Smoking bans going global

David Kaufman, M.D. Health Pro
  • Greetings! After introducing myself in my first post, I want to use this post to discuss the growing global smoking problem.

     

    In the US and Europe, the link between smoking and disease has been recognized for decades, and our culture has clearly changed. Many individual stores, towns, cities, states, and even countries have prohibited smoking in many or all public spaces, including Ireland, Spain, Italy and France (see this Wikipedia entry for a comprehensive list). A few years ago, who would have thought that France would try to limit smoking . . . after all, what is more French than the image of a world-weary Parisian with a cigarette dangling jauntily from the corner of his mouth?

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    Despite these bans in the industrialized world, the number of people smoking in developing countries like India and China has continued to rise, with developing nations now accounting for the vast majority of tobacco consumption in the world (See this article from the Economist for more information.) And as the New York Times reports, there are more smokers in China than total people living in the USA!

     

    The World Health Organization (WHO) just released a comprehensive report on tobacco smoking, listing several key facts:

    • More than 1 billion people in the world smoke
    • Tobacco use is increasing, especially in poorer nations
    • More than half of all children in the world are exposed to tobacco smoke
    • Tobacco use accounts for 10% of all deaths worldwide, and about half of all tobacco users die as a result of tobacco-caused disease
    • In the 20th Century, tobacco-related disease caused 100 MILLION deaths
    • If current trends continue, it is projected that the death toll from tobacco will be 1 BILLION during the current century.

    To put this in perspective: in the 20th century, tobacco killed almost twice as many people as World War Two. If current estimates are correct, in the 21st century, tobacco will kill 20 times as many people as World War II (55 million), or about 40 times as many people as were killed by the bubonic plague (Black Death) in 14th century Europe (about 25 million)!

     

    Of the eight leading causes of death worldwide, tobacco smoking contributes significantly to six of them:

     

    Ischemic heart disease (heart attack, angina)

     

    The World Health Organization recommends several steps to prevent people from taking up smoking, including higher taxes on tobacco, graphic warnings on cigarette packages, and strict bans on marketing and advertising. It also recommends strong limits on where people can smoke, modeled on Irish laws, which have been very effective in improving respiratory health. Bans also appear to cut the number of smokers, but many object to the limits on personal freedom. Whether bans would have similar effects in developing countries and whether similar concerns about personal freedom would come up are open questions, but it seems clear that the growth of tobacco use is a pressing public health issue that will need to be tackled soon.

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    What's your view? Do bans on smoking work? Do they make people quit or just go elsewhere to smoke? Do smoking bans limit others' exposure to smoke? Share your experiences on line!

Published On: March 04, 2008