 5.4 33.2 Bangladesh (2009) 4.8 6.9 1.2 1.19 7.1 13.9 10.1

Brazil (2008) 65.0 63.5 67.2 39.4 19.5 63.9 30.3 43.5 30.4 Brazil (2008) 1.8 0.7 6.1 1.71 1.6 33.7 3.8

China (2010) 31.5 32.0 21.4 21.8 20.5 45.4 6.0 150.4 2.4 4.3 7.4 4.1 China (2010) 1.3 0.5 3.5 1.84 2.5 39.6 6.3

Egypt (2009) 43.3 43.2 55.4 13.7 27.5 51.9 18.9 4.7 0.5 0.9 0.7 8.0 Egypt (2009) 2.1 0.4 2.1 1.72 2.8 47.8 9.3

Greece (2013) 15.3 13.9 17.9 9.7 6.3 25.7 3.8 3.3 2.7 10.0 1.9 28.4 Greece (2013) 10.7 4.3 3.7 4.84 2.0 146.2 7.4

India (2010) 28.6 31.2 5.2 25.1 21.5 36.0 15.1 181.4 4.7 7.2 6.2 10.7 India (2010) 3.0 1.0 2.89 9.4 16.8 6.5

Indonesia (2011) 27.1 27.5 17.0 10.6 30.4 39.7 5.0 138.8 10.1 39.6 66.3 45.6 Indonesia (2011) 29.6 5.6 32.1 1.76 3.8 34.2 8.8

Malaysia (2011) 45.8 45.7 51.7 68.9 72.0 85.2 47.8 6.0 13.4 14.4 14.5 18.9 Malaysia (2011) 7.8 2.7 4.19 2.6 74.4 5.5

Mexico (2009) 32.9 31.2 37.8 44.9 30.7 80.3 45.5 33.9 17.4 16.8 3 6.5 Mexico (2009) 11.0 2.8 6.2 3.51 2.6 28.8 2.6

Nigeria (2012) 26.7 27.1 ~ 14.2 8.8 15.9 32.6 10.9 2.8 3.0 2.8 6.5 Nigeria (2012) 7.8 1.1 1.1 2.53 9.3 22.7 10.0

Panama (2013) 41.0 39.0 47.7 46.8 27.2 49.7 37.2 0.7 8.8 6.0 10.5 16.4 Panama (2013) 2.3 1.2 1.5 3.80 2.2 56.9 4.0

Philippines (2009) 37.4 37.9 34.6 30.9 26.0 59.8 38.7 42.8 12.5 13.7 24.4 53.7 Philippines (2009) 18.3 8.3 2.8 0.83 2.3 11.2 3.7

Poland (2010) 17.7 15.2 21.2 39.0 24.8 59.3 27.9 5.0 2.0 2.8 13.9 Poland (2010) 6.3 0.8 4.29 2.4 95.1 6.5

Qatar (2013) 51.4 52.4 43.7 40.6 39.7 34.1 28.9 0.1 10.8 10.3 Qatar (2013) 7.4 1.0 4.9 2.41 0.2 57.0 0.6

Romania (2011) 30.6 28.6 34.7 35.1 25.8 76.7 25.3 5.2 26.7 Romania (2011) 5.2 4.4 5.0 4.95 4.0 116.2 11.3

Russian Federation (2009) 31.7 31.6 31.9 33.7 24.8 38.6 10.8 63.9 33.3 11.5 43.6 Russian Federation (2009) 20.9 13.0 6.6 1.32 0.9 30.1 2.4

Thailand (2009) 67.0 67.8 55.5 27.4 39.0 74.4 33.5 4.2 0.4 0.2 0.8 6.7 Thailand (2009) 6.6 0.3 1.1 2.66 3.1 34.3 4.9

Thailand (2011)* 62.6 62.9 59.0 20.2 32.6 68.1 28.7 10.3 0.1 0.2 0.6 18.2 Thailand (2011)* 3.9 0.2 1.3 2.98 3.2 39.9 5.1

Turkey (2008) 46.3 46.4 46.3 46.3 36.0 85.5 23.0 3.1 0.6 0.3 3.4 2.7 Turkey (2008) 2.8 2.5 3.3 3.27 2.4 80.6 7.2

Turkey (2012)* 53.0 51.6 57.5 41.1 29.9 91.4 25.2 5.2 1.8 1.1 6.3 3.6 Turkey (2012)* 2.0 3.1 1.9 4.36 3.0 111.1 9.1
122 Ukraine (2010) 57.6 56.6 61.5 28.0 24.7 46.3 14.0 14.0 11.0 14.9 9.8 20.5 Ukraine (2010) 9.6 2.0 2.2 1.60 2.4 37.5 6.7 123

Uruguay (2009) 42.9 40.5 46.2 37.4 52.1 67.4 42.5 0.9 6.9 13.1 13.1 20.9 Uruguay (2009) 5.4 1.6 5.2 3.34 2.6 55.7 5.2

Viet Nam (2010) 66.7 67.6 38.1 30.8 42.8 85.9 28.0 7.0 0.7 0.7 2.1 8.6 Viet Nam (2010) 3.2 0.8 0.9 1.11 3.5 18.9 7.2

: Data not available. : Data not available.


~: Indicates estimate based on less than 25 unweighted cases and has been suppressed. ~: Indicates estimate based on less than 25 unweighted cases and has been suppressed.
*: Thailand 2011 and Turkey 2012 data are only used for spreads 30 and 31. *: Thailand 2011 and Turkey 2012 data are only used for spreads 30 and 31.
For precision, the number of decimal places may vary, depending on the indicator and country. **: Estimates are calculated with outliers removed.
For precision, the number of decimal places may vary, depending on the indicator and country.
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Index
advertising of cigarettes 20, 75, 7879, India tax on tobacco 88
89, 12223 highlights 104 efficacy in decreasing tobacco use
bans on 20, 77, 78, 79 NCD tobacco targets 9495 20, 83, 91
see also promotion of cigarettes smokeless tobacco users 39 Thailand
anti-cigarette information, impact of 20, Indonesia, highlights 105 highlights 105
7273, 122 repeat survey results 8889
Argentina, highlights 100 Malaysia, highlights 107 Tobacco Questions for Surveys (TQS)
Mexico, highlights 100 7, 9, 2425, 9293, 11213
Bangladesh MPOWER 7, 9, 2021, 112 TQS Global Alliance 2425
highlights 104 tobacco targets 9, 9495
smokeless tobacco users 39 Nigeria, highlights 98 tobacco use
use of TQS in national survey 93 Non-Communicable Diseases, tobacco daily 3031, 115
Brazil targets 9495 prevalence of 3031, 114
highlights 101 surveillance of 21
NCD tobacco targets 9495 Panama, highlights 100 time to first use 5859, 120
Philippines, highlights 107 see also tobacco users
cessation aids 62, 120 see also Poland, highlights 102 tobacco users 20, 3031, 3233,
smoking, cessation promotion of cigarettes 7679, 12223 5859
China age 3435, 115
highlights 106 Qatar, highlights 99 dual 4041, 11617
NCD tobacco targets 9495 quitting 20, 4445, 5665, 117, number of 3233, 114
use of TQS in national survey 93 12021 see also smoking, smokeless
cigarettes 36 advice on 6565 tobacco
advertising of 20, 75, 7679, 89, attempts 20, 57, 6263, 89, 91, 120 advertising 20, 75, 7679, 89,
12223 impact of cost increase on 91 12223
average cost of 20, 81, 8283, 90, impact of packaging warnings on control policies 21, 50, 52, 54, 88,
123 20, 67, 91, 122 9091
electronic 16 intention 6061, 120 products 1617, 36
expenditure on 8485, 123 see also cigarettes; smokeless
inexpensive brands, Thailand 88 Romania, highlights 102 tobacco, smoking; tobacco use;
number smoked daily 4647, Russian Federation tobacco users
11718 highlights 103 Turkey
types of 16 NCD tobacco targets 9495 highlights 102
use of TQS in national survey 93 repeat survey results 9091
dual use of smoked and smokeless use of TQS in national survey 92
tobacco 4041, 116 secondhand smoke
at home 5455, 91, 119 Ukraine, highlights 102
Egypt, highlights 99 in public places 20, 49, 5051, 91, Uruguay, highlights 101
electronic nicotine delivery systems 16 119
electronic non-nicotine delivery in workplace 5253, 119 Viet Nam, highlights 106
systems 16 smokeless tobacco
number of users 39 warnings on cigarette packaging 20,
Global Adult Tobacco Survey (GATS) products 1617 67
countries participating in 23, 2627 use of 3839, 4041, 116, 117 impact of 67, 7071, 88, 91, 12122
dissemination of data 11011 smoking 29, 3637, 4041, 115, 116 standardized (plain) packaging 70
methodology 23, 114 age of initiation 4243, 117 WHO Framework Convention on
publications 12425 awareness of health risks of 6869 Tobacco Control 7, 9, 14, 1819,
timeline 11213 cessation 20, 6265, 7071, 12021 28, 48, 56, 66, 74, 80, 86, 96, 108,
total population coverage 32, 114 number of cigarettes smoked daily 112
128 tracking of MPOWER policies 20 4647, 11718 Conference of the Parties (COP)
tracking progress 8891 prevalence of current 3637, 115, 1819
websites 111 prevalence of daily 3637, 116
Global Tobacco Surveillance System smoking ban see tobacco control
(GTSS) 7, 9, 2223, 112 policies
Global Youth Tobacco Survey (GYTS) sponsorship of cigarette brands 75,
22, 112, 113 7879
Greece, highlights 102

health risks of smoking, awareness of


6869, 121
healthcare professionals, quit advice
6465, 121