EUF Vol. 1 No. 1

3 96

Review – Epidemiology
Global and Regional Patterns of Tobacco Smoking and Tobacco
Control Policies
Farhad Islami Michal Stoklosa Jeffrey Drope Ahmedin Jemal
a Surveillance and Health Services Research, American Cancer Society, Atlanta, GA, USA; bEconomic and Health Policy Research, American Cancer Society,
Atlanta, GA, USA
ava il abl e at
journa l homepage:
Article info
Article history:
Accepted October 20, 2014
Associate Editor:
James Catto
Keywords:
E-cigarettes
Global
Review
Smoking
Tobacco control
Abstract
Context: Tobacco smoking is a major worldwide cause of morbidity and mortality from
various diseases, including urologic diseases.
Objective: We reviewed, at global and regional levels, the prevalence and trends of
tobacco smoking and legislative and regulatory efforts around tobacco control. We also
provided information about electronic cigarette (e-cigarette) use.
Evidence acquisition: We used several sources to present the most up-to-date informa-
tion from national surveys, including the Global Adult Tobacco Survey, the Global
Tobacco Control Report, and the Global Youth Tobacco Survey.
Evidence synthesis: Smoking prevalence has been decreasing globally, although trends
in smoking vary substantially across countries and by gender. Among men, smoking
prevalence in most high-income countries started to decrease in the mid-1990s,
followed after a few decades by generally smaller decreases in some low- and mid-
dle-income countries (LMICs). However, there has been no change, or there has even
been an increase, in smoking prevalence in many other LMICs. Countries with the
highest male smoking prevalence are located in East Asia, Southeast Asia, and Eastern
Europe. Similar to men, smoking prevalence for women has been decreasing in most
high-income countries and some LMICs, although the decrease began later and was
slower than that for men. Except in a few countries, smoking is much less common for
women than for men. Most countries with the highest smoking prevalence inwomen are
in Europe. Countries that have implemented the best practices for tobacco control,
including monitoring, smoke-free policies, cessation programs, health warnings, adver-
tising bans, and taxation, have been able to reduce smoking rates and related harms.
E-cigarette use has rapidly increased since its introduction to the market.
Conclusions: Health care providers should advise smoking patients about quitting
smoking. Countries must improve the implementation and enforcement of tobacco
control policies. Particular attention should be paid to preventing an increase in smoking
among women in LMICs.
Patient summary: We reviewed smoking prevalence and tobacco control policies in
various regions. Countries with more effective tobacco control programs have seen
higher reductions in smoking prevalence and, consequently, in smoking-related mor-
tality. Because both longer duration and higher intensity of smoking (amount of tobacco
smoked per day) are associated with an increased risk of tobacco-related diseases,
smokers should quit smoking as soon as possible.
# 2015 European Association of Urology. Published by Elsevier B.V. All rights reserved.
* Corresponding author. Surveillance and Health Services Research, American Cancer Society, Inc.,
250 Williams Street, Atlanta, GA 30303, USA. Tel. +1 404 982 3654; Fax: +1 404 321 4669.
E-mail address: (F. Islami).
2405-4569/# 2015 European Association of Urology. Published by Elsevier B.V. All rights reserved.