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id	title	slug	type	status	content	archieml	archieml_update_statistics	published_at	updated_at	gdocSuccessorId	authors	excerpt	created_at_in_wordpress	updated_at_in_wordpress	featured_image	formattingOptions	markdown	wpApiSnapshot
1683	Smoking	smoking	page	publish	<!-- wp:html --> <div class="blog-info">This article was first published in May 2013; it was revised substantially in November 2019. The last update was done in August 2023.</div> <!-- /wp:html --> <!-- wp:paragraph --> <p>Tobacco smoking is one of the world's largest health problems. Millions of people live in poor health because of it. Researchers estimate that every year around <em>8 million people</em> die an early death due to smoking.<br><br>It has been a major health problem for many decades. For the entire 20th century, it is estimated that around 100 million people died prematurely because of smoking, most of them in rich countries.{ref}Jha, P. (2009). <a href="https://www.nature.com/articles/nrc2703">Avoidable global cancer deaths and total deaths from smoking</a>. <em>Nature Reviews Cancer</em>, <em>9</em>(9), 655.{/ref}</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>The share of smokers among the world population is falling, and because smoking is such a large health problem today, this is one of the most positive developments in global health. It makes it possible for millions of people to live a longer and healthier life.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p><em>For a brief overview of the most important facts, see the following article:</em></p> <!-- /wp:paragraph --> <!-- wp:owid/prominent-link {"title":"","linkUrl":"https://ourworldindata.org/smoking-big-problem-in-brief","className":"is-style-thin"} /--> <!-- wp:heading --> <h2>Smoking is one of the leading risks for early death</h2> <!-- /wp:heading --> <!-- wp:heading {"level":4} --> <h4>Smoking is responsible for about 8 million premature deaths each year</h4> <!-- /wp:heading --> <!-- wp:paragraph --> <p>The two regularly updated studies on the global death toll from tobacco use – published by the World Health Organization and the Institute for Health Metrics and Evaluation – agree that around 8 million people die prematurely yearly.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>The aggregate statistics refer to ‘tobacco use’ (rather than smoking alone) because other forms of consuming tobacco, such as chewing tobacco, also lead to premature deaths. The huge majority of deaths from tobacco use, however, are due to smoking. The death toll from smoking is very close to the total sum of deaths from tobacco use (higher than 99.9% in the case of the IHME estimates).</p> <!-- /wp:paragraph --> <!-- wp:heading {"level":4} --> <h4>World Health Organization: More than 8 million die from tobacco use every year</h4> <!-- /wp:heading --> <!-- wp:paragraph --> <p>The WHO estimates that more than 8 million people die prematurely yearly from tobacco use. This is the latest available WHO estimate as of August 2023.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>More than 7 million of those deaths result from direct tobacco use. About 1.3 million are non-smokers who are dying because they are exposed to second-hand smoke.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p><strong>Reference:</strong> <a href="https://www.who.int/news-room/fact-sheets/detail/tobacco">WHO (2023) – Fact Sheet: Tobacco</a>, updated in July 2023</p> <!-- /wp:paragraph --> <!-- wp:heading {"level":4} --> <h4>IHME's Global Burden of Disease study: 8.7 million die from tobacco use every year</h4> <!-- /wp:heading --> <!-- wp:paragraph --> <p>The IHME – in their annual Global Burden of Disease study – estimates that 8.7 million people die prematurely from tobacco use every year. As of August 2023, these are the latest estimates and refer to deaths in the year 2019.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>7.7 million of those deaths result from smoking while 1.3 million are non-smokers who are dying because they are exposed to second-hand smoke. (An additional 56,000 people die annually from chewing tobacco.) Most (71%) of those who die prematurely from smoking are men.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>These estimates of the annual number of deaths attributed to a wide range of risk factors are shown in the interactive chart. This visualization is, by default, showing the global total, but can be explored for any country or region using the "change country" toggle. Smoking is a risk factor for several of the world's leading causes of death, including lung and other forms of cancer, heart disease, and respiratory diseases. The references can be found i the footnote.{ref}The estimates of the Global Burden of Disease study can be found <a href="http://ihmeuw.org/5i08">here</a>. The latest study can be found at the website of The Lancet here: <a href="https://www.thelancet.com/gbd">TheLancet.com/GBD</a></p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>There are two publications that are closely related to the Global Burden of Disease study:</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Reitsma et al. (2021) – <a href="https://doi.org/10.1016/S0140-6736(21)01169-7">Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990–2019: A systematic analysis from the Global Burden of Disease Study 2019</a>. In <em>The Lancet</em>, 397(10292), 2337–2360.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>The GBD estimates are also presented in yet another prominent publication. The <a href="https://tobaccoatlas.org/"><strong>Tobacco Atlas</strong></a> is published by the American Cancer Society and Vital Strategies and presents estimates for the global death toll from smoking <a href="https://tobaccoatlas.org/data-sources/">taken from</a> the Global Burden of Disease Study published by the Institute for Health Metrics and Evaluation (IHME).{/ref}</p> <!-- /wp:paragraph --> <!-- wp:html --> <figure><iframe src="https://ourworldindata.org/grapher/number-of-deaths-by-risk-factor"></iframe></figure> <!-- /wp:html --> <!-- wp:heading {"level":4} --> <h4>Smoking led to about 100 million premature deaths in the 20th century</h4> <!-- /wp:heading --> <!-- wp:paragraph --> <p>Tobacco smoking has been one of the world's largest health problems for decades. Over the course of the 20th century, it killed around 100 million people, most of them in today's rich countries.{ref}Jha, P. (2009). <a href="https://www.nature.com/articles/nrc2703">Avoidable global cancer deaths and total deaths from smoking</a>. <em>Nature Reviews Cancer</em>, <em>9</em>(9), 655.{/ref} The health burdens of smoking are now moving from high-income to low-to-middle-income countries; some estimates have suggested that one billion people could die from tobacco over the 21st century.{ref}Mathers, C. D., & Loncar, D. (2006). Projections of global mortality and burden of disease from 2002 to 2030. <em>PLoS medicine</em>, <em>3</em>(11), e442.{/ref}<sup>,</sup>{ref}Jha, P., & Peto, R. (2014). <a href="https://www.nejm.org/doi/10.1056/NEJMra1308383">Global effects of smoking, of quitting, and of taxing tobacco</a>. <em>New England Journal of Medicine</em>, <em>370</em>(1), 60-68.{/ref}</p> <!-- /wp:paragraph --> <!-- wp:heading --> <h2>The global distribution of smoking deaths</h2> <!-- /wp:heading --> <!-- wp:heading {"level":4} --> <h4>In many countries, a high share of deaths is attributed to smoking</h4> <!-- /wp:heading --> <!-- wp:paragraph --> <p>In the map, we see the share of deaths attributed to direct smoking across the world. In many countries, this share is substantial.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p><strong>Related chart – the share of deaths from </strong><em><strong>secondhand smoking</strong></em><strong>.</strong> <a href="https://ourworldindata.org/grapher/share-deaths-secondhand-smoke">This map</a> shows the share of premature deaths attributed from secondhand smoke across the world.</p> <!-- /wp:paragraph --> <!-- wp:html --> <figure><iframe src="https://ourworldindata.org/grapher/share-deaths-smoking"></iframe></figure> <!-- /wp:html --> <!-- wp:heading {"level":4} --> <h4>Death rates from smoking are highest across Asia and Eastern Europe</h4> <!-- /wp:heading --> <!-- wp:paragraph --> <p>In the interactive map, we show death rates from tobacco smoking across the world. Death rates measure the number of premature deaths from smoking per 100,000 people in a given country or region. <br><br>We see large differences in death rates across the world. Rates tend to be highest across Asia and Eastern Europe, where figures are often over 100, and in some cases, over 150 deaths per 100,000 people. <br><br>Death rates are much lower across some of the lowest-income countries in the world, where very few people smoke.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p><strong>Related chart – <em>number</em> of deaths from smoking.</strong> <a href="https://ourworldindata.org/grapher/number-of-deaths-from-tobacco-smoking">This map</a> shows the annual number of deaths from tobacco smoking across the world.</p> <!-- /wp:paragraph --> <!-- wp:html --> <iframe src="https://ourworldindata.org/grapher/death-rate-smoking?tab=map" style="width: 100%; height: 600px; border: 0px none;"></iframe> <!-- /wp:html --> <!-- wp:heading {"level":4} --> <h4>Most deaths from smoking occur in older populations</h4> <!-- /wp:heading --> <!-- wp:paragraph --> <p>When we look at the breakdown of deaths from smoking by age, we see that it is mainly older populations that are affected. <br><br>In the visualizations, we show the death rates from smoking by age bracket and the share of annual deaths that occur in each age group.<br><br>Here, we see that death rates from smoking are much higher in people older than 70 years old, followed by those aged 50 to 69.<br></p> <!-- /wp:paragraph --> <!-- wp:html --> <figure><iframe src="https://ourworldindata.org/grapher/death-rates-smoking-age"></iframe></figure> <!-- /wp:html --> <!-- wp:html --> <iframe src="https://ourworldindata.org/grapher/smoking-deaths-by-age?stackMode=relative" style="width: 100%; height: 600px; border: 0px none;"></iframe> <!-- /wp:html --> <!-- wp:heading --> <h2>How have smoking deaths changed over time?</h2> <!-- /wp:heading --> <!-- wp:heading {"level":4} --> <h4>Death rates from smoking have declined in most countries</h4> <!-- /wp:heading --> <!-- wp:paragraph --> <p>Globally, smoking-related death rates <a href="https://ourworldindata.org/grapher/death-rate-smoking?tab=chart&country=OWID_WRL">have fallen</a>.<br><br>But there are differences across countries. Where in the world are death rates falling or rising?<br><br>In the scatterplot, we see the comparison of smoking death rates in 1990 (shown on the y-axis) versus the death rate in the latest data (on the x-axis). The grey line is the line of parity: countries that lie along this line had equal death rates at both points in time. Countries that lie <em>above</em> the grey line had higher death rates in 1990; for those that lie <em>below</em> the grey line, the opposite is true.<br><br>We see that almost all countries in the world lie above the grey line. This means that most countries have achieved a <em>decline</em> in death rates from smoking in recent decades.</p> <!-- /wp:paragraph --> <!-- wp:html --> <figure><iframe src="https://ourworldindata.org/grapher/smoking-death-rate-1990-2017"></iframe></figure> <!-- /wp:html --> <!-- wp:heading --> <h2>Prevalence of smoking across the world</h2> <!-- /wp:heading --> <!-- wp:heading {"level":3} --> <h3>Share who smoke</h3> <!-- /wp:heading --> <!-- wp:heading {"level":4} --> <h4>In which countries do people smoke the most?</h4> <!-- /wp:heading --> <!-- wp-block-tombstone 47977 --> <!-- wp:columns --> <div class="wp-block-columns"><!-- wp:column --> <div class="wp-block-column"><!-- wp:paragraph --> <p>Around one-in-four adults in the world smoke tobacco.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>But where in the world is smoking most common?</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>In the map, we see the share of adults aged 15 years and older, who smoke tobacco. </p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>There are a number of countries where more than a third of the population smokes. The places where many people smoke are clustered in regions. South-East Asia, the Pacific islands, and parts of Europe.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>In some countries, very few people smoke.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Several factors influence the prevalence of smoking. One is prosperity: if we look at <a href="https://ourworldindata.org/grapher/share-of-adults-who-are-smoking-by-level-of-prosperity">the relationship</a> between smoking prevalence and income, we find that richer countries tend to smoke more. But as you see in this correlation, there are very large differences at each level of income.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Smoking rates are high across many countries, but we know from the history of many countries that this can change quickly. Many of today’s high-income countries had much higher smoking rates in the past and have seen a large reduction.</p> <!-- /wp:paragraph --></div> <!-- /wp:column --> <!-- wp:column --> <div class="wp-block-column"><!-- wp:html --> <iframe style="width: 100%; height: 600px; border: 0px none;" src="https://ourworldindata.org/grapher/share-of-adults-who-smoke?tab=map&country=USA~BRA~RUS~IND~CHN~European+Union~IDN~OWID_WRL"></iframe> <!-- /wp:html --></div> <!-- /wp:column --></div> <!-- /wp:columns --> <!-- wp:heading {"level":3} --> <h3>Daily smokers</h3> <!-- /wp:heading --> <!-- wp:paragraph --> <p>This visualization shows the share of adults, aged 15 years and older, who smoke every day.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>We see that daily smoking is most common across Europe and Asia – more than 20% of adults in most countries in these regions smoke every day.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p><strong>Related chart – </strong><em><strong>number</strong></em><strong> of daily smokers</strong>. <a href="https://ourworldindata.org/grapher/number-of-total-daily-smokers?time=1980..2012">This map</a> shows the number of people who smoke every day across the world.</p> <!-- /wp:paragraph --> <!-- wp:html --> <figure><iframe src="https://ourworldindata.org/grapher/daily-smoking-prevalence-bounds"></iframe></figure> <!-- /wp:html --> <!-- wp:heading {"level":3} --> <h3>Smoking by gender</h3> <!-- /wp:heading --> <!-- wp:heading {"level":4} --> <h4>Who smokes more, men or women?</h4> <!-- /wp:heading --> <!-- wp-block-tombstone 24476 --> <!-- wp:paragraph --> <p>Nearly one-in-four adults in the world <a href="https://ourworldindata.org/which-countries-smoke-most">smokes tobacco</a>. But there are large differences between men and women.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>As the chart shows, more than one-third of men in the world smoke, while the same is true for less than one-in-ten women.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>In almost all countries, it is true that a large share of men smoke. In the visualization, we see the share of men who smoke (plotted on the vertical axis) compared with the same metric for women (plotted on the horizontal axis).</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>The grey line in the plot represents equality in the prevalence: countries where smoking is more common in men will lie above this line, and countries where more women smoke lie below.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>We see that almost all countries lie above the grey line, meaning a higher share of men smoke. There are only a few exceptions.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>In many countries — particularly across Asia and Africa — the differences are very large. </p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>We also see this when we look at a <a href="https://ourworldindata.org/grapher/share-of-women-who-are-smoking?tab=map">global map of smoking among women</a>: across much of Africa and Asia, rates are very low. For comparison, here is the world <a href="https://ourworldindata.org/grapher/share-of-men-who-are-smoking?time=latest">map of smoking rates in men</a>.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>The fact that men are more likely than women to smoke is reflected in health statistics, particularly lung cancer, for which smoking is a <a href="https://ourworldindata.org/smoking#share-of-cancer-deaths-attributed-to-smoking">primary risk factor</a>. We see that in nearly every country in the world, men are <a href="https://ourworldindata.org/grapher/lung-cancer-deaths-men-women">more likely to die</a> from lung cancer.</p> <!-- /wp:paragraph --> <!-- wp:html --> <iframe style="width: 100%; height: 600px; border: 0px none;" src="https://ourworldindata.org/grapher/comparing-the-share-of-men-and-women-who-are-smoking"></iframe> <!-- /wp:html --> <!-- wp:heading --> <h2>How has the prevalence of smoking changed over time?</h2> <!-- /wp:heading --> <!-- wp:heading {"level":3} --> <h3>The rise and fall of smoking in today's rich countries</h3> <!-- /wp:heading --> <!-- wp:paragraph --> <p>The smoking of cigarettes first saw a significant rise across today's rich countries in the early 20th century. Since then, trends in smoking have undergone a century-long cycle of peak and decline.<br><br>In the visualization, we see the average number of cigarettes sold per adult per day across many of today's rich countries, including the United States and European countries.<br><br>Here, we see that all countries followed a very similar trajectory: a steep rise in cigarette consumption during the early-to-mid 1900s; peaking from the mid-to-latter half of the century, before entering into a steep decline in the decades which followed. <br><br>Notably, this rise-peak-fall pathway took around a century in all cases. This long trajectory has had major health impacts for the populations of rich countries today. </p> <!-- /wp:paragraph --> <!-- wp:html --> <figure><iframe src="https://ourworldindata.org/grapher/sales-of-cigarettes-per-adult-per-day"></iframe></figure> <!-- /wp:html --> <!-- wp:heading {"level":3} --> <h3>Smoking rates are now falling in almost all countries</h3> <!-- /wp:heading --> <!-- wp:paragraph --> <p>The rise, peak, and decline of smoking in rich countries took around a century. The high peak had severe health impacts.<br><br>This timescale is important when we consider low-to-middle-income countries today: if they are to avoid the scale of the health consequences seen by rich countries, they must move through this pathway much quicker. The positive news is that most have – smoking is already falling in most countries today.<br><br>In this visualization, we see the share of adults who smoked in the year 2000 (on the y-axis) and in the most recent data (on the x-axis). The grey line here shows parity: countries that lie along this line would have the same smoking prevalence at both points in time. Countries that lie <em>above</em> this line had higher smoking prevalence back in 2000; for those <em>below</em> the opposite is true.<br><br>We see that most countries lie above the grey line: this means the share of adults who smoke has declined in most countries in the world over the past decade. This is a surprising fact to many, since it means smoking prevalence is not only falling in high-income countries but also in most low-to-middle incomes.{ref}Bilano, V., Gilmour, S., Moffiet, T., d'Espaignet, E. T., Stevens, G. A., Commar, A., ... & Shibuya, K. (2015). <a href="https://www.sciencedirect.com/science/article/pii/S0140673615602641">Global trends and projections for tobacco use, 1990–2025: an analysis of smoking indicators from the WHO Comprehensive Information Systems for Tobacco Control</a>. <em>The Lancet</em>, <em>385</em>(9972), 966-976.{/ref}</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Low-to-middle income countries have effectively 'leapfrogged' the century-long rise-peak-decline pathway of rich countries. Almost everywhere, smoking is on the decline.</p> <!-- /wp:paragraph --> <!-- wp:html --> <figure><iframe src="https://ourworldindata.org/grapher/adults-smoking-2000-2016"></iframe></figure> <!-- /wp:html --> <!-- wp:heading --> <h2>Smoking and cancer</h2> <!-- /wp:heading --> <!-- wp-block-tombstone 27900 --> <!-- wp:heading {"level":4} --> <h4>The rise and fall of lung cancer</h4> <!-- /wp:heading --> <!-- wp:paragraph --> <p>This chart shows death rates from lung cancer in the US since 1950. It is possible to view the data for other countries by using the tools in the chart.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>We see the same rise, peak, and decline pattern that we have seen in the cigarette consumption statistics.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>These trends are largely driven by the trends in <a href="https://owid.cloud/smoking">smoking</a>. Smoking is the biggest risk factor for lung cancer and we see that the trends in lung cancer follow those in smoking with a lag.</p> <!-- /wp:paragraph --> <!-- wp:html --> <iframe style="width: 100%; height: 600px; border: 0px none;" src="https://ourworldindata.org/grapher/lung-cancer-deaths-per-100000-by-sex-1950-2002"></iframe> <!-- /wp:html --> <!-- wp:heading {"level":4} --> <h4>Share of cancer deaths attributed to smoking</h4> <!-- /wp:heading --> <!-- wp:paragraph --> <p>The world map shows the Global Burden of Disease estimates of the share of cancer deaths that can be attributed to smoking.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Globally, <a href="https://ourworldindata.org/grapher/share-of-cancer-deaths-attributed-to-tobacco?tab=chart&country=~OWID_WRL">about a quarter</a> of cancer deaths are attributed to smoking.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>In most richer countries, the share is even higher.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>In poor countries, where fewer people were smoking in the past, tobacco is responsible for a smaller fraction of cancer deaths.</p> <!-- /wp:paragraph --> <!-- wp:html --> <iframe src="https://ourworldindata.org/grapher/share-of-cancer-deaths-attributed-to-tobacco" style="width: 100%; height: 600px; border: 0px none;"></iframe> <!-- /wp:html --> <!-- wp:heading --> <h2>What can we do to reduce smoking?</h2> <!-- /wp:heading --> <!-- wp:heading {"level":3} --> <h3>Pricing and taxes</h3> <!-- /wp:heading --> <!-- wp:heading {"level":4} --> <h4>Affordability of cigarettes</h4> <!-- /wp:heading --> <!-- wp:html --> <figure><iframe src="https://ourworldindata.org/grapher/affordability-cigarettes"></iframe></figure> <!-- /wp:html --> <!-- wp:heading {"level":4} --> <h4>Taxes on cigarettes</h4> <!-- /wp:heading --> <!-- wp:html --> <figure><iframe src="https://ourworldindata.org/grapher/share-of-tobacco-retail-price-that-is-tax"></iframe></figure> <!-- /wp:html --> <!-- wp:heading {"level":3} --> <h3>Bans on tobacco advertising</h3> <!-- /wp:heading --> <!-- wp:html --> <figure><iframe src="https://ourworldindata.org/grapher/enforcement-of-bans-on-tobacco-advertising"></iframe></figure> <!-- /wp:html --> <!-- wp:heading {"level":3} --> <h3>Support to quit smoking</h3> <!-- /wp:heading --> <!-- wp:html --> <figure><iframe src="https://ourworldindata.org/grapher/support-to-help-to-quit-tobacco-use"></iframe></figure> <!-- /wp:html --> <!-- wp:heading --> <h2>Data Sources</h2> <!-- /wp:heading --> <!-- wp:heading {"level":4} --> <h4>International Mortality and Smoking Statistics (IMASS)</h4> <!-- /wp:heading --> <!-- wp:list --> <ul><li><strong>Data:</strong> Consumption of tobacco products, prevalence of smoking and mortality</li><li><strong>Geographical coverage:</strong> 30 countries</li><li><strong>Time span:</strong> Often spanning back 100 years</li><li><strong>Available at: </strong>Online <a href="http://www.pnlee.co.uk/imass.htm">here</a></li></ul> <!-- /wp:list --> <!-- wp:heading {"level":4} --> <h4>Institute of Health Metrics and Evaluation (IHME), Global Burden of Disease (GBD)</h4> <!-- /wp:heading --> <!-- wp:list --> <ul><li><strong>Data:</strong> Death rates and absolute number of premature deaths from smoking and secondhand-smoke</li><li><strong>Geographical coverage:</strong> Global, across all regions and countries</li><li><strong>Time span:</strong> 1990 onwards</li><li><strong>Available at: </strong>Online <a href="http://ghdx.healthdata.org/gbd-results-tool">here</a></li></ul> <!-- /wp:list --> <!-- wp:heading {"level":4} --> <h4>World Health Organization (WHO) Global Health Observatory (GHO)</h4> <!-- /wp:heading --> <!-- wp:list --> <ul><li><strong>Data:</strong> Smoking prevalence, prices, taxes and policy support</li><li><strong>Geographical coverage:</strong> Global, across all regions and countries</li><li><strong>Available at: </strong>Online <a href="http://apps.who.int/gho/data/node.home">here</a></li></ul> <!-- /wp:list -->	{ "id": "wp-1683", "slug": "smoking", "content": { "toc": [], "body": [ { "type": "text", "value": [ { "text": "This article was first published in May 2013; it was revised substantially in November 2019. The last update was done in August 2023.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "Tobacco smoking is one of the world's largest health problems. Millions of people live in poor health because of it. Researchers estimate that every year around ", "spanType": "span-simple-text" }, { "children": [ { "text": "8 million people", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": " die an early death due to smoking.", "spanType": "span-simple-text" }, { "spanType": "span-newline" }, { "spanType": "span-newline" }, { "text": "It has been a major health problem for many decades. For the entire 20th century, it is estimated that around 100 million people died prematurely because of smoking, most of them in rich countries.{ref}Jha, P. (2009). ", "spanType": "span-simple-text" }, { "url": "https://www.nature.com/articles/nrc2703", "children": [ { "text": "Avoidable global cancer deaths and total deaths from smoking", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": ".\u00a0", "spanType": "span-simple-text" }, { "children": [ { "text": "Nature Reviews Cancer", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": ",\u00a0", "spanType": "span-simple-text" }, { "children": [ { "text": "9", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": "(9), 655.{/ref}", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "The share of smokers among the world population is falling, and because smoking is such a large health problem today, this is one of the most positive developments in global health. It makes it possible for millions of people to live a longer and healthier life.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "children": [ { "text": "For a brief overview of the most important facts, see the following article:", "spanType": "span-simple-text" } ], "spanType": "span-italic" } ], "parseErrors": [] }, { "url": "https://ourworldindata.org/smoking-big-problem-in-brief", "type": "prominent-link", "title": "", "description": "", "parseErrors": [] }, { "type": "text", "value": [ { "children": [ { "url": "#all-charts", "children": [ { "text": "See all interactive charts on smoking \u2193", "spanType": "span-simple-text" } ], "spanType": "span-link" } ], "spanType": "span-bold" } ], "parseErrors": [] }, { "type": "horizontal-rule", "parseErrors": [] }, { "text": [ { "text": "Smoking is one of the leading risks for early death", "spanType": "span-simple-text" } ], "type": "heading", "level": 1, "parseErrors": [] }, { "type": "horizontal-rule", "parseErrors": [] }, { "text": [ { "text": "Smoking is responsible for about 8 million premature deaths each year", "spanType": "span-simple-text" } ], "type": "heading", "level": 3, "parseErrors": [] }, { "type": "text", "value": [ { "text": "The two regularly updated studies on the global death toll from tobacco use \u2013 published by the World Health Organization and the Institute for Health Metrics and Evaluation \u2013 agree that around 8 million people die prematurely yearly.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "The aggregate statistics refer to \u2018tobacco use\u2019 (rather than smoking alone) because other forms of consuming tobacco, such as chewing tobacco, also lead to premature deaths. The huge majority of deaths from tobacco use, however, are due to smoking. The death toll from smoking is very close to the total sum of deaths from tobacco use (higher than 99.9% in the case of the IHME estimates).", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "text": [ { "text": "World Health Organization: More than 8 million die from tobacco use every year", "spanType": "span-simple-text" } ], "type": "heading", "level": 3, "parseErrors": [] }, { "type": "text", "value": [ { "text": "The WHO estimates that more than 8 million people die prematurely yearly from tobacco use. This is the latest available WHO estimate as of August 2023.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "More than 7 million of those deaths result from direct tobacco use. About 1.3 million are non-smokers who are dying because they are exposed to second-hand smoke.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "children": [ { "text": "Reference:", "spanType": "span-simple-text" } ], "spanType": "span-bold" }, { "url": "https://www.who.int/news-room/fact-sheets/detail/tobacco", "children": [ { "text": "WHO (2023) \u2013\u00a0Fact Sheet: Tobacco", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": ", updated in July 2023", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "text": [ { "text": "IHME's Global Burden of Disease study: 8.7 million die from tobacco use every year", "spanType": "span-simple-text" } ], "type": "heading", "level": 3, "parseErrors": [] }, { "type": "text", "value": [ { "text": "The IHME \u2013 in their annual Global Burden of Disease study \u2013 estimates that 8.7 million people die prematurely from tobacco use every year. As of August 2023, these are the latest estimates and refer to deaths in the year 2019.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "7.7 million of those deaths result from smoking while 1.3 million are non-smokers who are dying because they are exposed to second-hand smoke. (An additional 56,000 people die annually from chewing tobacco.) Most (71%) of those who die prematurely from smoking are men.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "These estimates of the annual number of deaths attributed to a wide range of risk factors are shown in the interactive chart. This visualization is, by default, showing the global total, but can be explored for any country or region using the \"change country\" toggle. Smoking is a risk factor for several of the world's leading causes of death, including lung and other forms of cancer, heart disease, and respiratory diseases. The references can be found i the footnote.{ref}The estimates of the Global Burden of Disease study can be found ", "spanType": "span-simple-text" }, { "url": "http://ihmeuw.org/5i08", "children": [ { "text": "here", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": ". The latest study can be found at the website of The Lancet here: ", "spanType": "span-simple-text" }, { "url": "https://www.thelancet.com/gbd", "children": [ { "text": "TheLancet.com/GBD", "spanType": "span-simple-text" } ], "spanType": "span-link" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "There are two publications that are closely related to the Global Burden of Disease study:", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "Reitsma et al. (2021) \u2013 ", "spanType": "span-simple-text" }, { "url": "https://doi.org/10.1016/S0140-6736(21)01169-7", "children": [ { "text": "Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990\u20132019: A systematic analysis from the Global Burden of Disease Study 2019", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": ". In ", "spanType": "span-simple-text" }, { "children": [ { "text": "The Lancet", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": ", 397(10292), 2337\u20132360.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "The GBD estimates are also presented in yet another prominent publication. The ", "spanType": "span-simple-text" }, { "url": "https://tobaccoatlas.org/", "children": [ { "children": [ { "text": "Tobacco Atlas", "spanType": "span-simple-text" } ], "spanType": "span-bold" } ], "spanType": "span-link" }, { "text": " is published by the American Cancer Society and Vital Strategies and presents estimates for the global death toll from smoking ", "spanType": "span-simple-text" }, { "url": "https://tobaccoatlas.org/data-sources/", "children": [ { "text": "taken from", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": " the Global Burden of Disease Study published by the Institute for Health Metrics and Evaluation (IHME).{/ref}", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/number-of-deaths-by-risk-factor", "type": "chart", "parseErrors": [] }, { "text": [ { "text": "Smoking led to about 100 million premature deaths in the 20th century", "spanType": "span-simple-text" } ], "type": "heading", "level": 3, "parseErrors": [] }, { "type": "text", "value": [ { "text": "Tobacco smoking has been one of the world's largest health problems for decades. Over the course of the 20th century, it killed around 100 million people, most of them in today's rich countries.{ref}Jha, P. (2009). ", "spanType": "span-simple-text" }, { "url": "https://www.nature.com/articles/nrc2703", "children": [ { "text": "Avoidable global cancer deaths and total deaths from smoking", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": ".\u00a0", "spanType": "span-simple-text" }, { "children": [ { "text": "Nature Reviews Cancer", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": ",\u00a0", "spanType": "span-simple-text" }, { "children": [ { "text": "9", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": "(9), 655.{/ref} The health burdens of smoking are now moving from high-income to low-to-middle-income countries; some estimates have suggested that one billion people could die from tobacco over the 21st century.{ref}Mathers, C. D., & Loncar, D. (2006). Projections of global mortality and burden of disease from 2002 to 2030.\u00a0", "spanType": "span-simple-text" }, { "children": [ { "text": "PLoS medicine", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": ",\u00a0", "spanType": "span-simple-text" }, { "children": [ { "text": "3", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": "(11), e442.{/ref}", "spanType": "span-simple-text" }, { "children": [ { "text": ",", "spanType": "span-simple-text" } ], "spanType": "span-superscript" }, { "text": "{ref}Jha, P., & Peto, R. (2014). ", "spanType": "span-simple-text" }, { "url": "https://www.nejm.org/doi/10.1056/NEJMra1308383", "children": [ { "text": "Global effects of smoking, of quitting, and of taxing tobacco", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": ".\u00a0", "spanType": "span-simple-text" }, { "children": [ { "text": "New England Journal of Medicine", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": ",\u00a0", "spanType": "span-simple-text" }, { "children": [ { "text": "370", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": "(1), 60-68.{/ref}", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "horizontal-rule", "parseErrors": [] }, { "text": [ { "text": "The global distribution of smoking deaths", "spanType": "span-simple-text" } ], "type": "heading", "level": 1, "parseErrors": [] }, { "type": "horizontal-rule", "parseErrors": [] }, { "text": [ { "text": "In many countries, a high share of deaths is attributed to smoking", "spanType": "span-simple-text" } ], "type": "heading", "level": 3, "parseErrors": [] }, { "type": "text", "value": [ { "text": "In the map, we see the share of deaths attributed to direct smoking across the world. In many countries, this share is substantial.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "children": [ { "text": "Related chart \u2013 the share of deaths from ", "spanType": "span-simple-text" } ], "spanType": "span-bold" }, { "children": [ { "children": [ { "text": "secondhand smoking", "spanType": "span-simple-text" } ], "spanType": "span-bold" } ], "spanType": "span-italic" }, { "children": [ { "text": ".", "spanType": "span-simple-text" } ], "spanType": "span-bold" }, { "url": "https://ourworldindata.org/grapher/share-deaths-secondhand-smoke", "children": [ { "text": "This map", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": " shows the share of premature deaths attributed from secondhand smoke across the world.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/share-deaths-smoking", "type": "chart", "parseErrors": [] }, { "text": [ { "text": "Death rates from smoking are highest across Asia and Eastern Europe", "spanType": "span-simple-text" } ], "type": "heading", "level": 3, "parseErrors": [] }, { "type": "text", "value": [ { "text": "In the interactive map, we show death rates from tobacco smoking across the world. Death rates measure the number of premature deaths from smoking per 100,000 people in a given country or region. ", "spanType": "span-simple-text" }, { "spanType": "span-newline" }, { "spanType": "span-newline" }, { "text": "We see large differences in death rates across the world. Rates tend to be highest across Asia and Eastern Europe, where figures are often over 100, and in some cases, over 150 deaths per 100,000 people. ", "spanType": "span-simple-text" }, { "spanType": "span-newline" }, { "spanType": "span-newline" }, { "text": "Death rates are much lower across some of the lowest-income countries in the world, where very few people smoke.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "children": [ { "text": "Related chart \u2013 ", "spanType": "span-simple-text" }, { "children": [ { "text": "number", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": " of deaths from smoking.", "spanType": "span-simple-text" } ], "spanType": "span-bold" }, { "url": "https://ourworldindata.org/grapher/number-of-deaths-from-tobacco-smoking", "children": [ { "text": "This map", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": " shows the annual number of deaths from tobacco smoking across the world.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/death-rate-smoking?tab=map", "type": "chart", "parseErrors": [] }, { "text": [ { "text": "Most deaths from smoking occur in older populations", "spanType": "span-simple-text" } ], "type": "heading", "level": 3, "parseErrors": [] }, { "type": "text", "value": [ { "text": "When we look at the breakdown of deaths from smoking by age, we see that it is mainly older populations that are affected. ", "spanType": "span-simple-text" }, { "spanType": "span-newline" }, { "spanType": "span-newline" }, { "text": "In the visualizations, we show the death rates from smoking by age bracket and the share of annual deaths that occur in each age group.", "spanType": "span-simple-text" }, { "spanType": "span-newline" }, { "spanType": "span-newline" }, { "text": "Here, we see that death rates from smoking are much higher in people older than 70 years old, followed by those aged 50 to 69.", "spanType": "span-simple-text" }, { "spanType": "span-newline" } ], "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/death-rates-smoking-age", "type": "chart", "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/smoking-deaths-by-age?stackMode=relative", "type": "chart", "parseErrors": [] }, { "type": "horizontal-rule", "parseErrors": [] }, { "text": [ { "text": "How have smoking deaths changed over time?", "spanType": "span-simple-text" } ], "type": "heading", "level": 1, "parseErrors": [] }, { "type": "horizontal-rule", "parseErrors": [] }, { "text": [ { "text": "Death rates from smoking have declined in most countries", "spanType": "span-simple-text" } ], "type": "heading", "level": 3, "parseErrors": [] }, { "type": "text", "value": [ { "text": "Globally, smoking-related death rates ", "spanType": "span-simple-text" }, { "url": "https://ourworldindata.org/grapher/death-rate-smoking?tab=chart&country=OWID_WRL", "children": [ { "text": "have fallen", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": ".", "spanType": "span-simple-text" }, { "spanType": "span-newline" }, { "spanType": "span-newline" }, { "text": "But there are differences across countries. Where in the world are death rates falling or rising?", "spanType": "span-simple-text" }, { "spanType": "span-newline" }, { "spanType": "span-newline" }, { "text": "In the scatterplot, we see the comparison of smoking death rates in 1990 (shown on the y-axis) versus the death rate in the latest data (on the x-axis). The grey line is the line of parity: countries that lie along this line had equal death rates at both points in time. Countries that lie ", "spanType": "span-simple-text" }, { "children": [ { "text": "above", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": " the grey line had higher death rates in 1990; for those that lie ", "spanType": "span-simple-text" }, { "children": [ { "text": "below", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": " the grey line, the opposite is true.", "spanType": "span-simple-text" }, { "spanType": "span-newline" }, { "spanType": "span-newline" }, { "text": "We see that almost all countries in the world lie above the grey line. This means that most countries have achieved a ", "spanType": "span-simple-text" }, { "children": [ { "text": "decline", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": " in death rates from smoking in recent decades.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/smoking-death-rate-1990-2017", "type": "chart", "parseErrors": [] }, { "type": "horizontal-rule", "parseErrors": [] }, { "text": [ { "text": "Prevalence of smoking across the world", "spanType": "span-simple-text" } ], "type": "heading", "level": 1, "parseErrors": [] }, { "type": "horizontal-rule", "parseErrors": [] }, { "text": [ { "text": "Share who smoke", "spanType": "span-simple-text" } ], "type": "heading", "level": 2, "parseErrors": [] }, { "text": [ { "text": "In which countries do people smoke the most?", "spanType": "span-simple-text" } ], "type": "heading", "level": 3, "parseErrors": [] }, { "type": "text", "value": [ { "text": "Around one-in-four adults in the world smoke tobacco.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "But where in the world is smoking most common?", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "In the map, we see the share of adults aged 15 years and older, who smoke tobacco. ", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "There are a number of countries where more than a third of the population smokes. The places where many people smoke are clustered in regions. South-East Asia, the Pacific islands, and parts of Europe.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "In some countries, very few people smoke.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "Several factors influence the prevalence of smoking. One is prosperity: if we look at ", "spanType": "span-simple-text" }, { "url": "https://ourworldindata.org/grapher/share-of-adults-who-are-smoking-by-level-of-prosperity", "children": [ { "text": "the relationship", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": " between smoking prevalence and income, we find that richer countries tend to smoke more. But as you see in this correlation, there are very large differences at each level of income.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "Smoking rates are high across many countries, but we know from the history of many countries that this can change quickly. Many of today\u2019s high-income countries had much higher smoking rates in the past and have seen a large reduction.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/share-of-adults-who-smoke?tab=map&country=USA~BRA~RUS~IND~CHN~European+Union~IDN~OWID_WRL", "type": "chart", "parseErrors": [] }, { "text": [ { "text": "Daily smokers", "spanType": "span-simple-text" } ], "type": "heading", "level": 2, "parseErrors": [] }, { "type": "text", "value": [ { "text": "This visualization shows the share of adults, aged 15 years and older, who smoke every day.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "We see that daily smoking is most common across Europe and Asia \u2013 more than 20% of adults in most countries in these regions smoke every day.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "children": [ { "text": "Related chart \u2013 ", "spanType": "span-simple-text" } ], "spanType": "span-bold" }, { "children": [ { "children": [ { "text": "number", "spanType": "span-simple-text" } ], "spanType": "span-bold" } ], "spanType": "span-italic" }, { "children": [ { "text": " of daily smokers", "spanType": "span-simple-text" } ], "spanType": "span-bold" }, { "text": ". ", "spanType": "span-simple-text" }, { "url": "https://ourworldindata.org/grapher/number-of-total-daily-smokers?time=1980..2012", "children": [ { "text": "This map", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": " shows the number of people who smoke every day across the world.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/daily-smoking-prevalence-bounds", "type": "chart", "parseErrors": [] }, { "text": [ { "text": "Smoking by gender", "spanType": "span-simple-text" } ], "type": "heading", "level": 2, "parseErrors": [] }, { "text": [ { "text": "Who smokes more, men or women?", "spanType": "span-simple-text" } ], "type": "heading", "level": 3, "parseErrors": [] }, { "type": "text", "value": [ { "text": "Nearly one-in-four adults in the world ", "spanType": "span-simple-text" }, { "url": "https://ourworldindata.org/which-countries-smoke-most", "children": [ { "text": "smokes tobacco", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": ". But there are large differences between men and women.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "As the chart shows, more than one-third of men in the world smoke, while the same is true for less than one-in-ten women.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "In almost all countries, it is true that a large share of men smoke. In the visualization, we see the share of men who smoke (plotted on the vertical axis) compared with the same metric for women (plotted on the horizontal axis).", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "The grey line in the plot represents equality in the prevalence: countries where smoking is more common in men will lie above this line, and countries where more women smoke lie below.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "We see that almost all countries lie above the grey line, meaning a higher share of men smoke. There are only a few exceptions.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "In many countries \u2014 particularly across Asia and Africa \u2014 the differences are very large. ", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "We also see this when we look at a ", "spanType": "span-simple-text" }, { "url": "https://ourworldindata.org/grapher/share-of-women-who-are-smoking?tab=map", "children": [ { "text": "global map of smoking among women", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": ": across much of Africa and Asia, rates are very low. For comparison, here is the world ", "spanType": "span-simple-text" }, { "url": "https://ourworldindata.org/grapher/share-of-men-who-are-smoking?time=latest", "children": [ { "text": "map of smoking rates in men", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": ".", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "The fact that men are more likely than women to smoke is reflected in health statistics, particularly lung cancer, for which smoking is a ", "spanType": "span-simple-text" }, { "url": "https://ourworldindata.org/smoking#share-of-cancer-deaths-attributed-to-smoking", "children": [ { "text": "primary risk factor", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": ". We see that in nearly every country in the world, men are ", "spanType": "span-simple-text" }, { "url": "https://ourworldindata.org/grapher/lung-cancer-deaths-men-women", "children": [ { "text": "more likely to die", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": " from lung cancer.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/comparing-the-share-of-men-and-women-who-are-smoking", "type": "chart", "parseErrors": [] }, { "type": "horizontal-rule", "parseErrors": [] }, { "text": [ { "text": "How has the prevalence of smoking changed over time?", "spanType": "span-simple-text" } ], "type": "heading", "level": 1, "parseErrors": [] }, { "type": "horizontal-rule", "parseErrors": [] }, { "text": [ { "text": "The rise and fall of smoking in today's rich countries", "spanType": "span-simple-text" } ], "type": "heading", "level": 2, "parseErrors": [] }, { "type": "text", "value": [ { "text": "The smoking of cigarettes first saw a significant rise across today's rich countries in the early 20th century. Since then, trends in smoking have undergone a century-long cycle of peak and decline.", "spanType": "span-simple-text" }, { "spanType": "span-newline" }, { "spanType": "span-newline" }, { "text": "In the visualization, we see the average number of cigarettes sold per adult per day across many of today's rich countries, including the United States and European countries.", "spanType": "span-simple-text" }, { "spanType": "span-newline" }, { "spanType": "span-newline" }, { "text": "Here, we see that all countries followed a very similar trajectory: a steep rise in cigarette consumption during the early-to-mid 1900s; peaking from the mid-to-latter half of the century, before entering into a steep decline in the decades which followed. ", "spanType": "span-simple-text" }, { "spanType": "span-newline" }, { "spanType": "span-newline" }, { "text": "Notably, this rise-peak-fall pathway took around a century in all cases. This long trajectory has had major health impacts for the populations of rich countries today. ", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/sales-of-cigarettes-per-adult-per-day", "type": "chart", "parseErrors": [] }, { "text": [ { "text": "Smoking rates are now falling in almost all countries", "spanType": "span-simple-text" } ], "type": "heading", "level": 2, "parseErrors": [] }, { "type": "text", "value": [ { "text": "The rise, peak, and decline of smoking in rich countries took around a century. The high peak had severe health impacts.", "spanType": "span-simple-text" }, { "spanType": "span-newline" }, { "spanType": "span-newline" }, { "text": "This timescale is important when we consider low-to-middle-income countries today: if they are to avoid the scale of the health consequences seen by rich countries, they must move through this pathway much quicker. The positive news is that most have \u2013 smoking is already falling in most countries today.", "spanType": "span-simple-text" }, { "spanType": "span-newline" }, { "spanType": "span-newline" }, { "text": "In this visualization, we see the share of adults who smoked in the year 2000 (on the y-axis) and in the most recent data (on the x-axis). The grey line here shows parity: countries that lie along this line would have the same smoking prevalence at both points in time. Countries that lie ", "spanType": "span-simple-text" }, { "children": [ { "text": "above", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": " this line had higher smoking prevalence back in 2000; for those ", "spanType": "span-simple-text" }, { "children": [ { "text": "below", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": " the opposite is true.", "spanType": "span-simple-text" }, { "spanType": "span-newline" }, { "spanType": "span-newline" }, { "text": "We see that most countries lie above the grey line: this means the share of adults who smoke has declined in most countries in the world over the past decade. This is a surprising fact to many, since it means smoking prevalence is not only falling in high-income countries but also in most low-to-middle incomes.{ref}Bilano, V., Gilmour, S., Moffiet, T., d'Espaignet, E. T., Stevens, G. A., Commar, A., ... & Shibuya, K. (2015). ", "spanType": "span-simple-text" }, { "url": "https://www.sciencedirect.com/science/article/pii/S0140673615602641", "children": [ { "text": "Global trends and projections for tobacco use, 1990\u20132025: an analysis of smoking indicators from the WHO Comprehensive Information Systems for Tobacco Control", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": ".\u00a0", "spanType": "span-simple-text" }, { "children": [ { "text": "The Lancet", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": ",\u00a0", "spanType": "span-simple-text" }, { "children": [ { "text": "385", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": "(9972), 966-976.{/ref}", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "Low-to-middle income countries have effectively 'leapfrogged' the century-long rise-peak-decline pathway of rich countries. Almost everywhere, smoking is on the decline.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/adults-smoking-2000-2016", "type": "chart", "parseErrors": [] }, { "type": "horizontal-rule", "parseErrors": [] }, { "text": [ { "text": "Smoking and cancer", "spanType": "span-simple-text" } ], "type": "heading", "level": 1, "parseErrors": [] }, { "type": "horizontal-rule", "parseErrors": [] }, { "text": [ { "text": "The rise and fall of lung cancer", "spanType": "span-simple-text" } ], "type": "heading", "level": 3, "parseErrors": [] }, { "type": "text", "value": [ { "text": "This chart shows death rates from lung cancer in the US since 1950. It is possible to view the data for other countries by using the tools in the chart.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "We see the same rise, peak, and decline pattern that we have seen in the cigarette consumption statistics.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "These trends are largely driven by the trends in ", "spanType": "span-simple-text" }, { "url": "https://owid.cloud/smoking", "children": [ { "text": "smoking", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": ". Smoking is the biggest risk factor for lung cancer and we see that the trends in lung cancer follow those in smoking with a lag.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/lung-cancer-deaths-per-100000-by-sex-1950-2002", "type": "chart", "parseErrors": [] }, { "text": [ { "text": "Share of cancer deaths attributed to smoking", "spanType": "span-simple-text" } ], "type": "heading", "level": 3, "parseErrors": [] }, { "type": "text", "value": [ { "text": "The world map shows the Global Burden of Disease estimates of the share of cancer deaths that can be attributed to smoking.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "Globally, ", "spanType": "span-simple-text" }, { "url": "https://ourworldindata.org/grapher/share-of-cancer-deaths-attributed-to-tobacco?tab=chart&country=~OWID_WRL", "children": [ { "text": "about a quarter", "spanType": "span-simple-text" } ], "spanType": 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"slug": "taxes-as-share-of-cigarette-price", "title": "Taxes as a share of cigarette price", "variantName": null, "keyChartLevel": 2 } ], "publicationContext": "listed" }	{ "errors": [ { "name": "unexpected wp component tag", "details": "Found unhandled wp:comment tag list" }, { "name": "unexpected wp component tag", "details": "Found unhandled wp:comment tag list" }, { "name": "unexpected wp component tag", "details": "Found unhandled wp:comment tag list" } ], "numBlocks": 122, "numErrors": 3, "wpTagCounts": { "html": 18, "list": 3, "column": 2, "columns": 1, "heading": 33, "paragraph": 49, "owid/prominent-link": 1 }, "htmlTagCounts": { "p": 49, "h2": 8, "h3": 8, "h4": 17, "ul": 3, "div": 4, "figure": 11, "iframe": 17 } }	2013-05-23 22:34:01	2024-02-16 14:22:38		[ "Hannah Ritchie", "Max Roser" ]	Tobacco smoking is one of the world’s largest health problems today.	2019-11-16 11:33:19	2023-08-30 14:35:02	https://ourworldindata.org/wp-content/uploads/2021/02/Screen-Shot-2021-02-09-at-12.49.32.png	{}	This article was first published in May 2013; it was revised substantially in November 2019. The last update was done in August 2023. Tobacco smoking is one of the world's largest health problems. Millions of people live in poor health because of it. Researchers estimate that every year around _8 million people_ die an early death due to smoking. It has been a major health problem for many decades. For the entire 20th century, it is estimated that around 100 million people died prematurely because of smoking, most of them in rich countries.{ref}Jha, P. (2009). [Avoidable global cancer deaths and total deaths from smoking](https://www.nature.com/articles/nrc2703). _Nature Reviews Cancer_, _9_(9), 655.{/ref} The share of smokers among the world population is falling, and because smoking is such a large health problem today, this is one of the most positive developments in global health. It makes it possible for millions of people to live a longer and healthier life. _For a brief overview of the most important facts, see the following article:_ ### https://ourworldindata.org/smoking-big-problem-in-brief [See all interactive charts on smoking ↓](#all-charts) --- # Smoking is one of the leading risks for early death --- ### Smoking is responsible for about 8 million premature deaths each year The two regularly updated studies on the global death toll from tobacco use – published by the World Health Organization and the Institute for Health Metrics and Evaluation – agree that around 8 million people die prematurely yearly. The aggregate statistics refer to ‘tobacco use’ (rather than smoking alone) because other forms of consuming tobacco, such as chewing tobacco, also lead to premature deaths. The huge majority of deaths from tobacco use, however, are due to smoking. The death toll from smoking is very close to the total sum of deaths from tobacco use (higher than 99.9% in the case of the IHME estimates). ### World Health Organization: More than 8 million die from tobacco use every year The WHO estimates that more than 8 million people die prematurely yearly from tobacco use. This is the latest available WHO estimate as of August 2023. More than 7 million of those deaths result from direct tobacco use. About 1.3 million are non-smokers who are dying because they are exposed to second-hand smoke. Reference:[WHO (2023) – Fact Sheet: Tobacco](https://www.who.int/news-room/fact-sheets/detail/tobacco), updated in July 2023 ### IHME's Global Burden of Disease study: 8.7 million die from tobacco use every year The IHME – in their annual Global Burden of Disease study – estimates that 8.7 million people die prematurely from tobacco use every year. As of August 2023, these are the latest estimates and refer to deaths in the year 2019. 7.7 million of those deaths result from smoking while 1.3 million are non-smokers who are dying because they are exposed to second-hand smoke. (An additional 56,000 people die annually from chewing tobacco.) Most (71%) of those who die prematurely from smoking are men. These estimates of the annual number of deaths attributed to a wide range of risk factors are shown in the interactive chart. This visualization is, by default, showing the global total, but can be explored for any country or region using the "change country" toggle. Smoking is a risk factor for several of the world's leading causes of death, including lung and other forms of cancer, heart disease, and respiratory diseases. The references can be found i the footnote.{ref}The estimates of the Global Burden of Disease study can be found [here](http://ihmeuw.org/5i08). The latest study can be found at the website of The Lancet here: [TheLancet.com/GBD](https://www.thelancet.com/gbd) There are two publications that are closely related to the Global Burden of Disease study: Reitsma et al. (2021) – [Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990–2019: A systematic analysis from the Global Burden of Disease Study 2019](https://doi.org/10.1016/S0140-6736(21)01169-7). In _The Lancet_, 397(10292), 2337–2360. The GBD estimates are also presented in yet another prominent publication. The [Tobacco Atlas](https://tobaccoatlas.org/) is published by the American Cancer Society and Vital Strategies and presents estimates for the global death toll from smoking [taken from](https://tobaccoatlas.org/data-sources/) the Global Burden of Disease Study published by the Institute for Health Metrics and Evaluation (IHME).{/ref} <Chart url="https://ourworldindata.org/grapher/number-of-deaths-by-risk-factor"/> ### Smoking led to about 100 million premature deaths in the 20th century Tobacco smoking has been one of the world's largest health problems for decades. Over the course of the 20th century, it killed around 100 million people, most of them in today's rich countries.{ref}Jha, P. (2009). [Avoidable global cancer deaths and total deaths from smoking](https://www.nature.com/articles/nrc2703). _Nature Reviews Cancer_, _9_(9), 655.{/ref} The health burdens of smoking are now moving from high-income to low-to-middle-income countries; some estimates have suggested that one billion people could die from tobacco over the 21st century.{ref}Mathers, C. D., & Loncar, D. (2006). Projections of global mortality and burden of disease from 2002 to 2030. _PLoS medicine_, _3_(11), e442.{/ref},{ref}Jha, P., & Peto, R. (2014). [Global effects of smoking, of quitting, and of taxing tobacco](https://www.nejm.org/doi/10.1056/NEJMra1308383). _New England Journal of Medicine_, _370_(1), 60-68.{/ref} --- # The global distribution of smoking deaths --- ### In many countries, a high share of deaths is attributed to smoking In the map, we see the share of deaths attributed to direct smoking across the world. In many countries, this share is substantial. Related chart – the share of deaths from _secondhand smoking_.[This map](https://ourworldindata.org/grapher/share-deaths-secondhand-smoke) shows the share of premature deaths attributed from secondhand smoke across the world. <Chart url="https://ourworldindata.org/grapher/share-deaths-smoking"/> ### Death rates from smoking are highest across Asia and Eastern Europe In the interactive map, we show death rates from tobacco smoking across the world. Death rates measure the number of premature deaths from smoking per 100,000 people in a given country or region. We see large differences in death rates across the world. Rates tend to be highest across Asia and Eastern Europe, where figures are often over 100, and in some cases, over 150 deaths per 100,000 people. Death rates are much lower across some of the lowest-income countries in the world, where very few people smoke. Related chart – _number_ of deaths from smoking.[This map](https://ourworldindata.org/grapher/number-of-deaths-from-tobacco-smoking) shows the annual number of deaths from tobacco smoking across the world. <Chart url="https://ourworldindata.org/grapher/death-rate-smoking?tab=map"/> ### Most deaths from smoking occur in older populations When we look at the breakdown of deaths from smoking by age, we see that it is mainly older populations that are affected. In the visualizations, we show the death rates from smoking by age bracket and the share of annual deaths that occur in each age group. Here, we see that death rates from smoking are much higher in people older than 70 years old, followed by those aged 50 to 69. <Chart url="https://ourworldindata.org/grapher/death-rates-smoking-age"/> <Chart url="https://ourworldindata.org/grapher/smoking-deaths-by-age?stackMode=relative"/> --- # How have smoking deaths changed over time? --- ### Death rates from smoking have declined in most countries Globally, smoking-related death rates [have fallen](https://ourworldindata.org/grapher/death-rate-smoking?tab=chart&country=OWID_WRL). But there are differences across countries. Where in the world are death rates falling or rising? In the scatterplot, we see the comparison of smoking death rates in 1990 (shown on the y-axis) versus the death rate in the latest data (on the x-axis). The grey line is the line of parity: countries that lie along this line had equal death rates at both points in time. Countries that lie _above_ the grey line had higher death rates in 1990; for those that lie _below_ the grey line, the opposite is true. We see that almost all countries in the world lie above the grey line. This means that most countries have achieved a _decline_ in death rates from smoking in recent decades. <Chart url="https://ourworldindata.org/grapher/smoking-death-rate-1990-2017"/> --- # Prevalence of smoking across the world --- ## Share who smoke ### In which countries do people smoke the most? Around one-in-four adults in the world smoke tobacco. But where in the world is smoking most common? In the map, we see the share of adults aged 15 years and older, who smoke tobacco. There are a number of countries where more than a third of the population smokes. The places where many people smoke are clustered in regions. South-East Asia, the Pacific islands, and parts of Europe. In some countries, very few people smoke. Several factors influence the prevalence of smoking. One is prosperity: if we look at [the relationship](https://ourworldindata.org/grapher/share-of-adults-who-are-smoking-by-level-of-prosperity) between smoking prevalence and income, we find that richer countries tend to smoke more. But as you see in this correlation, there are very large differences at each level of income. Smoking rates are high across many countries, but we know from the history of many countries that this can change quickly. Many of today’s high-income countries had much higher smoking rates in the past and have seen a large reduction. <Chart url="https://ourworldindata.org/grapher/share-of-adults-who-smoke?tab=map&country=USA~BRA~RUS~IND~CHN~European+Union~IDN~OWID_WRL"/> ## Daily smokers This visualization shows the share of adults, aged 15 years and older, who smoke every day. We see that daily smoking is most common across Europe and Asia – more than 20% of adults in most countries in these regions smoke every day. Related chart – _number_ of daily smokers. [This map](https://ourworldindata.org/grapher/number-of-total-daily-smokers?time=1980..2012) shows the number of people who smoke every day across the world. <Chart url="https://ourworldindata.org/grapher/daily-smoking-prevalence-bounds"/> ## Smoking by gender ### Who smokes more, men or women? Nearly one-in-four adults in the world [smokes tobacco](https://ourworldindata.org/which-countries-smoke-most). But there are large differences between men and women. As the chart shows, more than one-third of men in the world smoke, while the same is true for less than one-in-ten women. In almost all countries, it is true that a large share of men smoke. In the visualization, we see the share of men who smoke (plotted on the vertical axis) compared with the same metric for women (plotted on the horizontal axis). The grey line in the plot represents equality in the prevalence: countries where smoking is more common in men will lie above this line, and countries where more women smoke lie below. We see that almost all countries lie above the grey line, meaning a higher share of men smoke. There are only a few exceptions. In many countries — particularly across Asia and Africa — the differences are very large. We also see this when we look at a [global map of smoking among women](https://ourworldindata.org/grapher/share-of-women-who-are-smoking?tab=map): across much of Africa and Asia, rates are very low. For comparison, here is the world [map of smoking rates in men](https://ourworldindata.org/grapher/share-of-men-who-are-smoking?time=latest). The fact that men are more likely than women to smoke is reflected in health statistics, particularly lung cancer, for which smoking is a [primary risk factor](https://ourworldindata.org/smoking#share-of-cancer-deaths-attributed-to-smoking). We see that in nearly every country in the world, men are [more likely to die](https://ourworldindata.org/grapher/lung-cancer-deaths-men-women) from lung cancer. <Chart url="https://ourworldindata.org/grapher/comparing-the-share-of-men-and-women-who-are-smoking"/> --- # How has the prevalence of smoking changed over time? --- ## The rise and fall of smoking in today's rich countries The smoking of cigarettes first saw a significant rise across today's rich countries in the early 20th century. Since then, trends in smoking have undergone a century-long cycle of peak and decline. In the visualization, we see the average number of cigarettes sold per adult per day across many of today's rich countries, including the United States and European countries. Here, we see that all countries followed a very similar trajectory: a steep rise in cigarette consumption during the early-to-mid 1900s; peaking from the mid-to-latter half of the century, before entering into a steep decline in the decades which followed. Notably, this rise-peak-fall pathway took around a century in all cases. This long trajectory has had major health impacts for the populations of rich countries today. <Chart url="https://ourworldindata.org/grapher/sales-of-cigarettes-per-adult-per-day"/> ## Smoking rates are now falling in almost all countries The rise, peak, and decline of smoking in rich countries took around a century. The high peak had severe health impacts. This timescale is important when we consider low-to-middle-income countries today: if they are to avoid the scale of the health consequences seen by rich countries, they must move through this pathway much quicker. The positive news is that most have – smoking is already falling in most countries today. In this visualization, we see the share of adults who smoked in the year 2000 (on the y-axis) and in the most recent data (on the x-axis). The grey line here shows parity: countries that lie along this line would have the same smoking prevalence at both points in time. Countries that lie _above_ this line had higher smoking prevalence back in 2000; for those _below_ the opposite is true. We see that most countries lie above the grey line: this means the share of adults who smoke has declined in most countries in the world over the past decade. This is a surprising fact to many, since it means smoking prevalence is not only falling in high-income countries but also in most low-to-middle incomes.{ref}Bilano, V., Gilmour, S., Moffiet, T., d'Espaignet, E. T., Stevens, G. A., Commar, A., ... & Shibuya, K. (2015). [Global trends and projections for tobacco use, 1990–2025: an analysis of smoking indicators from the WHO Comprehensive Information Systems for Tobacco Control](https://www.sciencedirect.com/science/article/pii/S0140673615602641). _The Lancet_, _385_(9972), 966-976.{/ref} Low-to-middle income countries have effectively 'leapfrogged' the century-long rise-peak-decline pathway of rich countries. Almost everywhere, smoking is on the decline. <Chart url="https://ourworldindata.org/grapher/adults-smoking-2000-2016"/> --- # Smoking and cancer --- ### The rise and fall of lung cancer This chart shows death rates from lung cancer in the US since 1950. It is possible to view the data for other countries by using the tools in the chart. We see the same rise, peak, and decline pattern that we have seen in the cigarette consumption statistics. These trends are largely driven by the trends in [smoking](https://owid.cloud/smoking). Smoking is the biggest risk factor for lung cancer and we see that the trends in lung cancer follow those in smoking with a lag. <Chart url="https://ourworldindata.org/grapher/lung-cancer-deaths-per-100000-by-sex-1950-2002"/> ### Share of cancer deaths attributed to smoking The world map shows the Global Burden of Disease estimates of the share of cancer deaths that can be attributed to smoking. Globally, [about a quarter](https://ourworldindata.org/grapher/share-of-cancer-deaths-attributed-to-tobacco?tab=chart&country=~OWID_WRL) of cancer deaths are attributed to smoking. In most richer countries, the share is even higher. In poor countries, where fewer people were smoking in the past, tobacco is responsible for a smaller fraction of cancer deaths. <Chart url="https://ourworldindata.org/grapher/share-of-cancer-deaths-attributed-to-tobacco"/> --- # What can we do to reduce smoking? --- ## Pricing and taxes ### Affordability of cigarettes <Chart url="https://ourworldindata.org/grapher/affordability-cigarettes"/> ### Taxes on cigarettes <Chart url="https://ourworldindata.org/grapher/share-of-tobacco-retail-price-that-is-tax"/> ## Bans on tobacco advertising <Chart url="https://ourworldindata.org/grapher/enforcement-of-bans-on-tobacco-advertising"/> ## Support to quit smoking <Chart url="https://ourworldindata.org/grapher/support-to-help-to-quit-tobacco-use"/> --- # Data Sources --- ### International Mortality and Smoking Statistics (IMASS) * Data: Consumption of tobacco products, prevalence of smoking and mortality * Geographical coverage: 30 countries * Time span: Often spanning back 100 years * Available at: Online [here](http://www.pnlee.co.uk/imass.htm) ### Institute of Health Metrics and Evaluation (IHME), Global Burden of Disease (GBD) * Data: Death rates and absolute number of premature deaths from smoking and secondhand-smoke * Geographical coverage: Global, across all regions and countries * Time span: 1990 onwards * Available at: Online [here](http://ghdx.healthdata.org/gbd-results-tool) ### World Health Organization (WHO) Global Health Observatory (GHO) * Data: Smoking prevalence, prices, taxes and policy support * Geographical coverage: Global, across all regions and countries * Available at: Online [here](http://apps.who.int/gho/data/node.home) <AllCharts heading="Interactive charts on smoking"/>	{ "id": 1683, "date": "2013-05-23T22:34:01", "guid": { "rendered": "http://localhost/wordpress/?p=1683" }, "link": "https://owid.cloud/smoking", "meta": { "owid_publication_context_meta_field": [], "owid_key_performance_indicators_meta_field": { "raw": "7.7 million people die prematurely from smoking every year. \n\n46% are younger than 70 years old.", "rendered": "<p><strong>7.7 million</strong> people die prematurely from smoking every year.</p>\n<p>46% are younger than 70 years old.</p>\n" } }, "slug": "smoking", "tags": [], "type": "page", "title": { "rendered": "Smoking" }, "_links": { "self": [ { "href": "https://owid.cloud/wp-json/wp/v2/pages/1683" } ], "about": [ { "href": "https://owid.cloud/wp-json/wp/v2/types/page" } ], "author": [ { "href": "https://owid.cloud/wp-json/wp/v2/users/17", "embeddable": true } ], "curies": [ { "href": "https://api.w.org/{rel}", "name": "wp", "templated": true } ], "replies": [ { "href": "https://owid.cloud/wp-json/wp/v2/comments?post=1683", "embeddable": true } ], "wp:term": [ { "href": "https://owid.cloud/wp-json/wp/v2/categories?post=1683", "taxonomy": "category", "embeddable": true }, { "href": "https://owid.cloud/wp-json/wp/v2/tags?post=1683", "taxonomy": "post_tag", "embeddable": true } ], "collection": [ { "href": "https://owid.cloud/wp-json/wp/v2/pages" } ], "wp:attachment": [ { "href": "https://owid.cloud/wp-json/wp/v2/media?parent=1683" } ], "version-history": [ { "href": "https://owid.cloud/wp-json/wp/v2/pages/1683/revisions", "count": 29 } ], "wp:featuredmedia": [ { "href": "https://owid.cloud/wp-json/wp/v2/media/40470", "embeddable": true } ], "predecessor-version": [ { "id": 58098, "href": "https://owid.cloud/wp-json/wp/v2/pages/1683/revisions/58098" } ] }, "author": 17, "parent": 0, "status": "publish", "content": { "rendered": "\n<div class=\"blog-info\">This article was first published in May 2013; it was revised substantially in November 2019. The last update was done in August 2023.</div>\n\n\n\n<p>Tobacco smoking is one of the world’s largest health problems. Millions of people live in poor health because of it. Researchers estimate that every year around <em>8 million people</em> die an early death due to smoking.<br><br>It has been a major health problem for many decades. For the entire 20th century, it is estimated that around 100 million people died prematurely because of smoking, most of them in rich countries.{ref}Jha, P. (2009). <a href=\"https://www.nature.com/articles/nrc2703\">Avoidable global cancer deaths and total deaths from smoking</a>. <em>Nature Reviews Cancer</em>, <em>9</em>(9), 655.{/ref}</p>\n\n\n\n<p>The share of smokers among the world population is falling, and because smoking is such a large health problem today, this is one of the most positive developments in global health. It makes it possible for millions of people to live a longer and healthier life.</p>\n\n\n\n<p><em>For a brief overview of the most important facts, see the following article:</em></p>\n\n\n <block type=\"prominent-link\" style=\"is-style-thin\">\n <link-url>https://ourworldindata.org/smoking-big-problem-in-brief</link-url>\n <title></title>\n <content></content>\n <figure></figure>\n </block>\n\n\n<h2>Smoking is one of the leading risks for early death</h2>\n\n\n\n<h4>Smoking is responsible for about 8 million premature deaths each year</h4>\n\n\n\n<p>The two regularly updated studies on the global death toll from tobacco use \u2013 published by the World Health Organization and the Institute for Health Metrics and Evaluation \u2013 agree that around 8 million people die prematurely yearly.</p>\n\n\n\n<p>The aggregate statistics refer to \u2018tobacco use\u2019 (rather than smoking alone) because other forms of consuming tobacco, such as chewing tobacco, also lead to premature deaths. The huge majority of deaths from tobacco use, however, are due to smoking. The death toll from smoking is very close to the total sum of deaths from tobacco use (higher than 99.9% in the case of the IHME estimates).</p>\n\n\n\n<h4>World Health Organization: More than 8 million die from tobacco use every year</h4>\n\n\n\n<p>The WHO estimates that more than 8 million people die prematurely yearly from tobacco use. This is the latest available WHO estimate as of August 2023.</p>\n\n\n\n<p>More than 7 million of those deaths result from direct tobacco use. About 1.3 million are non-smokers who are dying because they are exposed to second-hand smoke.</p>\n\n\n\n<p><strong>Reference:</strong> <a href=\"https://www.who.int/news-room/fact-sheets/detail/tobacco\">WHO (2023) \u2013 Fact Sheet: Tobacco</a>, updated in July 2023</p>\n\n\n\n<h4>IHME’s Global Burden of Disease study: 8.7 million die from tobacco use every year</h4>\n\n\n\n<p>The IHME \u2013 in their annual Global Burden of Disease study \u2013 estimates that 8.7 million people die prematurely from tobacco use every year. As of August 2023, these are the latest estimates and refer to deaths in the year 2019.</p>\n\n\n\n<p>7.7 million of those deaths result from smoking while 1.3 million are non-smokers who are dying because they are exposed to second-hand smoke. (An additional 56,000 people die annually from chewing tobacco.) Most (71%) of those who die prematurely from smoking are men.</p>\n\n\n\n<p>These estimates of the annual number of deaths attributed to a wide range of risk factors are shown in the interactive chart. This visualization is, by default, showing the global total, but can be explored for any country or region using the “change country” toggle. Smoking is a risk factor for several of the world’s leading causes of death, including lung and other forms of cancer, heart disease, and respiratory diseases. The references can be found i the footnote.{ref}The estimates of the Global Burden of Disease study can be found <a href=\"http://ihmeuw.org/5i08\">here</a>. The latest study can be found at the website of The Lancet here: <a href=\"https://www.thelancet.com/gbd\">TheLancet.com/GBD</a></p>\n\n\n\n<p>There are two publications that are closely related to the Global Burden of Disease study:</p>\n\n\n\n<p>Reitsma et al. (2021) \u2013 <a href=\"https://doi.org/10.1016/S0140-6736(21)01169-7\">Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990\u20132019: A systematic analysis from the Global Burden of Disease Study 2019</a>. In <em>The Lancet</em>, 397(10292), 2337\u20132360.</p>\n\n\n\n<p>The GBD estimates are also presented in yet another prominent publication. The <a href=\"https://tobaccoatlas.org/\"><strong>Tobacco Atlas</strong></a> is published by the American Cancer Society and Vital Strategies and presents estimates for the global death toll from smoking <a href=\"https://tobaccoatlas.org/data-sources/\">taken from</a> the Global Burden of Disease Study published by the Institute for Health Metrics and Evaluation (IHME).{/ref}</p>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/number-of-deaths-by-risk-factor\"></iframe></figure>\n\n\n\n<h4>Smoking led to about 100 million premature deaths in the 20th century</h4>\n\n\n\n<p>Tobacco smoking has been one of the world’s largest health problems for decades. Over the course of the 20th century, it killed around 100 million people, most of them in today’s rich countries.{ref}Jha, P. (2009). <a href=\"https://www.nature.com/articles/nrc2703\">Avoidable global cancer deaths and total deaths from smoking</a>. <em>Nature Reviews Cancer</em>, <em>9</em>(9), 655.{/ref} The health burdens of smoking are now moving from high-income to low-to-middle-income countries; some estimates have suggested that one billion people could die from tobacco over the 21st century.{ref}Mathers, C. D., & Loncar, D. (2006). Projections of global mortality and burden of disease from 2002 to 2030. <em>PLoS medicine</em>, <em>3</em>(11), e442.{/ref}<sup>,</sup>{ref}Jha, P., & Peto, R. (2014). <a href=\"https://www.nejm.org/doi/10.1056/NEJMra1308383\">Global effects of smoking, of quitting, and of taxing tobacco</a>. <em>New England Journal of Medicine</em>, <em>370</em>(1), 60-68.{/ref}</p>\n\n\n\n<h2>The global distribution of smoking deaths</h2>\n\n\n\n<h4>In many countries, a high share of deaths is attributed to smoking</h4>\n\n\n\n<p>In the map, we see the share of deaths attributed to direct smoking across the world. In many countries, this share is substantial.</p>\n\n\n\n<p><strong>Related chart \u2013 the share of deaths from </strong><em><strong>secondhand smoking</strong></em><strong>.</strong> <a href=\"https://ourworldindata.org/grapher/share-deaths-secondhand-smoke\">This map</a> shows the share of premature deaths attributed from secondhand smoke across the world.</p>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/share-deaths-smoking\"></iframe></figure>\n\n\n\n<h4>Death rates from smoking are highest across Asia and Eastern Europe</h4>\n\n\n\n<p>In the interactive map, we show death rates from tobacco smoking across the world. Death rates measure the number of premature deaths from smoking per 100,000 people in a given country or region. <br><br>We see large differences in death rates across the world. Rates tend to be highest across Asia and Eastern Europe, where figures are often over 100, and in some cases, over 150 deaths per 100,000 people. <br><br>Death rates are much lower across some of the lowest-income countries in the world, where very few people smoke.</p>\n\n\n\n<p><strong>Related chart \u2013 <em>number</em> of deaths from smoking.</strong> <a href=\"https://ourworldindata.org/grapher/number-of-deaths-from-tobacco-smoking\">This map</a> shows the annual number of deaths from tobacco smoking across the world.</p>\n\n\n\n<iframe src=\"https://ourworldindata.org/grapher/death-rate-smoking?tab=map\" style=\"width: 100%; height: 600px; border: 0px none;\"></iframe>\n\n\n\n<h4>Most deaths from smoking occur in older populations</h4>\n\n\n\n<p>When we look at the breakdown of deaths from smoking by age, we see that it is mainly older populations that are affected. <br><br>In the visualizations, we show the death rates from smoking by age bracket and the share of annual deaths that occur in each age group.<br><br>Here, we see that death rates from smoking are much higher in people older than 70 years old, followed by those aged 50 to 69.<br></p>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/death-rates-smoking-age\"></iframe></figure>\n\n\n\n<iframe src=\"https://ourworldindata.org/grapher/smoking-deaths-by-age?stackMode=relative\" style=\"width: 100%; height: 600px; border: 0px none;\"></iframe>\n\n\n\n<h2>How have smoking deaths changed over time?</h2>\n\n\n\n<h4>Death rates from smoking have declined in most countries</h4>\n\n\n\n<p>Globally, smoking-related death rates <a href=\"https://ourworldindata.org/grapher/death-rate-smoking?tab=chart&country=OWID_WRL\">have fallen</a>.<br><br>But there are differences across countries. Where in the world are death rates falling or rising?<br><br>In the scatterplot, we see the comparison of smoking death rates in 1990 (shown on the y-axis) versus the death rate in the latest data (on the x-axis). The grey line is the line of parity: countries that lie along this line had equal death rates at both points in time. Countries that lie <em>above</em> the grey line had higher death rates in 1990; for those that lie <em>below</em> the grey line, the opposite is true.<br><br>We see that almost all countries in the world lie above the grey line. This means that most countries have achieved a <em>decline</em> in death rates from smoking in recent decades.</p>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/smoking-death-rate-1990-2017\"></iframe></figure>\n\n\n\n<h2>Prevalence of smoking across the world</h2>\n\n\n\n<h3>Share who smoke</h3>\n\n\n\n<h4>In which countries do people smoke the most?</h4>\n\n\n\n<div class=\"wp-block-columns\">\n<div class=\"wp-block-column\">\n<p>Around one-in-four adults in the world smoke tobacco.</p>\n\n\n\n<p>But where in the world is smoking most common?</p>\n\n\n\n<p>In the map, we see the share of adults aged 15 years and older, who smoke tobacco. </p>\n\n\n\n<p>There are a number of countries where more than a third of the population smokes. The places where many people smoke are clustered in regions. South-East Asia, the Pacific islands, and parts of Europe.</p>\n\n\n\n<p>In some countries, very few people smoke.</p>\n\n\n\n<p>Several factors influence the prevalence of smoking. One is prosperity: if we look at <a href=\"https://ourworldindata.org/grapher/share-of-adults-who-are-smoking-by-level-of-prosperity\">the relationship</a> between smoking prevalence and income, we find that richer countries tend to smoke more. But as you see in this correlation, there are very large differences at each level of income.</p>\n\n\n\n<p>Smoking rates are high across many countries, but we know from the history of many countries that this can change quickly. Many of today\u2019s high-income countries had much higher smoking rates in the past and have seen a large reduction.</p>\n</div>\n\n\n\n<div class=\"wp-block-column\">\n<iframe style=\"width: 100%; height: 600px; border: 0px none;\" src=\"https://ourworldindata.org/grapher/share-of-adults-who-smoke?tab=map&country=USA~BRA~RUS~IND~CHN~European+Union~IDN~OWID_WRL\"></iframe>\n</div>\n</div>\n\n\n\n<h3>Daily smokers</h3>\n\n\n\n<p>This visualization shows the share of adults, aged 15 years and older, who smoke every day.</p>\n\n\n\n<p>We see that daily smoking is most common across Europe and Asia \u2013 more than 20% of adults in most countries in these regions smoke every day.</p>\n\n\n\n<p><strong>Related chart \u2013 </strong><em><strong>number</strong></em><strong> of daily smokers</strong>. <a href=\"https://ourworldindata.org/grapher/number-of-total-daily-smokers?time=1980..2012\">This map</a> shows the number of people who smoke every day across the world.</p>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/daily-smoking-prevalence-bounds\"></iframe></figure>\n\n\n\n<h3>Smoking by gender</h3>\n\n\n\n<h4>Who smokes more, men or women?</h4>\n\n\n\n<p>Nearly one-in-four adults in the world <a href=\"https://ourworldindata.org/which-countries-smoke-most\">smokes tobacco</a>. But there are large differences between men and women.</p>\n\n\n\n<p>As the chart shows, more than one-third of men in the world smoke, while the same is true for less than one-in-ten women.</p>\n\n\n\n<p>In almost all countries, it is true that a large share of men smoke. In the visualization, we see the share of men who smoke (plotted on the vertical axis) compared with the same metric for women (plotted on the horizontal axis).</p>\n\n\n\n<p>The grey line in the plot represents equality in the prevalence: countries where smoking is more common in men will lie above this line, and countries where more women smoke lie below.</p>\n\n\n\n<p>We see that almost all countries lie above the grey line, meaning a higher share of men smoke. There are only a few exceptions.</p>\n\n\n\n<p>In many countries \u2014 particularly across Asia and Africa \u2014 the differences are very large. </p>\n\n\n\n<p>We also see this when we look at a <a href=\"https://ourworldindata.org/grapher/share-of-women-who-are-smoking?tab=map\">global map of smoking among women</a>: across much of Africa and Asia, rates are very low. For comparison, here is the world <a href=\"https://ourworldindata.org/grapher/share-of-men-who-are-smoking?time=latest\">map of smoking rates in men</a>.</p>\n\n\n\n<p>The fact that men are more likely than women to smoke is reflected in health statistics, particularly lung cancer, for which smoking is a <a href=\"https://ourworldindata.org/smoking#share-of-cancer-deaths-attributed-to-smoking\">primary risk factor</a>. We see that in nearly every country in the world, men are <a href=\"https://ourworldindata.org/grapher/lung-cancer-deaths-men-women\">more likely to die</a> from lung cancer.</p>\n\n\n\n<iframe style=\"width: 100%; height: 600px; border: 0px none;\" src=\"https://ourworldindata.org/grapher/comparing-the-share-of-men-and-women-who-are-smoking\"></iframe>\n\n\n\n<h2>How has the prevalence of smoking changed over time?</h2>\n\n\n\n<h3>The rise and fall of smoking in today’s rich countries</h3>\n\n\n\n<p>The smoking of cigarettes first saw a significant rise across today’s rich countries in the early 20th century. Since then, trends in smoking have undergone a century-long cycle of peak and decline.<br><br>In the visualization, we see the average number of cigarettes sold per adult per day across many of today’s rich countries, including the United States and European countries.<br><br>Here, we see that all countries followed a very similar trajectory: a steep rise in cigarette consumption during the early-to-mid 1900s; peaking from the mid-to-latter half of the century, before entering into a steep decline in the decades which followed. <br><br>Notably, this rise-peak-fall pathway took around a century in all cases. This long trajectory has had major health impacts for the populations of rich countries today. </p>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/sales-of-cigarettes-per-adult-per-day\"></iframe></figure>\n\n\n\n<h3>Smoking rates are now falling in almost all countries</h3>\n\n\n\n<p>The rise, peak, and decline of smoking in rich countries took around a century. The high peak had severe health impacts.<br><br>This timescale is important when we consider low-to-middle-income countries today: if they are to avoid the scale of the health consequences seen by rich countries, they must move through this pathway much quicker. The positive news is that most have \u2013 smoking is already falling in most countries today.<br><br>In this visualization, we see the share of adults who smoked in the year 2000 (on the y-axis) and in the most recent data (on the x-axis). The grey line here shows parity: countries that lie along this line would have the same smoking prevalence at both points in time. Countries that lie <em>above</em> this line had higher smoking prevalence back in 2000; for those <em>below</em> the opposite is true.<br><br>We see that most countries lie above the grey line: this means the share of adults who smoke has declined in most countries in the world over the past decade. This is a surprising fact to many, since it means smoking prevalence is not only falling in high-income countries but also in most low-to-middle incomes.{ref}Bilano, V., Gilmour, S., Moffiet, T., d’Espaignet, E. T., Stevens, G. A., Commar, A., … & Shibuya, K. (2015). <a href=\"https://www.sciencedirect.com/science/article/pii/S0140673615602641\">Global trends and projections for tobacco use, 1990\u20132025: an analysis of smoking indicators from the WHO Comprehensive Information Systems for Tobacco Control</a>. <em>The Lancet</em>, <em>385</em>(9972), 966-976.{/ref}</p>\n\n\n\n<p>Low-to-middle income countries have effectively ‘leapfrogged’ the century-long rise-peak-decline pathway of rich countries. Almost everywhere, smoking is on the decline.</p>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/adults-smoking-2000-2016\"></iframe></figure>\n\n\n\n<h2>Smoking and cancer</h2>\n\n\n\n<h4>The rise and fall of lung cancer</h4>\n\n\n\n<p>This chart shows death rates from lung cancer in the US since 1950. It is possible to view the data for other countries by using the tools in the chart.</p>\n\n\n\n<p>We see the same rise, peak, and decline pattern that we have seen in the cigarette consumption statistics.</p>\n\n\n\n<p>These trends are largely driven by the trends in <a href=\"https://owid.cloud/smoking\">smoking</a>. Smoking is the biggest risk factor for lung cancer and we see that the trends in lung cancer follow those in smoking with a lag.</p>\n\n\n\n<iframe style=\"width: 100%; height: 600px; border: 0px none;\" src=\"https://ourworldindata.org/grapher/lung-cancer-deaths-per-100000-by-sex-1950-2002\"></iframe>\n\n\n\n<h4>Share of cancer deaths attributed to smoking</h4>\n\n\n\n<p>The world map shows the Global Burden of Disease estimates of the share of cancer deaths that can be attributed to smoking.</p>\n\n\n\n<p>Globally, <a href=\"https://ourworldindata.org/grapher/share-of-cancer-deaths-attributed-to-tobacco?tab=chart&country=~OWID_WRL\">about a quarter</a> of cancer deaths are attributed to smoking.</p>\n\n\n\n<p>In most richer countries, the share is even higher.</p>\n\n\n\n<p>In poor countries, where fewer people were smoking in the past, tobacco is responsible for a smaller fraction of cancer deaths.</p>\n\n\n\n<iframe src=\"https://ourworldindata.org/grapher/share-of-cancer-deaths-attributed-to-tobacco\" style=\"width: 100%; height: 600px; border: 0px none;\"></iframe>\n\n\n\n<h2>What can we do to reduce smoking?</h2>\n\n\n\n<h3>Pricing and taxes</h3>\n\n\n\n<h4>Affordability of cigarettes</h4>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/affordability-cigarettes\"></iframe></figure>\n\n\n\n<h4>Taxes on cigarettes</h4>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/share-of-tobacco-retail-price-that-is-tax\"></iframe></figure>\n\n\n\n<h3>Bans on tobacco advertising</h3>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/enforcement-of-bans-on-tobacco-advertising\"></iframe></figure>\n\n\n\n<h3>Support to quit smoking</h3>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/support-to-help-to-quit-tobacco-use\"></iframe></figure>\n\n\n\n<h2>Data Sources</h2>\n\n\n\n<h4>International Mortality and Smoking Statistics (IMASS)</h4>\n\n\n\n<ul><li><strong>Data:</strong> Consumption of tobacco products, prevalence of smoking and mortality</li><li><strong>Geographical coverage:</strong> 30 countries</li><li><strong>Time span:</strong> Often spanning back 100 years</li><li><strong>Available at: </strong>Online <a href=\"http://www.pnlee.co.uk/imass.htm\">here</a></li></ul>\n\n\n\n<h4>Institute of Health Metrics and Evaluation (IHME), Global Burden of Disease (GBD)</h4>\n\n\n\n<ul><li><strong>Data:</strong> Death rates and absolute number of premature deaths from smoking and secondhand-smoke</li><li><strong>Geographical coverage:</strong> Global, across all regions and countries</li><li><strong>Time span:</strong> 1990 onwards</li><li><strong>Available at: </strong>Online <a href=\"http://ghdx.healthdata.org/gbd-results-tool\">here</a></li></ul>\n\n\n\n<h4>World Health Organization (WHO) Global Health Observatory (GHO)</h4>\n\n\n\n<ul><li><strong>Data:</strong> Smoking prevalence, prices, taxes and policy support</li><li><strong>Geographical coverage:</strong> Global, across all regions and countries</li><li><strong>Available at: </strong>Online <a href=\"http://apps.who.int/gho/data/node.home\">here</a></li></ul>\n", "protected": false }, "excerpt": { "rendered": "Tobacco smoking is one of the world\u2019s largest health problems today.", "protected": false }, "date_gmt": "2013-05-23T22:34:01", "modified": "2023-08-30T15:35:02", "template": "", "categories": [ 44, 46, 170 ], "menu_order": 276, "ping_status": "closed", "authors_name": [ "Hannah Ritchie", "Max Roser" ], "modified_gmt": "2023-08-30T14:35:02", "comment_status": "open", "featured_media": 40470, "featured_media_paths": { "thumbnail": "/app/uploads/2021/02/Screen-Shot-2021-02-09-at-12.49.32-150x81.png", "medium_large": "/app/uploads/2021/02/Screen-Shot-2021-02-09-at-12.49.32-768x415.png" } }

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<div class="blog-info">This article was first published in May 2013; it was revised substantially in November 2019. The last update was done in August 2023.</div>   <p>Tobacco smoking is one of the world's largest health problems. Millions of people live in poor health because of it. Researchers estimate that every year around <em>8 million people</em> die an early death due to smoking.<br><br>It has been a major health problem for many decades. For the entire 20th century, it is estimated that around 100 million people died prematurely because of smoking, most of them in rich countries.{ref}Jha, P. (2009). <a href="https://www.nature.com/articles/nrc2703">Avoidable global cancer deaths and total deaths from smoking</a>. <em>Nature Reviews Cancer</em>, <em>9</em>(9), 655.{/ref}</p>   <p>The share of smokers among the world population is falling, and because smoking is such a large health problem today, this is one of the most positive developments in global health. It makes it possible for millions of people to live a longer and healthier life.</p>   <p><em>For a brief overview of the most important facts, see the following article:</em></p>    <h2>Smoking is one of the leading risks for early death</h2>   <h4>Smoking is responsible for about 8 million premature deaths each year</h4>   <p>The two regularly updated studies on the global death toll from tobacco use – published by the World Health Organization and the Institute for Health Metrics and Evaluation – agree that around 8 million people die prematurely yearly.</p>   <p>The aggregate statistics refer to ‘tobacco use’ (rather than smoking alone) because other forms of consuming tobacco, such as chewing tobacco, also lead to premature deaths. The huge majority of deaths from tobacco use, however, are due to smoking. The death toll from smoking is very close to the total sum of deaths from tobacco use (higher than 99.9% in the case of the IHME estimates).</p>   <h4>World Health Organization: More than 8 million die from tobacco use every year</h4>   <p>The WHO estimates that more than 8 million people die prematurely yearly from tobacco use. This is the latest available WHO estimate as of August 2023.</p>   <p>More than 7 million of those deaths result from direct tobacco use. About 1.3 million are non-smokers who are dying because they are exposed to second-hand smoke.</p>   <p><strong>Reference:</strong> <a href="https://www.who.int/news-room/fact-sheets/detail/tobacco">WHO (2023) – Fact Sheet: Tobacco</a>, updated in July 2023</p>   <h4>IHME's Global Burden of Disease study: 8.7 million die from tobacco use every year</h4>   <p>The IHME – in their annual Global Burden of Disease study – estimates that 8.7 million people die prematurely from tobacco use every year. As of August 2023, these are the latest estimates and refer to deaths in the year 2019.</p>   <p>7.7 million of those deaths result from smoking while 1.3 million are non-smokers who are dying because they are exposed to second-hand smoke. (An additional 56,000 people die annually from chewing tobacco.) Most (71%) of those who die prematurely from smoking are men.</p>   <p>These estimates of the annual number of deaths attributed to a wide range of risk factors are shown in the interactive chart. This visualization is, by default, showing the global total, but can be explored for any country or region using the "change country" toggle. Smoking is a risk factor for several of the world's leading causes of death, including lung and other forms of cancer, heart disease, and respiratory diseases. The references can be found i the footnote.{ref}The estimates of the Global Burden of Disease study can be found <a href="http://ihmeuw.org/5i08">here</a>. The latest study can be found at the website of The Lancet here: <a href="https://www.thelancet.com/gbd">TheLancet.com/GBD</a></p>   <p>There are two publications that are closely related to the Global Burden of Disease study:</p>   <p>Reitsma et al. (2021) – <a href="https://doi.org/10.1016/S0140-6736(21)01169-7">Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990–2019: A systematic analysis from the Global Burden of Disease Study 2019</a>. In <em>The Lancet</em>, 397(10292), 2337–2360.</p>   <p>The GBD estimates are also presented in yet another prominent publication. The <a href="https://tobaccoatlas.org/"><strong>Tobacco Atlas</strong></a> is published by the American Cancer Society and Vital Strategies and presents estimates for the global death toll from smoking <a href="https://tobaccoatlas.org/data-sources/">taken from</a> the Global Burden of Disease Study published by the Institute for Health Metrics and Evaluation (IHME).{/ref}</p>   <figure><iframe src="https://ourworldindata.org/grapher/number-of-deaths-by-risk-factor"></iframe></figure>   <h4>Smoking led to about 100 million premature deaths in the 20th century</h4>   <p>Tobacco smoking has been one of the world's largest health problems for decades. Over the course of the 20th century, it killed around 100 million people, most of them in today's rich countries.{ref}Jha, P. (2009). <a href="https://www.nature.com/articles/nrc2703">Avoidable global cancer deaths and total deaths from smoking</a>. <em>Nature Reviews Cancer</em>, <em>9</em>(9), 655.{/ref} The health burdens of smoking are now moving from high-income to low-to-middle-income countries; some estimates have suggested that one billion people could die from tobacco over the 21st century.{ref}Mathers, C. D., & Loncar, D. (2006). Projections of global mortality and burden of disease from 2002 to 2030. <em>PLoS medicine</em>, <em>3</em>(11), e442.{/ref}<sup>,</sup>{ref}Jha, P., & Peto, R. (2014). <a href="https://www.nejm.org/doi/10.1056/NEJMra1308383">Global effects of smoking, of quitting, and of taxing tobacco</a>. <em>New England Journal of Medicine</em>, <em>370</em>(1), 60-68.{/ref}</p>   <h2>The global distribution of smoking deaths</h2>   <h4>In many countries, a high share of deaths is attributed to smoking</h4>   <p>In the map, we see the share of deaths attributed to direct smoking across the world. In many countries, this share is substantial.</p>   <p><strong>Related chart – the share of deaths from </strong><em><strong>secondhand smoking</strong></em><strong>.</strong> <a href="https://ourworldindata.org/grapher/share-deaths-secondhand-smoke">This map</a> shows the share of premature deaths attributed from secondhand smoke across the world.</p>   <figure><iframe src="https://ourworldindata.org/grapher/share-deaths-smoking"></iframe></figure>   <h4>Death rates from smoking are highest across Asia and Eastern Europe</h4>   <p>In the interactive map, we show death rates from tobacco smoking across the world. Death rates measure the number of premature deaths from smoking per 100,000 people in a given country or region. <br><br>We see large differences in death rates across the world. Rates tend to be highest across Asia and Eastern Europe, where figures are often over 100, and in some cases, over 150 deaths per 100,000 people. <br><br>Death rates are much lower across some of the lowest-income countries in the world, where very few people smoke.</p>   <p><strong>Related chart – <em>number</em> of deaths from smoking.</strong> <a href="https://ourworldindata.org/grapher/number-of-deaths-from-tobacco-smoking">This map</a> shows the annual number of deaths from tobacco smoking across the world.</p>   <iframe src="https://ourworldindata.org/grapher/death-rate-smoking?tab=map" style="width: 100%; height: 600px; border: 0px none;"></iframe>   <h4>Most deaths from smoking occur in older populations</h4>   <p>When we look at the breakdown of deaths from smoking by age, we see that it is mainly older populations that are affected. <br><br>In the visualizations, we show the death rates from smoking by age bracket and the share of annual deaths that occur in each age group.<br><br>Here, we see that death rates from smoking are much higher in people older than 70 years old, followed by those aged 50 to 69.<br></p>   <figure><iframe src="https://ourworldindata.org/grapher/death-rates-smoking-age"></iframe></figure>   <iframe src="https://ourworldindata.org/grapher/smoking-deaths-by-age?stackMode=relative" style="width: 100%; height: 600px; border: 0px none;"></iframe>   <h2>How have smoking deaths changed over time?</h2>   <h4>Death rates from smoking have declined in most countries</h4>   <p>Globally, smoking-related death rates <a href="https://ourworldindata.org/grapher/death-rate-smoking?tab=chart&country=OWID_WRL">have fallen</a>.<br><br>But there are differences across countries. Where in the world are death rates falling or rising?<br><br>In the scatterplot, we see the comparison of smoking death rates in 1990 (shown on the y-axis) versus the death rate in the latest data (on the x-axis). The grey line is the line of parity: countries that lie along this line had equal death rates at both points in time. Countries that lie <em>above</em> the grey line had higher death rates in 1990; for those that lie <em>below</em> the grey line, the opposite is true.<br><br>We see that almost all countries in the world lie above the grey line. This means that most countries have achieved a <em>decline</em> in death rates from smoking in recent decades.</p>   <figure><iframe src="https://ourworldindata.org/grapher/smoking-death-rate-1990-2017"></iframe></figure>   <h2>Prevalence of smoking across the world</h2>   <h3>Share who smoke</h3>   <h4>In which countries do people smoke the most?</h4>    <div class="wp-block-columns"> <div class="wp-block-column"> <p>Around one-in-four adults in the world smoke tobacco.</p>   <p>But where in the world is smoking most common?</p>   <p>In the map, we see the share of adults aged 15 years and older, who smoke tobacco. </p>   <p>There are a number of countries where more than a third of the population smokes. The places where many people smoke are clustered in regions. South-East Asia, the Pacific islands, and parts of Europe.</p>   <p>In some countries, very few people smoke.</p>   <p>Several factors influence the prevalence of smoking. One is prosperity: if we look at <a href="https://ourworldindata.org/grapher/share-of-adults-who-are-smoking-by-level-of-prosperity">the relationship</a> between smoking prevalence and income, we find that richer countries tend to smoke more. But as you see in this correlation, there are very large differences at each level of income.</p>   <p>Smoking rates are high across many countries, but we know from the history of many countries that this can change quickly. Many of today’s high-income countries had much higher smoking rates in the past and have seen a large reduction.</p> </div>   <div class="wp-block-column"> <iframe style="width: 100%; height: 600px; border: 0px none;" src="https://ourworldindata.org/grapher/share-of-adults-who-smoke?tab=map&country=USA~BRA~RUS~IND~CHN~European+Union~IDN~OWID_WRL"></iframe> </div> </div>   <h3>Daily smokers</h3>   <p>This visualization shows the share of adults, aged 15 years and older, who smoke every day.</p>   <p>We see that daily smoking is most common across Europe and Asia – more than 20% of adults in most countries in these regions smoke every day.</p>   <p><strong>Related chart – </strong><em><strong>number</strong></em><strong> of daily smokers</strong>. <a href="https://ourworldindata.org/grapher/number-of-total-daily-smokers?time=1980..2012">This map</a> shows the number of people who smoke every day across the world.</p>   <figure><iframe src="https://ourworldindata.org/grapher/daily-smoking-prevalence-bounds"></iframe></figure>   <h3>Smoking by gender</h3>   <h4>Who smokes more, men or women?</h4>    <p>Nearly one-in-four adults in the world <a href="https://ourworldindata.org/which-countries-smoke-most">smokes tobacco</a>. But there are large differences between men and women.</p>   <p>As the chart shows, more than one-third of men in the world smoke, while the same is true for less than one-in-ten women.</p>   <p>In almost all countries, it is true that a large share of men smoke. In the visualization, we see the share of men who smoke (plotted on the vertical axis) compared with the same metric for women (plotted on the horizontal axis).</p>   <p>The grey line in the plot represents equality in the prevalence: countries where smoking is more common in men will lie above this line, and countries where more women smoke lie below.</p>   <p>We see that almost all countries lie above the grey line, meaning a higher share of men smoke. There are only a few exceptions.</p>   <p>In many countries — particularly across Asia and Africa — the differences are very large. </p>   <p>We also see this when we look at a <a href="https://ourworldindata.org/grapher/share-of-women-who-are-smoking?tab=map">global map of smoking among women</a>: across much of Africa and Asia, rates are very low. For comparison, here is the world <a href="https://ourworldindata.org/grapher/share-of-men-who-are-smoking?time=latest">map of smoking rates in men</a>.</p>   <p>The fact that men are more likely than women to smoke is reflected in health statistics, particularly lung cancer, for which smoking is a <a href="https://ourworldindata.org/smoking#share-of-cancer-deaths-attributed-to-smoking">primary risk factor</a>. We see that in nearly every country in the world, men are <a href="https://ourworldindata.org/grapher/lung-cancer-deaths-men-women">more likely to die</a> from lung cancer.</p>   <iframe style="width: 100%; height: 600px; border: 0px none;" src="https://ourworldindata.org/grapher/comparing-the-share-of-men-and-women-who-are-smoking"></iframe>   <h2>How has the prevalence of smoking changed over time?</h2>   <h3>The rise and fall of smoking in today's rich countries</h3>   <p>The smoking of cigarettes first saw a significant rise across today's rich countries in the early 20th century. Since then, trends in smoking have undergone a century-long cycle of peak and decline.<br><br>In the visualization, we see the average number of cigarettes sold per adult per day across many of today's rich countries, including the United States and European countries.<br><br>Here, we see that all countries followed a very similar trajectory: a steep rise in cigarette consumption during the early-to-mid 1900s; peaking from the mid-to-latter half of the century, before entering into a steep decline in the decades which followed. <br><br>Notably, this rise-peak-fall pathway took around a century in all cases. This long trajectory has had major health impacts for the populations of rich countries today. </p>   <figure><iframe src="https://ourworldindata.org/grapher/sales-of-cigarettes-per-adult-per-day"></iframe></figure>   <h3>Smoking rates are now falling in almost all countries</h3>   <p>The rise, peak, and decline of smoking in rich countries took around a century. The high peak had severe health impacts.<br><br>This timescale is important when we consider low-to-middle-income countries today: if they are to avoid the scale of the health consequences seen by rich countries, they must move through this pathway much quicker. The positive news is that most have – smoking is already falling in most countries today.<br><br>In this visualization, we see the share of adults who smoked in the year 2000 (on the y-axis) and in the most recent data (on the x-axis). The grey line here shows parity: countries that lie along this line would have the same smoking prevalence at both points in time. Countries that lie <em>above</em> this line had higher smoking prevalence back in 2000; for those <em>below</em> the opposite is true.<br><br>We see that most countries lie above the grey line: this means the share of adults who smoke has declined in most countries in the world over the past decade. This is a surprising fact to many, since it means smoking prevalence is not only falling in high-income countries but also in most low-to-middle incomes.{ref}Bilano, V., Gilmour, S., Moffiet, T., d'Espaignet, E. T., Stevens, G. A., Commar, A., ... & Shibuya, K. (2015). <a href="https://www.sciencedirect.com/science/article/pii/S0140673615602641">Global trends and projections for tobacco use, 1990–2025: an analysis of smoking indicators from the WHO Comprehensive Information Systems for Tobacco Control</a>. <em>The Lancet</em>, <em>385</em>(9972), 966-976.{/ref}</p>   <p>Low-to-middle income countries have effectively 'leapfrogged' the century-long rise-peak-decline pathway of rich countries. Almost everywhere, smoking is on the decline.</p>   <figure><iframe src="https://ourworldindata.org/grapher/adults-smoking-2000-2016"></iframe></figure>   <h2>Smoking and cancer</h2>    <h4>The rise and fall of lung cancer</h4>   <p>This chart shows death rates from lung cancer in the US since 1950. It is possible to view the data for other countries by using the tools in the chart.</p>   <p>We see the same rise, peak, and decline pattern that we have seen in the cigarette consumption statistics.</p>   <p>These trends are largely driven by the trends in <a href="https://owid.cloud/smoking">smoking</a>. Smoking is the biggest risk factor for lung cancer and we see that the trends in lung cancer follow those in smoking with a lag.</p>   <iframe style="width: 100%; height: 600px; border: 0px none;" src="https://ourworldindata.org/grapher/lung-cancer-deaths-per-100000-by-sex-1950-2002"></iframe>   <h4>Share of cancer deaths attributed to smoking</h4>   <p>The world map shows the Global Burden of Disease estimates of the share of cancer deaths that can be attributed to smoking.</p>   <p>Globally, <a href="https://ourworldindata.org/grapher/share-of-cancer-deaths-attributed-to-tobacco?tab=chart&country=~OWID_WRL">about a quarter</a> of cancer deaths are attributed to smoking.</p>   <p>In most richer countries, the share is even higher.</p>   <p>In poor countries, where fewer people were smoking in the past, tobacco is responsible for a smaller fraction of cancer deaths.</p>   <iframe src="https://ourworldindata.org/grapher/share-of-cancer-deaths-attributed-to-tobacco" style="width: 100%; height: 600px; border: 0px none;"></iframe>   <h2>What can we do to reduce smoking?</h2>   <h3>Pricing and taxes</h3>   <h4>Affordability of cigarettes</h4>   <figure><iframe src="https://ourworldindata.org/grapher/affordability-cigarettes"></iframe></figure>   <h4>Taxes on cigarettes</h4>   <figure><iframe src="https://ourworldindata.org/grapher/share-of-tobacco-retail-price-that-is-tax"></iframe></figure>   <h3>Bans on tobacco advertising</h3>   <figure><iframe src="https://ourworldindata.org/grapher/enforcement-of-bans-on-tobacco-advertising"></iframe></figure>   <h3>Support to quit smoking</h3>   <figure><iframe src="https://ourworldindata.org/grapher/support-to-help-to-quit-tobacco-use"></iframe></figure>   <h2>Data Sources</h2>   <h4>International Mortality and Smoking Statistics (IMASS)</h4>   <ul><li><strong>Data:</strong> Consumption of tobacco products, prevalence of smoking and mortality</li><li><strong>Geographical coverage:</strong> 30 countries</li><li><strong>Time span:</strong> Often spanning back 100 years</li><li><strong>Available at: </strong>Online <a href="http://www.pnlee.co.uk/imass.htm">here</a></li></ul>   <h4>Institute of Health Metrics and Evaluation (IHME), Global Burden of Disease (GBD)</h4>   <ul><li><strong>Data:</strong> Death rates and absolute number of premature deaths from smoking and secondhand-smoke</li><li><strong>Geographical coverage:</strong> Global, across all regions and countries</li><li><strong>Time span:</strong> 1990 onwards</li><li><strong>Available at: </strong>Online <a href="http://ghdx.healthdata.org/gbd-results-tool">here</a></li></ul>   <h4>World Health Organization (WHO) Global Health Observatory (GHO)</h4>   <ul><li><strong>Data:</strong> Smoking prevalence, prices, taxes and policy support</li><li><strong>Geographical coverage:</strong> Global, across all regions and countries</li><li><strong>Available at: </strong>Online <a href="http://apps.who.int/gho/data/node.home">here</a></li></ul>

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                        "text": "This article was first published in May 2013; it was revised substantially in November 2019. The last update was done in August 2023.",
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                        "text": "Tobacco smoking is one of the world's largest health problems. Millions of people live in poor health because of it. Researchers estimate that every year around ",
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                                "text": "8 million people",
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                        "text": " die an early death due to smoking.",
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                        "text": "It has been a major health problem for many decades. For the entire 20th century, it is estimated that around 100 million people died prematurely because of smoking, most of them in rich countries.{ref}Jha, P. (2009). ",
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                        "url": "https://www.nature.com/articles/nrc2703",
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                                "text": "Avoidable global cancer deaths and total deaths from smoking",
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                        "text": ".\u00a0",
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                                "text": "Nature Reviews Cancer",
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                        "text": ",\u00a0",
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                                "text": "9",
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                        "text": "(9), 655.{/ref}",
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                        "text": "The share of smokers among the world population is falling, and because smoking is such a large health problem today, this is one of the most positive developments in global health. It makes it possible for millions of people to live a longer and healthier life.",
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                        "children": [
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                                "text": "For a brief overview of the most important facts, see the following article:",
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                "url": "https://ourworldindata.org/smoking-big-problem-in-brief",
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                                "url": "#all-charts",
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                                        "text": "See all interactive charts on smoking \u2193",
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                "text": [
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                        "text": "Smoking is one of the leading risks for early death",
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                "text": [
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                        "text": "Smoking is responsible for about 8 million premature deaths each year",
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                        "text": "The two regularly updated studies on the global death toll from tobacco use \u2013 published by the World Health Organization and the Institute for Health Metrics and Evaluation \u2013 agree that around 8 million people die prematurely yearly.",
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                        "text": "The aggregate statistics refer to \u2018tobacco use\u2019 (rather than smoking alone) because other forms of consuming tobacco, such as chewing tobacco, also lead to premature deaths. The huge majority of deaths from tobacco use, however, are due to smoking. The death toll from smoking is very close to the total sum of deaths from tobacco use (higher than 99.9% in the case of the IHME estimates).",
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                "text": [
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                        "text": "World Health Organization: More than 8 million die from tobacco use every year",
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                        "text": "The WHO estimates that more than 8 million people die prematurely yearly from tobacco use. This is the latest available WHO estimate as of August 2023.",
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                        "text": "More than 7 million of those deaths result from direct tobacco use. About 1.3 million are non-smokers who are dying because they are exposed to second-hand smoke.",
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                                "text": "Reference:",
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                        "url": "https://www.who.int/news-room/fact-sheets/detail/tobacco",
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                                "text": "WHO (2023) \u2013\u00a0Fact Sheet: Tobacco",
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                        "text": ", updated in July 2023",
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                "text": [
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                        "text": "IHME's Global Burden of Disease study: 8.7 million die from tobacco use every year",
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                        "text": "The IHME \u2013 in their annual Global Burden of Disease study \u2013 estimates that 8.7 million people die prematurely from tobacco use every year. As of August 2023, these are the latest estimates and refer to deaths in the year 2019.",
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                        "text": "7.7 million of those deaths result from smoking while 1.3 million are non-smokers who are dying because they are exposed to second-hand smoke. (An additional 56,000 people die annually from chewing tobacco.) Most (71%) of those who die prematurely from smoking are men.",
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                        "text": "These estimates of the annual number of deaths attributed to a wide range of risk factors are shown in the interactive chart. This visualization is, by default, showing the global total, but can be explored for any country or region using the \"change country\" toggle. Smoking is a risk factor for several of the world's leading causes of death, including lung and other forms of cancer, heart disease, and respiratory diseases. The references can be found i the footnote.{ref}The estimates of the Global Burden of Disease study can be found ",
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                        "url": "http://ihmeuw.org/5i08",
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                                "text": "here",
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                        "text": ". The latest study can be found at the website of The Lancet here: ",
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                        "url": "https://www.thelancet.com/gbd",
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                                "text": "TheLancet.com/GBD",
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                        "text": "There are two publications that are closely related to the Global Burden of Disease study:",
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                        "text": "Reitsma et al. (2021) \u2013 ",
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                                "text": "Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990\u20132019: A systematic analysis from the Global Burden of Disease Study 2019",
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                        "text": ". In ",
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                                "text": "The Lancet",
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                        "text": ", 397(10292), 2337\u20132360.",
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                        "text": "The GBD estimates are also presented in yet another prominent publication. The ",
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                        "text": " is published by the American Cancer Society and Vital Strategies and presents estimates for the global death toll from smoking ",
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                                "text": "taken from",
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                        "text": " the Global Burden of Disease Study published by the Institute for Health Metrics and Evaluation (IHME).{/ref}",
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                        "text": "Smoking led to about 100 million premature deaths in the 20th century",
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                        "text": "Tobacco smoking has been one of the world's largest health problems for decades. Over the course of the 20th century, it killed around 100 million people, most of them in today's rich countries.{ref}Jha, P. (2009). ",
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                                "text": "Avoidable global cancer deaths and total deaths from smoking",
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                        "text": ".\u00a0",
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                                "text": "Nature Reviews Cancer",
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                        "text": "(9), 655.{/ref} The health burdens of smoking are now moving from high-income to low-to-middle-income countries; some estimates have suggested that one billion people could die from tobacco over the 21st century.{ref}Mathers, C. D., & Loncar, D. (2006). Projections of global mortality and burden of disease from 2002 to 2030.\u00a0",
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                                "text": "PLoS medicine",
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                        "text": "(11), e442.{/ref}",
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                        "text": "{ref}Jha, P., & Peto, R. (2014). ",
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                        "url": "https://www.nejm.org/doi/10.1056/NEJMra1308383",
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                                "text": "Global effects of smoking, of quitting, and of taxing tobacco",
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                        "text": ".\u00a0",
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                                "text": "New England Journal of Medicine",
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                        "text": "In the map, we see the share of deaths attributed to direct smoking across the world. In many countries, this share is substantial.",
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                                "text": "Related chart \u2013 the share of deaths from ",
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                                        "text": "secondhand smoking",
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                                "text": "This map",
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                        "text": " shows the share of premature deaths attributed from secondhand smoke across the world.",
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                "text": [
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                        "text": "Death rates from smoking are highest across Asia and Eastern Europe",
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                        "text": "In the interactive map, we show death rates from tobacco smoking across the world. Death rates measure the number of premature deaths from smoking per 100,000 people in a given country or region. ",
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                        "text": "We see large differences in death rates across the world. Rates tend to be highest across Asia and Eastern Europe, where figures are often over 100, and in some cases, over 150 deaths per 100,000 people. ",
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                        "spanType": "span-newline"
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                        "spanType": "span-newline"
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                        "text": "Death rates are much lower across some of the lowest-income countries in the world, where very few people smoke.",
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                        "children": [
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                                "text": "Related chart \u2013 ",
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                            {
                                "children": [
                                    {
                                        "text": "number",
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                                "text": " of deaths from smoking.",
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                        "url": "https://ourworldindata.org/grapher/number-of-deaths-from-tobacco-smoking",
                        "children": [
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                                "text": "This map",
                                "spanType": "span-simple-text"
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                        "text": " shows the annual number of deaths from tobacco smoking across the world.",
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                "url": "https://ourworldindata.org/grapher/death-rate-smoking?tab=map",
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                "text": [
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                        "text": "Most deaths from smoking occur in older populations",
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                        "text": "When we look at the breakdown of deaths from smoking by age, we see that it is mainly older populations that are affected. ",
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                        "spanType": "span-newline"
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                        "text": "In the visualizations, we show the death rates from smoking by age bracket and the share of annual deaths that occur in each age group.",
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                        "spanType": "span-newline"
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                        "spanType": "span-newline"
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                        "text": "Here, we see that death rates from smoking are much higher in people older than 70 years old, followed by those aged 50 to 69.",
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                "url": "https://ourworldindata.org/grapher/death-rates-smoking-age",
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                "url": "https://ourworldindata.org/grapher/smoking-deaths-by-age?stackMode=relative",
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                "text": [
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                        "text": "How have smoking deaths changed over time?",
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                "text": [
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                        "text": "Death rates from smoking have declined in most countries",
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                        "text": "Globally, smoking-related death rates ",
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                        "url": "https://ourworldindata.org/grapher/death-rate-smoking?tab=chart&country=OWID_WRL",
                        "children": [
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                                "text": "have fallen",
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                        "text": ".",
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                        "spanType": "span-newline"
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                        "spanType": "span-newline"
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                    {
                        "text": "But there are differences across countries. Where in the world are death rates falling or rising?",
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                        "spanType": "span-newline"
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                        "spanType": "span-newline"
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                        "text": "In the scatterplot, we see the comparison of smoking death rates in 1990 (shown on the y-axis) versus the death rate in the latest data (on the x-axis). The grey line is the line of parity: countries that lie along this line had equal death rates at both points in time. Countries that lie ",
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                        "children": [
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                                "text": "above",
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                        "text": " the grey line had higher death rates in 1990; for those that lie ",
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                        "children": [
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                                "text": "below",
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                        "text": " the grey line, the opposite is true.",
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                        "spanType": "span-newline"
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                        "spanType": "span-newline"
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                        "text": "We see that almost all countries in the world lie above the grey line. This means that most countries have achieved a ",
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                        "children": [
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                                "text": "decline",
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                        "text": " in death rates from smoking in recent decades.",
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                "type": "horizontal-rule",
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                "text": [
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                        "text": "Prevalence of smoking across the world",
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                "level": 1,
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                "text": [
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                        "text": "Share who smoke",
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                "text": [
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                        "text": "In which countries do people smoke the most?",
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                        "text": "Around one-in-four adults in the world smoke tobacco.",
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                "type": "text",
                "value": [
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                        "text": "But where in the world is smoking most common?",
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                "type": "text",
                "value": [
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                        "text": "In the map, we see the share of adults aged 15 years and older, who smoke tobacco. ",
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                "type": "text",
                "value": [
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                        "text": "There are a number of countries where more than a third of the population smokes. The places where many people smoke are clustered in regions. South-East Asia, the Pacific islands, and parts of Europe.",
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                        "text": "In some countries, very few people smoke.",
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                        "text": "Several factors influence the prevalence of smoking. One is prosperity: if we look at ",
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                        "url": "https://ourworldindata.org/grapher/share-of-adults-who-are-smoking-by-level-of-prosperity",
                        "children": [
                            {
                                "text": "the relationship",
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                        "text": " between smoking prevalence and income, we find that richer countries tend to smoke more. But as you see in this correlation, there are very large differences at each level of income.",
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                        "text": "Smoking rates are high across many countries, but we know from the history of many countries that this can change quickly. Many of today\u2019s high-income countries had much higher smoking rates in the past and have seen a large reduction.",
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                "url": "https://ourworldindata.org/grapher/share-of-adults-who-smoke?tab=map&country=USA~BRA~RUS~IND~CHN~European+Union~IDN~OWID_WRL",
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                "text": [
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                        "text": "Daily smokers",
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                        "text": "This visualization shows the share of adults, aged 15 years and older, who smoke every day.",
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                        "text": "We see that daily smoking is most common across Europe and Asia \u2013 more than 20% of adults in most countries in these regions smoke every day.",
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                        "children": [
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                                "text": "Related chart \u2013 ",
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                        "children": [
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                                "children": [
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                                        "text": "number",
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                        "children": [
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                                "text": " of daily smokers",
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                    {
                        "text": ". ",
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                        "url": "https://ourworldindata.org/grapher/number-of-total-daily-smokers?time=1980..2012",
                        "children": [
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                                "text": "This map",
                                "spanType": "span-simple-text"
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                        "spanType": "span-link"
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                        "text": " shows the number of people who smoke every day across the world.",
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                "url": "https://ourworldindata.org/grapher/daily-smoking-prevalence-bounds",
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                "text": [
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                        "text": "Smoking by gender",
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                "text": [
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                        "text": "Who smokes more, men or women?",
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                        "text": "Nearly one-in-four adults in the world ",
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                        "url": "https://ourworldindata.org/which-countries-smoke-most",
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                                "text": "smokes tobacco",
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                        "text": ". But there are large differences between men and women.",
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                        "text": "As the chart shows, more than one-third of men in the world smoke, while the same is true for less than one-in-ten women.",
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                "type": "text",
                "value": [
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                        "text": "In almost all countries, it is true that a large share of men smoke. In the visualization, we see the share of men who smoke (plotted on the vertical axis) compared with the same metric for women (plotted on the horizontal axis).",
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                "value": [
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                        "text": "The grey line in the plot represents equality in the prevalence: countries where smoking is more common in men will lie above this line, and countries where more women smoke lie below.",
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                "type": "text",
                "value": [
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                        "text": "We see that almost all countries lie above the grey line, meaning a higher share of men smoke. There are only a few exceptions.",
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                "type": "text",
                "value": [
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                        "text": "In many countries \u2014 particularly across Asia and Africa \u2014 the differences are very large. ",
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                "value": [
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                        "text": "We also see this when we look at a ",
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                        "url": "https://ourworldindata.org/grapher/share-of-women-who-are-smoking?tab=map",
                        "children": [
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                                "text": "global map of smoking among women",
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                        "text": ": across much of Africa and Asia, rates are very low. For comparison, here is the world ",
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                        "url": "https://ourworldindata.org/grapher/share-of-men-who-are-smoking?time=latest",
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                                "text": "map of smoking rates in men",
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                        "text": ".",
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                        "text": "The fact that men are more likely than women to smoke is reflected in health statistics, particularly lung cancer, for which smoking is a ",
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                    {
                        "url": "https://ourworldindata.org/smoking#share-of-cancer-deaths-attributed-to-smoking",
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                                "text": "primary risk factor",
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                    {
                        "text": ". We see that in nearly every country in the world, men are ",
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                                "text": "more likely to die",
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                        "text": " from lung cancer.",
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                "url": "https://ourworldindata.org/grapher/comparing-the-share-of-men-and-women-who-are-smoking",
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                "type": "horizontal-rule",
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                "text": [
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                        "text": "How has the prevalence of smoking changed over time?",
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                "text": [
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                        "text": "The rise and fall of smoking in today's rich countries",
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                        "text": "The smoking of cigarettes first saw a significant rise across today's rich countries in the early 20th century. Since then, trends in smoking have undergone a century-long cycle of peak and decline.",
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                        "text": "In the visualization, we see the average number of cigarettes sold per adult per day across many of today's rich countries, including the United States and European countries.",
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                        "spanType": "span-newline"
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                        "text": "Here, we see that all countries followed a very similar trajectory: a steep rise in cigarette consumption during the early-to-mid 1900s; peaking from the mid-to-latter half of the century, before entering into a steep decline in the decades which followed. ",
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                        "text": "Notably, this rise-peak-fall pathway took around a century in all cases. This long trajectory has had major health impacts for the populations of rich countries today. ",
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                "url": "https://ourworldindata.org/grapher/sales-of-cigarettes-per-adult-per-day",
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                "text": [
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                        "text": "Smoking rates are now falling in almost all countries",
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                        "text": "The rise, peak, and decline of smoking in rich countries took around a century. The high peak had severe health impacts.",
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                        "text": "This timescale is important when we consider low-to-middle-income countries today: if they are to avoid the scale of the health consequences seen by rich countries, they must move through this pathway much quicker. The positive news is that most have \u2013 smoking is already falling in most countries today.",
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                        "text": "In this visualization, we see the share of adults who smoked in the year 2000 (on the y-axis) and in the most recent data (on the x-axis). The grey line here shows parity: countries that lie along this line would have the same smoking prevalence at both points in time. Countries that lie ",
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                        "children": [
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                                "text": "above",
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                        "text": " this line had higher smoking prevalence back in 2000; for those ",
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                                "text": "below",
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                        "text": " the opposite is true.",
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                        "text": "We see that most countries lie above the grey line: this means the share of adults who smoke has declined in most countries in the world over the past decade. This is a surprising fact to many, since it means smoking prevalence is not only falling in high-income countries but also in most low-to-middle incomes.{ref}Bilano, V., Gilmour, S., Moffiet, T., d'Espaignet, E. T., Stevens, G. A., Commar, A., ... & Shibuya, K. (2015). ",
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                    },
                    {
                        "url": "https://www.sciencedirect.com/science/article/pii/S0140673615602641",
                        "children": [
                            {
                                "text": "Global trends and projections for tobacco use, 1990\u20132025: an analysis of smoking indicators from the WHO Comprehensive Information Systems for Tobacco Control",
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                            }
                        ],
                        "spanType": "span-link"
                    },
                    {
                        "text": ".\u00a0",
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                        "children": [
                            {
                                "text": "The Lancet",
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                        "text": ",\u00a0",
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                        "children": [
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                                "text": "385",
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                        "text": "(9972), 966-976.{/ref}",
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                        "text": "Low-to-middle income countries have effectively 'leapfrogged' the century-long rise-peak-decline pathway of rich countries. Almost everywhere, smoking is on the decline.",
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                "text": [
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                        "text": "Smoking and cancer",
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                "text": [
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                        "text": "The rise and fall of lung cancer",
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2013-05-23 22:34:01

2024-02-16 14:22:38

[
    "Hannah Ritchie",
    "Max Roser"
]

Tobacco smoking is one of the world’s largest health problems today.

2019-11-16 11:33:19

2023-08-30 14:35:02

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This article was first published in May 2013; it was revised substantially in November 2019. The last update was done in August 2023. Tobacco smoking is one of the world's largest health problems. Millions of people live in poor health because of it. Researchers estimate that every year around _8 million people_ die an early death due to smoking. It has been a major health problem for many decades. For the entire 20th century, it is estimated that around 100 million people died prematurely because of smoking, most of them in rich countries.{ref}Jha, P. (2009). [Avoidable global cancer deaths and total deaths from smoking](https://www.nature.com/articles/nrc2703). _Nature Reviews Cancer_, _9_(9), 655.{/ref} The share of smokers among the world population is falling, and because smoking is such a large health problem today, this is one of the most positive developments in global health. It makes it possible for millions of people to live a longer and healthier life. _For a brief overview of the most important facts, see the following article:_ ### https://ourworldindata.org/smoking-big-problem-in-brief **[See all interactive charts on smoking ↓](#all-charts)** --- # Smoking is one of the leading risks for early death --- ### Smoking is responsible for about 8 million premature deaths each year The two regularly updated studies on the global death toll from tobacco use – published by the World Health Organization and the Institute for Health Metrics and Evaluation – agree that around 8 million people die prematurely yearly. The aggregate statistics refer to ‘tobacco use’ (rather than smoking alone) because other forms of consuming tobacco, such as chewing tobacco, also lead to premature deaths. The huge majority of deaths from tobacco use, however, are due to smoking. The death toll from smoking is very close to the total sum of deaths from tobacco use (higher than 99.9% in the case of the IHME estimates). ### World Health Organization: More than 8 million die from tobacco use every year The WHO estimates that more than 8 million people die prematurely yearly from tobacco use. This is the latest available WHO estimate as of August 2023. More than 7 million of those deaths result from direct tobacco use. About 1.3 million are non-smokers who are dying because they are exposed to second-hand smoke. **Reference:**[WHO (2023) – Fact Sheet: Tobacco](https://www.who.int/news-room/fact-sheets/detail/tobacco), updated in July 2023 ### IHME's Global Burden of Disease study: 8.7 million die from tobacco use every year The IHME – in their annual Global Burden of Disease study – estimates that 8.7 million people die prematurely from tobacco use every year. As of August 2023, these are the latest estimates and refer to deaths in the year 2019. 7.7 million of those deaths result from smoking while 1.3 million are non-smokers who are dying because they are exposed to second-hand smoke. (An additional 56,000 people die annually from chewing tobacco.) Most (71%) of those who die prematurely from smoking are men. These estimates of the annual number of deaths attributed to a wide range of risk factors are shown in the interactive chart. This visualization is, by default, showing the global total, but can be explored for any country or region using the "change country" toggle. Smoking is a risk factor for several of the world's leading causes of death, including lung and other forms of cancer, heart disease, and respiratory diseases. The references can be found i the footnote.{ref}The estimates of the Global Burden of Disease study can be found [here](http://ihmeuw.org/5i08). The latest study can be found at the website of The Lancet here: [TheLancet.com/GBD](https://www.thelancet.com/gbd) There are two publications that are closely related to the Global Burden of Disease study: Reitsma et al. (2021) – [Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990–2019: A systematic analysis from the Global Burden of Disease Study 2019](https://doi.org/10.1016/S0140-6736(21)01169-7). In _The Lancet_, 397(10292), 2337–2360. The GBD estimates are also presented in yet another prominent publication. The [**Tobacco Atlas**](https://tobaccoatlas.org/) is published by the American Cancer Society and Vital Strategies and presents estimates for the global death toll from smoking [taken from](https://tobaccoatlas.org/data-sources/) the Global Burden of Disease Study published by the Institute for Health Metrics and Evaluation (IHME).{/ref} <Chart url="https://ourworldindata.org/grapher/number-of-deaths-by-risk-factor"/> ### Smoking led to about 100 million premature deaths in the 20th century Tobacco smoking has been one of the world's largest health problems for decades. Over the course of the 20th century, it killed around 100 million people, most of them in today's rich countries.{ref}Jha, P. (2009). [Avoidable global cancer deaths and total deaths from smoking](https://www.nature.com/articles/nrc2703). _Nature Reviews Cancer_, _9_(9), 655.{/ref} The health burdens of smoking are now moving from high-income to low-to-middle-income countries; some estimates have suggested that one billion people could die from tobacco over the 21st century.{ref}Mathers, C. D., & Loncar, D. (2006). Projections of global mortality and burden of disease from 2002 to 2030. _PLoS medicine_, _3_(11), e442.{/ref},{ref}Jha, P., & Peto, R. (2014). [Global effects of smoking, of quitting, and of taxing tobacco](https://www.nejm.org/doi/10.1056/NEJMra1308383). _New England Journal of Medicine_, _370_(1), 60-68.{/ref} --- # The global distribution of smoking deaths --- ### In many countries, a high share of deaths is attributed to smoking In the map, we see the share of deaths attributed to direct smoking across the world. In many countries, this share is substantial. **Related chart – the share of deaths from **_**secondhand smoking**_**.**[This map](https://ourworldindata.org/grapher/share-deaths-secondhand-smoke) shows the share of premature deaths attributed from secondhand smoke across the world. <Chart url="https://ourworldindata.org/grapher/share-deaths-smoking"/> ### Death rates from smoking are highest across Asia and Eastern Europe In the interactive map, we show death rates from tobacco smoking across the world. Death rates measure the number of premature deaths from smoking per 100,000 people in a given country or region. We see large differences in death rates across the world. Rates tend to be highest across Asia and Eastern Europe, where figures are often over 100, and in some cases, over 150 deaths per 100,000 people. Death rates are much lower across some of the lowest-income countries in the world, where very few people smoke. **Related chart – _number_ of deaths from smoking.**[This map](https://ourworldindata.org/grapher/number-of-deaths-from-tobacco-smoking) shows the annual number of deaths from tobacco smoking across the world. <Chart url="https://ourworldindata.org/grapher/death-rate-smoking?tab=map"/> ### Most deaths from smoking occur in older populations When we look at the breakdown of deaths from smoking by age, we see that it is mainly older populations that are affected. In the visualizations, we show the death rates from smoking by age bracket and the share of annual deaths that occur in each age group. Here, we see that death rates from smoking are much higher in people older than 70 years old, followed by those aged 50 to 69. <Chart url="https://ourworldindata.org/grapher/death-rates-smoking-age"/> <Chart url="https://ourworldindata.org/grapher/smoking-deaths-by-age?stackMode=relative"/> --- # How have smoking deaths changed over time? --- ### Death rates from smoking have declined in most countries Globally, smoking-related death rates [have fallen](https://ourworldindata.org/grapher/death-rate-smoking?tab=chart&country=OWID_WRL). But there are differences across countries. Where in the world are death rates falling or rising? In the scatterplot, we see the comparison of smoking death rates in 1990 (shown on the y-axis) versus the death rate in the latest data (on the x-axis). The grey line is the line of parity: countries that lie along this line had equal death rates at both points in time. Countries that lie _above_ the grey line had higher death rates in 1990; for those that lie _below_ the grey line, the opposite is true. We see that almost all countries in the world lie above the grey line. This means that most countries have achieved a _decline_ in death rates from smoking in recent decades. <Chart url="https://ourworldindata.org/grapher/smoking-death-rate-1990-2017"/> --- # Prevalence of smoking across the world --- ## Share who smoke ### In which countries do people smoke the most? Around one-in-four adults in the world smoke tobacco. But where in the world is smoking most common? In the map, we see the share of adults aged 15 years and older, who smoke tobacco. There are a number of countries where more than a third of the population smokes. The places where many people smoke are clustered in regions. South-East Asia, the Pacific islands, and parts of Europe. In some countries, very few people smoke. Several factors influence the prevalence of smoking. One is prosperity: if we look at [the relationship](https://ourworldindata.org/grapher/share-of-adults-who-are-smoking-by-level-of-prosperity) between smoking prevalence and income, we find that richer countries tend to smoke more. But as you see in this correlation, there are very large differences at each level of income. Smoking rates are high across many countries, but we know from the history of many countries that this can change quickly. Many of today’s high-income countries had much higher smoking rates in the past and have seen a large reduction. <Chart url="https://ourworldindata.org/grapher/share-of-adults-who-smoke?tab=map&country=USA~BRA~RUS~IND~CHN~European+Union~IDN~OWID_WRL"/> ## Daily smokers This visualization shows the share of adults, aged 15 years and older, who smoke every day. We see that daily smoking is most common across Europe and Asia – more than 20% of adults in most countries in these regions smoke every day. **Related chart – **_**number**_** of daily smokers**. [This map](https://ourworldindata.org/grapher/number-of-total-daily-smokers?time=1980..2012) shows the number of people who smoke every day across the world. <Chart url="https://ourworldindata.org/grapher/daily-smoking-prevalence-bounds"/> ## Smoking by gender ### Who smokes more, men or women? Nearly one-in-four adults in the world [smokes tobacco](https://ourworldindata.org/which-countries-smoke-most). But there are large differences between men and women. As the chart shows, more than one-third of men in the world smoke, while the same is true for less than one-in-ten women. In almost all countries, it is true that a large share of men smoke. In the visualization, we see the share of men who smoke (plotted on the vertical axis) compared with the same metric for women (plotted on the horizontal axis). The grey line in the plot represents equality in the prevalence: countries where smoking is more common in men will lie above this line, and countries where more women smoke lie below. We see that almost all countries lie above the grey line, meaning a higher share of men smoke. There are only a few exceptions. In many countries — particularly across Asia and Africa — the differences are very large. We also see this when we look at a [global map of smoking among women](https://ourworldindata.org/grapher/share-of-women-who-are-smoking?tab=map): across much of Africa and Asia, rates are very low. For comparison, here is the world [map of smoking rates in men](https://ourworldindata.org/grapher/share-of-men-who-are-smoking?time=latest). The fact that men are more likely than women to smoke is reflected in health statistics, particularly lung cancer, for which smoking is a [primary risk factor](https://ourworldindata.org/smoking#share-of-cancer-deaths-attributed-to-smoking). We see that in nearly every country in the world, men are [more likely to die](https://ourworldindata.org/grapher/lung-cancer-deaths-men-women) from lung cancer. <Chart url="https://ourworldindata.org/grapher/comparing-the-share-of-men-and-women-who-are-smoking"/> --- # How has the prevalence of smoking changed over time? --- ## The rise and fall of smoking in today's rich countries The smoking of cigarettes first saw a significant rise across today's rich countries in the early 20th century. Since then, trends in smoking have undergone a century-long cycle of peak and decline. In the visualization, we see the average number of cigarettes sold per adult per day across many of today's rich countries, including the United States and European countries. Here, we see that all countries followed a very similar trajectory: a steep rise in cigarette consumption during the early-to-mid 1900s; peaking from the mid-to-latter half of the century, before entering into a steep decline in the decades which followed. Notably, this rise-peak-fall pathway took around a century in all cases. This long trajectory has had major health impacts for the populations of rich countries today. <Chart url="https://ourworldindata.org/grapher/sales-of-cigarettes-per-adult-per-day"/> ## Smoking rates are now falling in almost all countries The rise, peak, and decline of smoking in rich countries took around a century. The high peak had severe health impacts. This timescale is important when we consider low-to-middle-income countries today: if they are to avoid the scale of the health consequences seen by rich countries, they must move through this pathway much quicker. The positive news is that most have – smoking is already falling in most countries today. In this visualization, we see the share of adults who smoked in the year 2000 (on the y-axis) and in the most recent data (on the x-axis). The grey line here shows parity: countries that lie along this line would have the same smoking prevalence at both points in time. Countries that lie _above_ this line had higher smoking prevalence back in 2000; for those _below_ the opposite is true. We see that most countries lie above the grey line: this means the share of adults who smoke has declined in most countries in the world over the past decade. This is a surprising fact to many, since it means smoking prevalence is not only falling in high-income countries but also in most low-to-middle incomes.{ref}Bilano, V., Gilmour, S., Moffiet, T., d'Espaignet, E. T., Stevens, G. A., Commar, A., ... & Shibuya, K. (2015). [Global trends and projections for tobacco use, 1990–2025: an analysis of smoking indicators from the WHO Comprehensive Information Systems for Tobacco Control](https://www.sciencedirect.com/science/article/pii/S0140673615602641). _The Lancet_, _385_(9972), 966-976.{/ref} Low-to-middle income countries have effectively 'leapfrogged' the century-long rise-peak-decline pathway of rich countries. Almost everywhere, smoking is on the decline. <Chart url="https://ourworldindata.org/grapher/adults-smoking-2000-2016"/> --- # Smoking and cancer --- ### The rise and fall of lung cancer This chart shows death rates from lung cancer in the US since 1950. It is possible to view the data for other countries by using the tools in the chart. We see the same rise, peak, and decline pattern that we have seen in the cigarette consumption statistics. These trends are largely driven by the trends in [smoking](https://owid.cloud/smoking). Smoking is the biggest risk factor for lung cancer and we see that the trends in lung cancer follow those in smoking with a lag. <Chart url="https://ourworldindata.org/grapher/lung-cancer-deaths-per-100000-by-sex-1950-2002"/> ### Share of cancer deaths attributed to smoking The world map shows the Global Burden of Disease estimates of the share of cancer deaths that can be attributed to smoking. Globally, [about a quarter](https://ourworldindata.org/grapher/share-of-cancer-deaths-attributed-to-tobacco?tab=chart&country=~OWID_WRL) of cancer deaths are attributed to smoking. In most richer countries, the share is even higher. In poor countries, where fewer people were smoking in the past, tobacco is responsible for a smaller fraction of cancer deaths. <Chart url="https://ourworldindata.org/grapher/share-of-cancer-deaths-attributed-to-tobacco"/> --- # What can we do to reduce smoking? --- ## Pricing and taxes ### Affordability of cigarettes <Chart url="https://ourworldindata.org/grapher/affordability-cigarettes"/> ### Taxes on cigarettes <Chart url="https://ourworldindata.org/grapher/share-of-tobacco-retail-price-that-is-tax"/> ## Bans on tobacco advertising <Chart url="https://ourworldindata.org/grapher/enforcement-of-bans-on-tobacco-advertising"/> ## Support to quit smoking <Chart url="https://ourworldindata.org/grapher/support-to-help-to-quit-tobacco-use"/> --- # Data Sources --- ### International Mortality and Smoking Statistics (IMASS) * **Data:** Consumption of tobacco products, prevalence of smoking and mortality * **Geographical coverage:** 30 countries * **Time span:** Often spanning back 100 years * **Available at: **Online [here](http://www.pnlee.co.uk/imass.htm) ### Institute of Health Metrics and Evaluation (IHME), Global Burden of Disease (GBD) * **Data:** Death rates and absolute number of premature deaths from smoking and secondhand-smoke * **Geographical coverage:** Global, across all regions and countries * **Time span:** 1990 onwards * **Available at: **Online [here](http://ghdx.healthdata.org/gbd-results-tool) ### World Health Organization (WHO) Global Health Observatory (GHO) * **Data:** Smoking prevalence, prices, taxes and policy support * **Geographical coverage:** Global, across all regions and countries * **Available at: **Online [here](http://apps.who.int/gho/data/node.home) <AllCharts heading="Interactive charts on smoking"/>

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        "rendered": "\n<div class=\"blog-info\">This article was first published in May 2013; it was revised substantially in November 2019. The last update was done in August 2023.</div>\n\n\n\n<p>Tobacco smoking is one of the world&#8217;s largest health problems. Millions of people live in poor health because of it. Researchers estimate that every year around <em>8 million people</em> die an early death due to smoking.<br><br>It has been a major health problem for many decades. For the entire 20th century, it is estimated that around 100 million people died prematurely because of smoking, most of them in rich countries.{ref}Jha, P. (2009). <a href=\"https://www.nature.com/articles/nrc2703\">Avoidable global cancer deaths and total deaths from smoking</a>.&nbsp;<em>Nature Reviews Cancer</em>,&nbsp;<em>9</em>(9), 655.{/ref}</p>\n\n\n\n<p>The share of smokers among the world population is falling, and because smoking is such a large health problem today, this is one of the most positive developments in global health. It makes it possible for millions of people to live a longer and healthier life.</p>\n\n\n\n<p><em>For a brief overview of the most important facts, see the following article:</em></p>\n\n\n    <block type=\"prominent-link\" style=\"is-style-thin\">\n        <link-url>https://ourworldindata.org/smoking-big-problem-in-brief</link-url>\n        <title></title>\n        <content></content>\n        <figure></figure>\n    </block>\n\n\n<h2>Smoking is one of the leading risks for early death</h2>\n\n\n\n<h4>Smoking is responsible for about 8 million premature deaths each year</h4>\n\n\n\n<p>The two regularly updated studies on the global death toll from tobacco use \u2013 published by the World Health Organization and the Institute for Health Metrics and Evaluation \u2013 agree that around 8 million people die prematurely yearly.</p>\n\n\n\n<p>The aggregate statistics refer to \u2018tobacco use\u2019 (rather than smoking alone) because other forms of consuming tobacco, such as chewing tobacco, also lead to premature deaths. The huge majority of deaths from tobacco use, however, are due to smoking. The death toll from smoking is very close to the total sum of deaths from tobacco use (higher than 99.9% in the case of the IHME estimates).</p>\n\n\n\n<h4>World Health Organization: More than 8 million die from tobacco use every year</h4>\n\n\n\n<p>The WHO estimates that more than 8 million people die prematurely yearly from tobacco use. This is the latest available WHO estimate as of August 2023.</p>\n\n\n\n<p>More than 7 million of those deaths result from direct tobacco use. About 1.3 million are non-smokers who are dying because they are exposed to second-hand smoke.</p>\n\n\n\n<p><strong>Reference:</strong> <a href=\"https://www.who.int/news-room/fact-sheets/detail/tobacco\">WHO (2023) \u2013&nbsp;Fact Sheet: Tobacco</a>, updated in July 2023</p>\n\n\n\n<h4>IHME&#8217;s Global Burden of Disease study: 8.7 million die from tobacco use every year</h4>\n\n\n\n<p>The IHME \u2013 in their annual Global Burden of Disease study \u2013 estimates that 8.7 million people die prematurely from tobacco use every year. As of August 2023, these are the latest estimates and refer to deaths in the year 2019.</p>\n\n\n\n<p>7.7 million of those deaths result from smoking while 1.3 million are non-smokers who are dying because they are exposed to second-hand smoke. (An additional 56,000 people die annually from chewing tobacco.) Most (71%) of those who die prematurely from smoking are men.</p>\n\n\n\n<p>These estimates of the annual number of deaths attributed to a wide range of risk factors are shown in the interactive chart. This visualization is, by default, showing the global total, but can be explored for any country or region using the &#8220;change country&#8221; toggle. Smoking is a risk factor for several of the world&#8217;s leading causes of death, including lung and other forms of cancer, heart disease, and respiratory diseases. The references can be found i the footnote.{ref}The estimates of the Global Burden of Disease study can be found <a href=\"http://ihmeuw.org/5i08\">here</a>. The latest study can be found at the website of The Lancet here: <a href=\"https://www.thelancet.com/gbd\">TheLancet.com/GBD</a></p>\n\n\n\n<p>There are two publications that are closely related to the Global Burden of Disease study:</p>\n\n\n\n<p>Reitsma et al. (2021) \u2013 <a href=\"https://doi.org/10.1016/S0140-6736(21)01169-7\">Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990\u20132019: A systematic analysis from the Global Burden of Disease Study 2019</a>. In <em>The Lancet</em>, 397(10292), 2337\u20132360.</p>\n\n\n\n<p>The GBD estimates are also presented in yet another prominent publication. The <a href=\"https://tobaccoatlas.org/\"><strong>Tobacco Atlas</strong></a> is published by the American Cancer Society and Vital Strategies and presents estimates for the global death toll from smoking <a href=\"https://tobaccoatlas.org/data-sources/\">taken from</a> the Global Burden of Disease Study published by the Institute for Health Metrics and Evaluation (IHME).{/ref}</p>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/number-of-deaths-by-risk-factor\"></iframe></figure>\n\n\n\n<h4>Smoking led to about 100 million premature deaths in the 20th century</h4>\n\n\n\n<p>Tobacco smoking has been one of the world&#8217;s largest health problems for decades. Over the course of the 20th century, it killed around 100 million people, most of them in today&#8217;s rich countries.{ref}Jha, P. (2009). <a href=\"https://www.nature.com/articles/nrc2703\">Avoidable global cancer deaths and total deaths from smoking</a>.&nbsp;<em>Nature Reviews Cancer</em>,&nbsp;<em>9</em>(9), 655.{/ref} The health burdens of smoking are now moving from high-income to low-to-middle-income countries; some estimates have suggested that one billion people could die from tobacco over the 21st century.{ref}Mathers, C. D., &amp; Loncar, D. (2006). Projections of global mortality and burden of disease from 2002 to 2030.&nbsp;<em>PLoS medicine</em>,&nbsp;<em>3</em>(11), e442.{/ref}<sup>,</sup>{ref}Jha, P., &amp; Peto, R. (2014). <a href=\"https://www.nejm.org/doi/10.1056/NEJMra1308383\">Global effects of smoking, of quitting, and of taxing tobacco</a>.&nbsp;<em>New England Journal of Medicine</em>,&nbsp;<em>370</em>(1), 60-68.{/ref}</p>\n\n\n\n<h2>The global distribution of smoking deaths</h2>\n\n\n\n<h4>In many countries, a high share of deaths is attributed to smoking</h4>\n\n\n\n<p>In the map, we see the share of deaths attributed to direct smoking across the world. In many countries, this share is substantial.</p>\n\n\n\n<p><strong>Related chart \u2013 the share of deaths from </strong><em><strong>secondhand smoking</strong></em><strong>.</strong> <a href=\"https://ourworldindata.org/grapher/share-deaths-secondhand-smoke\">This map</a> shows the share of premature deaths attributed from secondhand smoke across the world.</p>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/share-deaths-smoking\"></iframe></figure>\n\n\n\n<h4>Death rates from smoking are highest across Asia and Eastern Europe</h4>\n\n\n\n<p>In the interactive map, we show death rates from tobacco smoking across the world. Death rates measure the number of premature deaths from smoking per 100,000 people in a given country or region. <br><br>We see large differences in death rates across the world. Rates tend to be highest across Asia and Eastern Europe, where figures are often over 100, and in some cases, over 150 deaths per 100,000 people. <br><br>Death rates are much lower across some of the lowest-income countries in the world, where very few people smoke.</p>\n\n\n\n<p><strong>Related chart \u2013 <em>number</em> of deaths from smoking.</strong> <a href=\"https://ourworldindata.org/grapher/number-of-deaths-from-tobacco-smoking\">This map</a> shows the annual number of deaths from tobacco smoking across the world.</p>\n\n\n\n<iframe src=\"https://ourworldindata.org/grapher/death-rate-smoking?tab=map\" style=\"width: 100%; height: 600px; border: 0px none;\"></iframe>\n\n\n\n<h4>Most deaths from smoking occur in older populations</h4>\n\n\n\n<p>When we look at the breakdown of deaths from smoking by age, we see that it is mainly older populations that are affected. <br><br>In the visualizations, we show the death rates from smoking by age bracket and the share of annual deaths that occur in each age group.<br><br>Here, we see that death rates from smoking are much higher in people older than 70 years old, followed by those aged 50 to 69.<br></p>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/death-rates-smoking-age\"></iframe></figure>\n\n\n\n<iframe src=\"https://ourworldindata.org/grapher/smoking-deaths-by-age?stackMode=relative\" style=\"width: 100%; height: 600px; border: 0px none;\"></iframe>\n\n\n\n<h2>How have smoking deaths changed over time?</h2>\n\n\n\n<h4>Death rates from smoking have declined in most countries</h4>\n\n\n\n<p>Globally, smoking-related death rates <a href=\"https://ourworldindata.org/grapher/death-rate-smoking?tab=chart&amp;country=OWID_WRL\">have fallen</a>.<br><br>But there are differences across countries. Where in the world are death rates falling or rising?<br><br>In the scatterplot, we see the comparison of smoking death rates in 1990 (shown on the y-axis) versus the death rate in the latest data (on the x-axis). The grey line is the line of parity: countries that lie along this line had equal death rates at both points in time. Countries that lie <em>above</em> the grey line had higher death rates in 1990; for those that lie <em>below</em> the grey line, the opposite is true.<br><br>We see that almost all countries in the world lie above the grey line. This means that most countries have achieved a <em>decline</em> in death rates from smoking in recent decades.</p>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/smoking-death-rate-1990-2017\"></iframe></figure>\n\n\n\n<h2>Prevalence of smoking across the world</h2>\n\n\n\n<h3>Share who smoke</h3>\n\n\n\n<h4>In which countries do people smoke the most?</h4>\n\n\n\n<div class=\"wp-block-columns\">\n<div class=\"wp-block-column\">\n<p>Around one-in-four adults in the world smoke tobacco.</p>\n\n\n\n<p>But where in the world is smoking most common?</p>\n\n\n\n<p>In the map, we see the share of adults aged 15 years and older, who smoke tobacco. </p>\n\n\n\n<p>There are a number of countries where more than a third of the population smokes. The places where many people smoke are clustered in regions. South-East Asia, the Pacific islands, and parts of Europe.</p>\n\n\n\n<p>In some countries, very few people smoke.</p>\n\n\n\n<p>Several factors influence the prevalence of smoking. One is prosperity: if we look at <a href=\"https://ourworldindata.org/grapher/share-of-adults-who-are-smoking-by-level-of-prosperity\">the relationship</a> between smoking prevalence and income, we find that richer countries tend to smoke more. But as you see in this correlation, there are very large differences at each level of income.</p>\n\n\n\n<p>Smoking rates are high across many countries, but we know from the history of many countries that this can change quickly. Many of today\u2019s high-income countries had much higher smoking rates in the past and have seen a large reduction.</p>\n</div>\n\n\n\n<div class=\"wp-block-column\">\n<iframe style=\"width: 100%; height: 600px; border: 0px none;\" src=\"https://ourworldindata.org/grapher/share-of-adults-who-smoke?tab=map&amp;country=USA~BRA~RUS~IND~CHN~European+Union~IDN~OWID_WRL\"></iframe>\n</div>\n</div>\n\n\n\n<h3>Daily smokers</h3>\n\n\n\n<p>This visualization shows the share of adults, aged 15 years and older, who smoke every day.</p>\n\n\n\n<p>We see that daily smoking is most common across Europe and Asia \u2013 more than 20% of adults in most countries in these regions smoke every day.</p>\n\n\n\n<p><strong>Related chart \u2013 </strong><em><strong>number</strong></em><strong> of daily smokers</strong>. <a href=\"https://ourworldindata.org/grapher/number-of-total-daily-smokers?time=1980..2012\">This map</a> shows the number of people who smoke every day across the world.</p>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/daily-smoking-prevalence-bounds\"></iframe></figure>\n\n\n\n<h3>Smoking by gender</h3>\n\n\n\n<h4>Who smokes more, men or women?</h4>\n\n\n\n<p>Nearly one-in-four adults in the world <a href=\"https://ourworldindata.org/which-countries-smoke-most\">smokes tobacco</a>. But there are large differences between men and women.</p>\n\n\n\n<p>As the chart shows, more than one-third of men in the world smoke, while the same is true for less than one-in-ten women.</p>\n\n\n\n<p>In almost all countries, it is true that a large share of men smoke. In the visualization, we see the share of men who smoke (plotted on the vertical axis) compared with the same metric for women (plotted on the horizontal axis).</p>\n\n\n\n<p>The grey line in the plot represents equality in the prevalence: countries where smoking is more common in men will lie above this line, and countries where more women smoke lie below.</p>\n\n\n\n<p>We see that almost all countries lie above the grey line, meaning a higher share of men smoke. There are only a few exceptions.</p>\n\n\n\n<p>In many countries \u2014 particularly across Asia and Africa \u2014 the differences are very large. </p>\n\n\n\n<p>We also see this when we look at a <a href=\"https://ourworldindata.org/grapher/share-of-women-who-are-smoking?tab=map\">global map of smoking among women</a>: across much of Africa and Asia, rates are very low. For comparison, here is the world <a href=\"https://ourworldindata.org/grapher/share-of-men-who-are-smoking?time=latest\">map of smoking rates in men</a>.</p>\n\n\n\n<p>The fact that men are more likely than women to smoke is reflected in health statistics, particularly lung cancer, for which smoking is a <a href=\"https://ourworldindata.org/smoking#share-of-cancer-deaths-attributed-to-smoking\">primary risk factor</a>. We see that in nearly every country in the world, men are <a href=\"https://ourworldindata.org/grapher/lung-cancer-deaths-men-women\">more likely to die</a> from lung cancer.</p>\n\n\n\n<iframe style=\"width: 100%; height: 600px; border: 0px none;\" src=\"https://ourworldindata.org/grapher/comparing-the-share-of-men-and-women-who-are-smoking\"></iframe>\n\n\n\n<h2>How has the prevalence of smoking changed over time?</h2>\n\n\n\n<h3>The rise and fall of smoking in today&#8217;s rich countries</h3>\n\n\n\n<p>The smoking of cigarettes first saw a significant rise across today&#8217;s rich countries in the early 20th century. Since then, trends in smoking have undergone a century-long cycle of peak and decline.<br><br>In the visualization, we see the average number of cigarettes sold per adult per day across many of today&#8217;s rich countries, including the United States and European countries.<br><br>Here, we see that all countries followed a very similar trajectory: a steep rise in cigarette consumption during the early-to-mid 1900s; peaking from the mid-to-latter half of the century, before entering into a steep decline in the decades which followed. <br><br>Notably, this rise-peak-fall pathway took around a century in all cases. This long trajectory has had major health impacts for the populations of rich countries today. </p>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/sales-of-cigarettes-per-adult-per-day\"></iframe></figure>\n\n\n\n<h3>Smoking rates are now falling in almost all countries</h3>\n\n\n\n<p>The rise, peak, and decline of smoking in rich countries took around a century. The high peak had severe health impacts.<br><br>This timescale is important when we consider low-to-middle-income countries today: if they are to avoid the scale of the health consequences seen by rich countries, they must move through this pathway much quicker. The positive news is that most have \u2013 smoking is already falling in most countries today.<br><br>In this visualization, we see the share of adults who smoked in the year 2000 (on the y-axis) and in the most recent data (on the x-axis). The grey line here shows parity: countries that lie along this line would have the same smoking prevalence at both points in time. Countries that lie <em>above</em> this line had higher smoking prevalence back in 2000; for those <em>below</em> the opposite is true.<br><br>We see that most countries lie above the grey line: this means the share of adults who smoke has declined in most countries in the world over the past decade. This is a surprising fact to many, since it means smoking prevalence is not only falling in high-income countries but also in most low-to-middle incomes.{ref}Bilano, V., Gilmour, S., Moffiet, T., d&#8217;Espaignet, E. T., Stevens, G. A., Commar, A., &#8230; &amp; Shibuya, K. (2015). <a href=\"https://www.sciencedirect.com/science/article/pii/S0140673615602641\">Global trends and projections for tobacco use, 1990\u20132025: an analysis of smoking indicators from the WHO Comprehensive Information Systems for Tobacco Control</a>.&nbsp;<em>The Lancet</em>,&nbsp;<em>385</em>(9972), 966-976.{/ref}</p>\n\n\n\n<p>Low-to-middle income countries have effectively &#8216;leapfrogged&#8217; the century-long rise-peak-decline pathway of rich countries. Almost everywhere, smoking is on the decline.</p>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/adults-smoking-2000-2016\"></iframe></figure>\n\n\n\n<h2>Smoking and cancer</h2>\n\n\n\n<h4>The rise and fall of lung cancer</h4>\n\n\n\n<p>This chart shows death rates from lung cancer in the US since 1950. It is possible to view the data for other countries by using the tools in the chart.</p>\n\n\n\n<p>We see the same rise, peak, and decline pattern that we have seen in the cigarette consumption statistics.</p>\n\n\n\n<p>These trends are largely driven by the trends in <a href=\"https://owid.cloud/smoking\">smoking</a>. Smoking is the biggest risk factor for lung cancer and we see that the trends in lung cancer follow those in smoking with a lag.</p>\n\n\n\n<iframe style=\"width: 100%; height: 600px; border: 0px none;\" src=\"https://ourworldindata.org/grapher/lung-cancer-deaths-per-100000-by-sex-1950-2002\"></iframe>\n\n\n\n<h4>Share of cancer deaths attributed to smoking</h4>\n\n\n\n<p>The world map shows the Global Burden of Disease estimates of the share of cancer deaths that can be attributed to smoking.</p>\n\n\n\n<p>Globally, <a href=\"https://ourworldindata.org/grapher/share-of-cancer-deaths-attributed-to-tobacco?tab=chart&amp;country=~OWID_WRL\">about a quarter</a> of cancer deaths are attributed to smoking.</p>\n\n\n\n<p>In most richer countries, the share is even higher.</p>\n\n\n\n<p>In poor countries, where fewer people were smoking in the past, tobacco is responsible for a smaller fraction of cancer deaths.</p>\n\n\n\n<iframe src=\"https://ourworldindata.org/grapher/share-of-cancer-deaths-attributed-to-tobacco\" style=\"width: 100%; height: 600px; border: 0px none;\"></iframe>\n\n\n\n<h2>What can we do to reduce smoking?</h2>\n\n\n\n<h3>Pricing and taxes</h3>\n\n\n\n<h4>Affordability of cigarettes</h4>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/affordability-cigarettes\"></iframe></figure>\n\n\n\n<h4>Taxes on cigarettes</h4>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/share-of-tobacco-retail-price-that-is-tax\"></iframe></figure>\n\n\n\n<h3>Bans on tobacco advertising</h3>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/enforcement-of-bans-on-tobacco-advertising\"></iframe></figure>\n\n\n\n<h3>Support to quit smoking</h3>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/support-to-help-to-quit-tobacco-use\"></iframe></figure>\n\n\n\n<h2>Data Sources</h2>\n\n\n\n<h4>International Mortality and Smoking Statistics (IMASS)</h4>\n\n\n\n<ul><li><strong>Data:</strong>&nbsp;Consumption of tobacco products, prevalence of smoking and mortality</li><li><strong>Geographical coverage:</strong>&nbsp;30 countries</li><li><strong>Time span:</strong>&nbsp;Often spanning back 100 years</li><li><strong>Available at:&nbsp;</strong>Online <a href=\"http://www.pnlee.co.uk/imass.htm\">here</a></li></ul>\n\n\n\n<h4>Institute of Health Metrics and Evaluation (IHME), Global Burden of Disease (GBD)</h4>\n\n\n\n<ul><li><strong>Data:</strong>&nbsp;Death rates and absolute number of premature deaths from smoking and secondhand-smoke</li><li><strong>Geographical coverage:</strong> Global, across all regions and countries</li><li><strong>Time span:</strong> 1990 onwards</li><li><strong>Available at:&nbsp;</strong>Online <a href=\"http://ghdx.healthdata.org/gbd-results-tool\">here</a></li></ul>\n\n\n\n<h4>World Health Organization (WHO) Global Health Observatory (GHO)</h4>\n\n\n\n<ul><li><strong>Data:</strong>&nbsp;Smoking prevalence, prices, taxes and policy support</li><li><strong>Geographical coverage:</strong> Global, across all regions and countries</li><li><strong>Available at:&nbsp;</strong>Online <a href=\"http://apps.who.int/gho/data/node.home\">here</a></li></ul>\n",
        "protected": false
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    "excerpt": {
        "rendered": "Tobacco smoking is one of the world\u2019s largest health problems today.",
        "protected": false
    },
    "date_gmt": "2013-05-23T22:34:01",
    "modified": "2023-08-30T15:35:02",
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    "menu_order": 276,
    "ping_status": "closed",
    "authors_name": [
        "Hannah Ritchie",
        "Max Roser"
    ],
    "modified_gmt": "2023-08-30T14:35:02",
    "comment_status": "open",
    "featured_media": 40470,
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