world cancer report - iarc

Region Deaths due to % of total deaths Years of life lost due to % of total years of
tobacco use (1,000s) (all causes) tobacco use (1,000s) life lost (all causes)
Established market economies 1,286 14.9 11,607 21.2
Former socialist economies of Europe 1,101 22.7 10,072 26.3
India 1,523 13.3 18,183 12.0
China 2,229 16.0 23,418 18.0
Other Asian countries and islands 681 8.8 7,475 7.7
Sub-Saharan Africa 298 2.9 3,945 1.7
Latin America and the Caribbean 447 9.4 4,888 8.8
Middle East 817 12.3 9,477 9.2
World 8,383 12.3 88,129 10.3
Developed regions 2,387 17.7 20,742 23.4
Developing regions 5,996 10.9 67,386 8.7
Table 4.2 The estimated burden of mortality attributable to tobacco use in 2020. Numbers of deaths and years of life lost due to tobacco use are shown. These
figures are also expressed as a percentage of the total numbers of deaths and years of life lost from all causes.
areas include pricing, smuggling, tax-free
products, advertising and sponsorship,
the Internet, test methods, package
design and labelling, agriculture and information
sharing. These topics partly overlap
with those necessary for any national
tobacco control legislation, particularly
actions to limit supply, including those calculated
to modify the product and limit its
availability or by modifying people's attitudes
[11]. In respect of affecting supply,
and apart from banning the product,
options include modifying the composition
of tobacco and in particular setting limits
for selected constituents (tar content),
changing the presentation (information
provided, health warning, generic packaging),
controlling advertising and sales promotion,
and increasing the price paid by
consumers through taxation. So far as
demand is concerned, steps may be taken
to restrict smoking in public places and at
the workplace, to prevent youth from
smoking and to make health education
compulsory. Elements of legislation of
special importance for young people
130 Prevention and screening
include restriction of advertising, banning
of smoking in schools and other places
where children and adolescents congregate
and, finally, educating children.
Approaches to control of tobacco-related
cancer can be divided between those
directed towards health protection and
those acting through health promotion.
Health protection
Health protection approaches have been
effective in reducing tobacco consumption
in many countries. A 1% increase in
the price of tobacco products is followed
by a 0.5-0.8% decrease in sales. Tax
increases that raise the real price of cigarettes
by 10% are considered to reduce
smoking by about 4% in high-income countries
and by about 8% in other countries.
Furthermore, increasing taxes on tobacco
products is easy to implement. However,
this measure can be seen as a “tax on the
poor”, in view of the increasing prevalence
of smoking with lower social class (Fig.
4.2). Reducing subsidies for tobacco
growing is an approach complementary to
increasing taxes. Subsidies for tobacco
growing are very important: for example,
in 1990, the European Union spent more
than 700 million pounds sterling for this
purpose, as compared to slightly more
than 5 million pounds for tobacco control
initiatives. In many developing countries,
tobacco yields a higher net income for the
producer than most food crops.
Restrictions in sales of tobacco products
concern mainly the youth. The rationale
for this is that most smokers take up their
habit before age 18. Restrictions may
include a complete ban of sales, a ban of
automatic vending machines, and banning
free distribution of tobacco products.
Promotion of a tobacco-free environment
has focused on hospitals and other health
services, schools, workplaces, as well as
different public settings. Separate spaces
for smokers are often provided; sometimes
a workplace ban only concerns
areas where clients or the public are present.
The strongest resistance against any
restriction often comes from owners and
managers of settings receiving the public,