Tobacco use is a major contributor to the Western Pacific Region’s disease burden. In both developed and developing countries within the Region, tobacco consumption causes or aggravates several chronic diseases—such as cancer, heart disease, chronic obstructive pulmonary disease, peripheral vascular disease, osteoporosis, hyperthyroidism and hypothyroidism, and diabetes—that together comprise up to 18% of the total disability-adjusted life years (DALYs) lost. These estimates do not include the years of healthy life lost by non-smokers whose health is compromised by exposure to second-hand smoke. Moreover, the long lead time between exposure to tobacco smoke and the development of clinical disease and the rapidly increasing pool of young smokers in the Western Pacific imply that the consequences of tobacco use within the Region will be far greater in the future, unless action is taken immediately to curb tobacco use.
Much of the disease burden and premature mortality attributable to tobacco use disproportionately affect the poor. Worldwide, poor and uneducated men are more likely to smoke than men with higher incomes or education. In those countries where reliable data on mortality exist, much of the excess mortality of poor and less-educated men can be attributed to smoking. Furthermore, smokers who live in low- and middle-income countries quit less often. For example, while in most high-income countries about 30% of men are former smokers, only 2% of men in China had quit in 1993, and only 10% of Vietnamese males had given up smoking in 1997.
Poverty and tobacco use are linked in other ways. Several studies have shown that in the poorest households of some low-income countries, as much as 10%-17% of total household expenditure is on tobacco. This mean impoverished families have less money to spend on essential items such as food, health care and education. Indeed, tobacco's role in exacerbating poverty has not been fully elucidated, and requires greater scrutiny.
The economic costs of tobacco use to society are staggering. The high price of treating tobacco-related diseases is compounded by productivity losses. Smokers are less productive workers, due to increased sickness. Deaths from tobacco often occur during the productive years of life, depleting a nation’s workforce.
In addition, there is growing concern among Member States in the Western Pacific Region regarding the increasing numbers of women and children exposed to the harm of tobacco. Already, a number of Pacific island countries have extremely high rates of tobacco use, involving both chewing and smoking, among their women. Recent data from the Global Youth Tobacco Survey (GYTS) indicate a disturbing high rate of tobacco use, and early age of initiation, among the Region’s youth. A separate issue involves the countless numbers of women and children who are exposed to second-hand smoke, particularly in countries such as Cambodia, China, the Philippines and Viet Nam, where smoking rates among men are extremely high.
The addictive properties of nicotine make cessation difficult, even for those tobacco users who are highly motivated to quit. This, coupled with a lack of effective cessation guidelines and programmes in many Western Pacific Region countries, particularly addressing the issue of chewing tobacco, and the high cost of pharmacologic treatment for nicotine addiction, are challenges that Member States need to address.
- Every year, 4.9 million people lose their lives to smoking.
- Every seven seconds, someone in the world dies from a tobacco-related illness.
- One in five tobacco-related deaths occurs in the Western Pacific.
- Smokers are exposed to over 4000 toxic substances in cigarette smoke. Over 25 of these are known human carcinogens.
- Tobacco causes over 40 diseases, many of them fatal or disabling. Smoking is responsible for over 90% of all cases of lung cancer, 75% of chronic bronchitis and emphysema cases and nearly 25% of cases of ischaemic heart disease. Chewing tobacco causes a significant proportion of oral cancer.