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No Butts About It, Tobacco Kills

CorpWatch, San Francisco Tobacco Free Coalition, and San Francisco Tobacco Free Project
June 30th, 1997

The following was excerpted from the World Health Organization's Tobacco Use: A Public Health Disaster

Tobacco is fast becoming a greater cause of death and disability than any single disease

At present, it is estimated that tobacco kills over 3 million people per year. Based on current trends, however, the death toll will rise to 10 million deaths per year by the 2020s or 2030s, with 70% of those deaths occurring in developing countries. According to WHO estimates, there are approximately 1.1 thousand million smokers in the world -- about one-third of the global population aged 15 years and over. Globally, approximately 47% of men and 12% of women smoke. In developing countries, available data suggest that 48% of men smoke as do 7% of women, while in developed countries, 42% of men and 24% of women smoke.

Tobacco is a risk factor for some 25 diseases and while its effects on health are well known, the sheer scale of its impact on global disease burden may still not be fully appreciated. No SINGLE disease is expected to make such a giant claim on health as this one risk factor. Estimates indicate that tobacco is already responsible for about 2.6% of the total death and disease burden, and that it is projected to triple its share to 8.9% of the total by the year 2020. For each 1 000 tonnes of tobacco produced, about 1 000 people will eventually die.

In the more developed countries, the impact of tobacco on the health of men is being manifested at present, although it has yet to reach its peak among women. The epidemic is only now beginning in low- and middle-income countries. The biggest and sharpest increases in disease burden are expected in China and India, where the use of tobacco has grown most steeply. If current trends continue, two to three million annual tobacco-caused deaths are predicted for China alone by the 2020s.

Smoking shortens life span

The risk at the individual level is even more alarming. Based on current data, lifelong smokers, on average, have a 50% chance of dying from tobacco. And half of these will die in middle age, before age seventy. Smokers who die from smoking before age 70 will lose, on average, 22 years of normal life expectancy.

Of all the diseases causally associated with smoking, lung cancer is the best known. However, smoking actually causes more deaths from diseases other than lung cancer. In 1995, there were 514 000 smoking-caused lung cancer deaths in developed countries, compared to 625 000 smoking attributable deaths from heart and other vascular diseases in the same year. Studies in the United Kingdom have shown that smokers in their 30s and 40s are five times more likely to have a heart attack than non-smokers.

Tobacco Addiction

All tobacco products contain substantial amounts of nicotine, which is absorbed readily from tobacco smoke in the lungs and from smokeless tobacco in the mouth or nose. Nicotine has been clearly recognized as a drug of addiction, and tobacco dependence has been classified as a mental and behavioural disorder according to the WHO International Classification of Diseases, ICD-10 (Classification F17.2). Experts in the field of substance abuse consider tobacco dependence to be as strong or stronger than dependence on such substances as heroin or cocaine. Smoking typically begins in adolescence. If a person remains smoke-free throughout adolescence, it is highly unlikely that he or she will ever begin smoking. Therefore, it is vital that intensive efforts be made to help young people stay smoke-free.

Although 75-85% of smokers, where this has been measured, want to quit and about one third have made at least three serious attempts, less than half of smokers succeed in stopping permanently before the age of 60. Nicotine dependence is clearly a major barrier to successful cessation.


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