LONDON -–Women in developing countries are starting to smoke at younger ages, according to a study that found "alarming patterns" of tobacco use around the world.
Despite years of anti-smoking measures being encouraged across the world, most developing countries have low quit rates, according to the study in The Lancet medical journal on Friday -- and tobacco is likely to kill half its users.
Wide differences exist in the rates of smoking between genders and nations, as well as major disparities in access to effective anti-smoking policies and treatments.
"Although 1.1 billion people have been covered by the adoption of the most effective tobacco-control policies since 2008, 83 percent of the world's population are not covered by two or more of these policies," Gary Giovino of the University at Buffalo School of Public Health and Health Professions in New York, who led the research, told Reuters.
Such measures include legislation in some developed nations banning smoking in public places, imposing advertising bans and requiring more graphic health warnings on cigarette packets.
The findings come as the world's leading tobacco firms, British American Tobacco, Britain's Imperial Tobacco, Philip Morris and Japan Tobacco lost a crucial legal appeal in Australia this week against the introduction of plain tobacco packaging.
Australia's planned "no logo" laws are in line with World Health Organization (WHO) recommendations and are being watched closely by Britain, Norway, New Zealand, Canada and India, which are considering similar measures to help fight smoking.
Tobacco kills up to half of its users, according to the WHO. Smoking causes lung cancer, which is often fatal, and other chronic respiratory diseases. It is also a major risk factor for cardiovascular diseases, the world's number one killers. Other forms of tobacco use include snuff or chewing tobacco.
Giovino said his findings "reinforce the need for effective tobacco control."
Higher rate of smoking in men
Using data from Global Adult Tobacco Surveys (GATS) carried out between 2008 and 2010, Giovino's team compared patterns of tobacco use and cessation in people aged 15 or older from 14 low- and middle-income countries. They included data from Britain and the United States for comparison.
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They found disproportionately high rates of smoking among men -- at an average 41 percent versus 5 percent in women -- and wide variation in smoking prevalence between GATS countries, ranging from about 22 percent of men in Brazil to more than 60 percent in Russia.
Rates of female smoking ranged from 0.5 percent in Egypt to almost 25 percent in Poland. Women in Britain and the United States also had high smoking rates, at 21 percent and 16 percent respectively.
A recent study by the Centers for Disease Control found that the rate of decline in youth smoking in the United States has virtually ceased in recent years.
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The new study in The Lancet found that around 64 percent of tobacco users smoke manufactured cigarettes, although loose-leaf chewing tobacco and snuff were particularly common in India and Bangladesh.
Giovino also pointed to the link between tobacco use and escalating health-care costs.
"Tobacco contributes an enormous burden to the health care system in developed countries, and that scenario will play out in the not-too-distant future in low and middle income countries. It already has in many countries, in India for example," Giovino told the U.S. government-funded Voice of America broadcaster.
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Hundreds of millions of smokers in China
With an estimated 301 million tobacco users, China has more than any other country, closely followed by India with almost 275 million. Other countries included in the study were Bangladesh, Mexico, Philippines, Thailand, Turkey, Ukraine, Uruguay and Vietnam.
The researchers said the rise in tobacco use among young women was of particular concern.
Researchers also said that powerful pro-tobacco forces were at work in countries such as China.
"The China National Tobacco Company has supported elementary schools in China, dozens and dozens of them. And they use their support to promote propaganda about tobacco use, and they are basically telling students that genius comes from hard work and tobacco helps them to be successful. That to me is mind boggling, that a government would tell its children to use tobacco to be successful when tobacco will addict them and shorten their lives," Giovino told Voice of America.
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In a commentary about the study also published in The Lancet, Jeffrey Koplan from Emory University in Atlanta and Judith Mackay from the World Lung Foundation in Hong Kong called for more investment in tobacco control measures, saying current under-funding was "extraordinary."
In low income countries, they said, for every $9,100 received in tobacco taxes, only $1 was spent on tobacco control.
Cigarettes are to be banished from sight in England's shops. After 2015, retailers won't be allowed to display tobacco. The British government is also considering whether to require tobacco products be sold in plain packaging. ITV's Chris Choi reports.
The WHO says tobacco already kills around 6 million people a year worldwide, including more than 600,000 non-smokers who die from exposure to second-hand smoke.
By 2030, if current trends continue, the WHO predicts tobacco could be killing 8 million people a year.
Reuters contributed to this report.
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