The effects of tobacco control policies on global smoking prevalence
Open accessAbstract
Substantial global effort has been devoted to curtailing the tobacco epidemic over the past two decades, especially after the adoption of the Framework Convention on Tobacco Control 1 by the World Health Organization in 2003. In 2015, in recognition of the burden resulting from tobacco use, strengthened tobacco control was included as a global development target in the 2030 Agenda for Sustainable Development 2 . Here we show that comprehensive tobacco control policies—including smoking bans, health warnings, advertising bans and tobacco taxes—are effective in reducing smoking prevalence; amplified positive effects are seen when these policies are implemented simultaneously within a given country. We find that if all 155 countries included in our counterfactual analysis had adopted smoking bans, health warnings and advertising bans at the strictest level and raised cigarette prices to at least 7.73 international dollars in 2009, there would have been about 100 million fewer smokers in the world in 2017. These findings highlight the urgent need for countries to move toward an accelerated implementation of a set of strong tobacco control practices, thus curbing the burden of smoking-attributable diseases and deaths.
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Tobacco control measures, particularly when implemented comprehensively, work, leading to a 27.2% global decline in male smoking prevalence since 1990 and a 37.9% decline among women.
“Most importantly, they strongly suggest that tobacco control measures, particularly when implemented comprehensively, work, collectively leading to a 27.2% (95% CI: 26.0% to 28.3%) global decline in smoking prevalence among men since 1990, and a much larger decline, 37.9% (95% CI: 35.3% to 40.1%) among women.31 32”
From Evolution of the global smoking epidemic over the past half century: strengthening the evidence base for policy action (2022) · cites this paper as [31]
The Main section says tobacco-control policies reduce smoking prevalence and estimates that stronger combined policies would have produced further reductions. But its reported global declines are 7.7% for men and 15.2% for women between 2009 and 2017; it does not substantiate the cited 27.2% and 37.9% declines since 1990 or attribute those figures to the policies. (LLM, conf=0.88)
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References 26 · Cited by 299
Research works printed but not linked: 20
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- Authors
- Flor, L. S., Reitsma, M. B., Gupta, V., Ng, M., & Gakidou, E.
- Affiliations
- University of Washington (US)
- IBM (United States) (US)
- Corresponding author
- Gakidou, Emmanuela
- Venue
- Nature Medicine
- Published
- 2021-01-21
- Volume
- 27
- Issue
- 2
- Pages
- 239-243
- ISSN
- 1078-8956 (ISSN-L)
- 1546-170X
- PMC
- PMC7884287
- OpenAlex
- W3124394605
- Cited by
- 299
- References
- 26
- Citations by year
- 2026: 48 · 2025: 83 · 2024: 51 · 2023: 52 · 2022: 50 · 2021: 15
- FWCI
- 26.36
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Nature Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- National University of Singapore (submittedVersion)
- Funders
- Bloomberg Philanthropies
- 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 control, smoking prevalence, smoking bans, health warnings, tobacco advertising ban, tobacco taxation, cigarette prices, Framework Convention on Tobacco Control, 2030 Agenda for Sustainable Development, counterfactual analysis
- MeSH terms
- Adolescent, Adult, Female, Health Policy, Humans, Male, Middle Aged, Public Policy, Smoking, Taxes, Nicotiana, World Health Organization, Young Adult
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