Tobacco Harm Reduction and the right to health

4 The global public health crisis caused by smoking tobacco Death and disease The facts are stark. The World Health Organization (WHO) estimates that one billion people will have died from tobacco-related diseases by the end of this century . That is roughly equivalent to the entire population of North and South America, or 13 per cent of the current global population . 1 Each year, over seven million people die from diseases related to tobacco use – more than from malaria, HIV and tuberculosis combined. Smoking is the single biggest cause of non-communicable disease (NCD) worldwide. Half of all those who smoke will die prematurely and painfully due to diseases directly related to an extraordinary range of illnesses, from cancers of the lung, throat, pancreas, bladder, stomach, kidney, or cervix, to heart attack or stroke. Loved ones suffer these losses too. Many millions of people worldwide also experience years of disability and reduced quality of life due to diseases such as chronic obstructive pulmonary disease (COPD), macular degeneration, cataracts, diabetes, fertility problems and rheumatoid arthritis, which are all caused by, linked to or exacerbated by smoking. Smoking also directly impacts on bystanders . The WHO estimates that a third of all people around the world are regularly exposed to the effects of tobacco smoke. This exposure is estimated by the WHO to be responsible for about 600,000 deaths per year, and approximately 1% of the global burden of disease worldwide. 2 Economic impact Trying to establish the precise economic impact of smoking on the global economy is difficult. However, in 2017, the WHO and the US National Cancer Institute published a study which estimated that the worldwide healthcare cost of smoking in just one year (2012) was $422 billion, which would account for 5.7% of all global health expenditure. Estimated indirect costs totalled $357 billion for morbidity and $657 billion for mortality. The total annual economic cost of smoking was therefore estimated to be $1.4 trillion, or 1.8% of the world’s annual GDP. 3 Who smokes? It’s estimated that 1.1 billion people smoke tobacco every day, of whom it is thought 80% live in low-and middle-income countries (LMIC). 4 In many higher income countries, levels of daily adult smoking have fallen since the early 1970s and are now ‘low’ as defined by international standards, meaning under 20% of the population smoke. This is largely due to greater public awareness of the importance of a healthier lifestyle and the introduction of tobacco control measures (including advertising bans, smoke-free environments, availability restrictions and higher taxation). 1.1 billion people smoke tobacco every day; 80% live in low- and middle- income countries But in many higher income countries, smoking rates have now begun to level off: substantial numbers of people continue to smoke. In these countries, levels of smoking, and consequently smoking-related death and disease are disproportionately high among vulnerable and marginalised groups, including people living in poverty, from minority ethnic or indigenous communities, from the LGBTQ+ community, people living with mental health conditions or with substance use problems. 1 Roser, M., Ritchie, H. and Ortiz-Ospina, E. (2019) – World Population Growth . Published online at OurWorldInData.org. Retrieved from: https://ourworldindata.org/world-population-growth 2 World Health Organization (WHO), Global Health Observatory Data: Second-hand Smoke (publication date unknown). Retrieved from: https://www.who.int/gho/phe/secondhand_smoke/en/#targetText =Second%2Dhand%20smoke%20 (SHS),asthma%2C%20have%20long%20been%20established. 3 National Cancer Institute and WHO (2017), NCI Tobacco Control Monograph Series 21 – The Economics of Tobacco and Tobacco Control. Retrieved from: https://cancercontrol.cancer.gov/brp/tcrb/monographs/21/docs/m21_complete. pdf 4 WHO (2019) Tobacco: key facts . Retrieved from: https://www.who.int/news-room/fact-sheets/detail/tobacco