Tobacco use in 3 billion individuals from 16 countries: an analysis of nationally representative cross-sectional household surveys
Abstract
Background Despite the high global burden of diseases caused by tobacco, valid and comparable prevalence data for patterns of adult tobacco use and factors influencing use are absent for many low-income and middle-income countries. We assess these patterns through analysis of data from the Global Adult Tobacco Survey (GATS). Methods Between Oct 1, 2008, and March 15, 2010, GATS used nationally representative household surveys with comparable methods to obtain relevant information from individuals aged 15 years or older in 14 low-income and middle-income countries (Bangladesh, Brazil, China, Egypt, India, Mexico, Philippines, Poland, Russia, Thailand, Turkey, Ukraine, Uruguay, and Vietnam). We compared weighted point estimates and 95% CIs of tobacco use between these 14 countries and with data from the 2008 UK General Lifestyle Survey and the 2006-07 US Tobacco Use Supplement to the Current Population Survey. All these surveys had cross-sectional study designs. Findings In countries participating in GATS, 48·6% (95% CI 47·6-49·6) of men and 11·3% (10·7-12·0) of women were tobacco users. 40·7% of men (ranging from 21·6% in Brazil to 60·2% in Russia) and 5·0% of women (0·5% in Egypt to 24·4% in Poland) in GATS countries smoked a tobacco product. Manufactured cigarettes were favoured by most smokers (82%) overall, but smokeless tobacco and bidis were commonly used in India and Bangladesh. For individuals who had ever smoked daily, women aged 55-64 years at the time of the survey began smoking at an older age than did equivalently aged men in most GATS countries. However, those individuals who had ever smoked daily and were aged 25-34-years when surveyed started to do so at much the same age in both sexes. Quit ratios were very low (<20% overall) in China, India, Russia, Egypt, and Bangladesh. Interpretation The first wave of GATS showed high rates of smoking in men, early initiation of smoking in women, and low quit ratios, reinforcing the view that efforts to prevent initiation and promote cessation of tobacco use are needed to reduce associated morbidity and mortality. Funding Bloomberg Philanthropies' Initiative to Reduce Tobacco Use, Bill and Melinda Gates Foundation, Brazilian and Indian Governments.
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The average age at tobacco initiation varies by country, income, education, and age cohort.
“the average age at tobacco initiation varies by country, income, education, and age cohort (31, 33–35).”
The 2012 Global Adult Tobacco Survey conducted in 16 countries found higher current tobacco use prevalence in North America, Europe, and South Asia than in this study.
“the 2012 Global Adult tobacco Survey (GATS) that was conducted in 16 countries found higher current tobacco use prevalence in North America, Europe, and South Asia (31).”
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“However, compared with our estimates, the 2012 Global Adult tobacco Survey (GATS) that was conducted in 16 countries found higher current tobacco use prevalence in North America, Europe, and South Asia (31).”
Result
- Authors
- Giovino, G. A., Mirza, S. A., Samet, J. M., Gupta, P. C., Jarvis, M. J., Bhala, N., Peto, R., Zatonski, W., Hsia, J., Morton, J., Palipudi, K. M., & Asma, S.
- Affiliations
- University at Buffalo, State University of New York (US)
- Centers for Disease Control and Prevention (US)
- University of Southern California (US)
- Healis Sekhsaria Institute For Public Health (IN)
- University College London (GB)
- University of Oxford (GB)
- Corresponding author
- Giovino, Gary A
- ORCID
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2012-08
- Volume
- 380
- Issue
- 9842
- Pages
- 668-679
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- OpenAlex
- W2113459167
- Cited by
- 740
- References
- 1
- Citations by year
- 2026: 10 · 2025: 30 · 2024: 25 · 2023: 28 · 2022: 38 · 2021: 40 · 2020: 60 · 2019: 66 · 2018: 55 · 2017: 60 · 2016: 64 · 2015: 79 · 2014: 88 · 2013: 82 · 2012: 13
- FWCI
- 56.16
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- Government of the United Kingdom
- Centers for Disease Control and Prevention Foundation
- University of North Carolina at Chapel Hill
- Johns Hopkins Bloomberg School of Public Health
- National Cancer Institute
- National Center for Chronic Disease Prevention and Health Promotion
- Topics
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Global Public Health Policies and Epidemiology
- Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
- Keywords
- tobacco use, smoking prevalence, low- and middle-income countries, Global Adult Tobacco Survey, sex differences in smoking, smoking initiation age, bidis, smokeless tobacco, smoking cessation, tobacco control, cross-national comparison, household surveys, Bangladesh, India, Russia, China, Egypt, Brazil, Thailand, Poland, Turkey, Ukraine, Vietnam, Mexico, Philippines
- MeSH terms
- Adolescent, Adult, Age Factors, Aged, Cross-Sectional Studies, Developing Countries, Female, Humans, Male, Middle Aged, Smoking, Tobacco, Smokeless, Prevalence, Smoking Cessation, Age Distribution, Sex Distribution, Young Adult
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