Up in Smoke: Tobacco Use by Country

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March 23, 2012 --

According to a joint report published this week by the American Cancer Society and World Lung Foundation, around six million people died last year from smoking. In addition to the human cost, the World Health Organization also estimated that the global cost of dealing with health conditions tied to tobacco use was $500 billion. In the United States, tobacco use has been curbed as a result of highly visible public health campaigns against cigarette manufacturers following decades of denials by the industry over the health risks of smoking. Smoking is still responsible for high rates of fatal health conditions, including heart disease and certain cancers. There are many other markets, however, where tobacco companies don't have the same history of litigation or the same kind of public health campaigns against their product. Not only do consumption rates skew higher, but so do deaths per capita as a result of smoking. Although nations may have signed on to the World Health Organization's Framework Convention on Tobacco Control, which mandates the implementation of legislation to curb tobacco use, many of the signatories are simply not enforcing their own laws, according the joint report. Find out which countries have some of the highest number of smokers -- both among adults and minors -- and the public health dilemmas facing these countries as a result.

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Tobacco use is the single highest cause of death in the People's Republic. According to the report, China lost around 1.2 million people out of the country's population of 1.3 billion people to health complications as a result of smoking. The American Cancer Society adds that the number could climb to 3.5 million by the end of the decade. Given China's population, it should come as no surprise that the People's Republic is also the world's largest cigarette market, both in terms of production and consumption. China accounts for nearly 40 percent of all cigarettes consumed in 2009. There are nearly 350 million smokers in China, according to a report in The People's Daily, 50 million of which are young people. And up to 540 million are exposed to secondhand smoke. The People's Republic has tried to deter consumers from buying tobacco through price hikes, but that hasn't yet had an impact, according to China's minister of industry and information technology, Miao Wei.

In Greece, cigarette smoking is higher per capita than in any other country. In 2008, Greece's 3.8 million smokers consumed roughly 3,055 cigarettes annually per capita, according to the Seattle Times. Around 40 percent of adults in Greece smoke, significantly higher than the average of 29 percent in other European Union nations, according to BBC News. Youth smoking is also a problem in Greece. According to rough estimates, between 10 and 32 percent of 15-year-olds in Greece smoke, as well as many as 50 percent of 16- to 19-year-olds, according to one study. The Greek government has been trying to reduce smoking through modest efforts intended to limit tobacco use. In 2010, Greece passed a law banning smoking in public places and in tobacco advertisements themselves. Hefty fines will be levied against smokers and businesses that violate the law.

According to the report, Turkey has the highest mortality rate of any nation in terms of men dying from health complications relating to smoking. Around 37 percent of deaths among men in Turkey in 2004 were the result of tobacco use. Despite the passage of laws banning smoking in public places and taxing cigarettes to raise the price, nearly one-third of Turkey's population smokes, and that rate is rising.

Although Turkey has the highest mortality rates for men when it comes to fatal conditions related to smoking, the Maldives has the largest percentage of women who succumb to fatal tobacco-related health conditions. According to the joint report, nearly a quarter of women in the Maldives died in 2004 because of smoking. The Maldives may only have a population of 360,000, but they imported some 346 million cigarettes in 2010, according to a report quoting the Maldives Customs Service.

Lebanon has the highest percentage of adult smokers in the world, according to a 2009 report from the World Health Organization (PDF) using available data on national smoking rates. Fifty-eight percent of Lebanon's adults smoke. When it comes to youth smoking, some 65 percent of boys age 13 to 15 use tobacco. Lebanon also has a smoking culture that includes not only cigarette consumption but the use of a water pipe than can be just as damaging as cigarette smoke, despite perceptions to the contrary, according to CNN. In 2011, as part of an effort to curb the prevalence of tobacco use, Lebanon's parliament passed a bill banning smoking in public places, like restaurants, cafes and offices, as well as airplanes, according to the Lebanese newspaper The Daily Star.

Although tobacco isn't the only factor contributing to Russia's shrinking population, which has even been called a demographic crisis, smoking is a major cause of Russia's exceedingly high death rates linked to non-natural causes. (Alcohol abuse is the top non-natural killer.) Around 44 million of Russia's 138 million people smoke, according to government estimates. Up to 400,000 people in Russia die annually due to tobacco-related causes, as reported by Radio Free Liberty/Radio Europe. Smoking is not only widespread, but tobacco itself is cheap. According to that same RFE/RL report, cigarettes are actually cheaper than chocolate because of a lack of taxes intended to raise the price and discouraging new smokers. Unlike many other developed nations, Russia doesn't yet have laws on the books banning smoking in public places. That could change by 2014, however, when Russia is due to host the Winter Olympics. The health ministry intends to impose stringent smoking bans by then, according to the Moscow Times.

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