Tobacco use declining globally, says new WHO Report

The World Health Organization (WHO) recently published its Global Report on Trends in Prevalence of Tobacco Use 2000-2030. According to the Report, while global progress is inconsistent, 150 countries are successfully reducing tobacco use, with Brazil achieving a relative reduction of 35 percent since 2010, and the Netherlands close to reaching the WHO’s 30 percent target. Here, Malcolm Saxton, Senior Consultant for Chemistry at Broughton, outlines the Report’s findings.

The WHO created the Global Report on Trends in Prevalence of Tobacco Use 2000-2030 using nationally representative population-based surveys of people aged 15 and above. Data from these national surveys was compiled into a single datasheet of prevalence classified by type of tobacco use, use frequency, year, country, sex, age of respondent, and sample size. The WHO defines “tobacco use” as the consumption of any type of tobacco product — smoked and/or smokeless — and excludes the use of e-cigarettes or other nicotine products that do not contain tobacco.

The report notes that we are gradually approaching the WHO’s global voluntary target of a 30 percent relative reduction in tobacco use, having reached 24.9 percent in 2022. However, progress is uneven across different countries and regions, and more effort is needed to achieve the overall reduction target of 30 percent.

There are now four fewer countries on track to meet the WHO’s goal than there were two years ago. However, only six countries are reportedly experiencing an increase in tobacco use: Egypt, Jordan, Oman, Congo, Indonesia, and Moldova, and nine countries have seen no significant change in tobacco use prevalence rates.

The findings show that one in five adults worldwide are consuming tobacco products — a significant decline from one in three in 2000. Based on current trends, the Report predicts that 56 countries are likely to achieve at least a 30 percent relative reduction in tobacco use by 2025. Current efforts are likely to yield a global tobacco use prevalence of 19.8 percent in 2025, which equates to a 25 percent relative reduction since 2010, falling behind the WHO target of 30 percent by 2025.

The impact of the COVID-19 pandemic varied enormously across the countries surveyed, and, according to the Report, this likely had an impact on tobacco reduction trends. However, it’s positive to know that despite the challenges posed by the pandemic, most countries have tried to control the tobacco epidemic and monitor progress by conducting population health surveys.

A need for greater controls?

According to the Report, the main influence on tobacco use trends is the effort individual countries have invested in tobacco control, which usually “start with adopting a whole of government approach for multisectoral action.”

These actions can be guided by the MPOWER policy package, outlined by the WHO Framework Convention on Tobacco Control (WHO FCTC). The WHO MPOWER package includes key reduction measures, such as high tax and prices for tobacco products, large graphic health warnings, smoke-free public places, and comprehensive bans on tobacco advertising. According to the WHO, combining these measures with support for tobacco users to quit could help ensure a sustained decline in tobacco use prevalence.

Expanding the scope to nicotine use

The Report finds that many countries are still not monitoring at a sufficient level to fully inform their tobacco control policy priorities. At a minimum, countries must carry out research and establish surveillance and monitoring systems, as set out in Article 20 of the WHO FCTC. According to the MPOWER policy package, “monitoring patterns and trends in tobacco use and exposure generates reliable, timely data that are fundamental to helping countries understand the impact of tobacco control policy intervention.”

One example of data gaps is in e-cigarette use. According to the Report, there is currently insufficient data to calculate global estimates of e-cigarette use among adults or adolescents. This would be important information in understanding the impact of reduced-risk nicotine products on the reduction of tobacco use worldwide. A robust estimate of global trends in e-cigarette consumption requires more countries to add this question to their population-based surveys.

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