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The Global Tobacco Epidemic

In 1964, the U.S. Surgeon General Report on Smoking and Health created shockwaves by confirming what many scientists had suspected for decades: cigarette smokers were at higher risk of dying, and of suffering from lung cancer, coronary heart disease, emphysema and chronic bronchitis. For the first time, Americans were confronted with the notion that smoking cigarettes was a deadly habit. Since that time, large-scale public health interventions were progressively rolled out to help not only inform Americans about the dangers of smoking, but also to prevent them from starting to smoke, to help them quit, and to protect non-smokers from second-hand smoke. Not everyone was convinced – about 18.4% of American adults still smoke- but the prevalence of the problem has greatly diminished over time. Similar scenarios unfolded in most high-income nations over the past 25 years, and consumption of tobacco products in occidental countries is slowly decreasing.

Yet, the consumption of tobacco products around the world has never been so high, in part because the tobacco epidemic has now become a global phenomenon. Faced with increasing health regulations in developed countries, the tobacco industry turned to new markets to find new users. And what better markets than those of developing economies, where governments and civil societies had not yet mobilized to protect the health of their citizens from this emerging risk factor?  Low- and middle-income economies, once thought of as mainly afflicted by infectious conditions and basic health and sanitation challenges, have started to face a double burden of disease and are increasingly suffering from non-communicable diseases (NCDs) such as cancer, diabetes, cardiovascular disorders and chronic respiratory illnesses. The health profile of low- and middle-income countries is therefore changing rapidly, precipitating increases in health care costs and depriving families of income, and tobacco is one of the key risk factors driving this change. It is the single greatest preventable cause of NCDs, which are now the number one cause of premature death and disability worldwide, killing more people than HIV, tuberculosis and malaria combined.  

Cigarette consumption graph

Did you know that, around the world...?

  • One billion people smoke cigarettes.
  • Half of cigarette users will die because they smoke.
  • Six million people die every year because of tobacco. This figure includes five million smokers, but also about 600,000 non-smokers exposed to second-hand smoke.
  • It is expected that, without any action, eight million people will die annually, by 2030. Over 80% of these deaths will be in low- and middle-income countries.
  • Non-communicable diseases (NCDs) kill 35 million people annually, 80% of which are in low- and middle-income countries. Tobacco is responsible for 1 out of 6 NCD deaths.
  • 100 million people were killed by tobacco in the 20th century – as many as 1 billion are expected to die in the 21st century.
  • Tobacco smoking is an important risk factor for tuberculosis, and can increase the risk of death of infected patients.
  • Not only cigarettes kill. Smokeless tobacco products, such as chewing tobacco, are commonly used in many low- and middle-income countries, and also cause oral cancers, hypertension, and heart disease.


For more information on the global tobacco epidemic and its impact on NCDs, please visit our American Cancer Society Global Tobacco Control Resources page.