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Emerging economies buck trend for decline in smoking（610 words）
By Federica Cocco
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Smoking rates have risen sharply in a small number of countries, running against a trend in which world tobacco is in retreat.
Tobacco use is becoming increasingly concentrated in low- and middle-income countries that are home to 80 per cent of the world’s 1bn smokers, according to the World Health Organisation.
According to a study out today from the National Cancer Institute and the WHO, the number of tobacco-related deaths is projected to increase from about 6 million deaths annually to about 8 million annually by 2030, with more than 80 per cent of these occurring in low- and middle-income countries.
Much of the increase is in evidence in emerging markets where consumers are becoming wealthier, and tobacco companies are seizing the opportunity to make cigarettes more readily available.
Higher rates have been observed in some countries in Africa where smoking was never part of the culture. Across the continent the prevalence rate was 14 per cent, compared with 23 per cent in the Americas and 31 per cent in the eastern Mediterranean, according to a survey by The Lancet, the medical journal.
The influence of tobacco companies is also evident in Indonesia, where the smoking rate rose almost 30 per cent over the past 15 years, making the country home to more than 70m smokers.
Among adult men, 67.4 per cent are smokers, and Indonesia is on track to displace China, followed by Russia and the US, as home to the world’s largest smoking population.
But while heavy-smoking countries have enforced strict anti-tobacco policies — Russia has among the strongest tobacco control laws in the world — Indonesia has so far resisted.
The Industry Ministry in Jakarta announced a year ago that its cigarette production would double to 524.2bn a year by 2020 in a move that was, however, blocked by the Supreme Court.
Despite warnings of a public heath disaster and estimates putting healthcare costs at up to Rp11tn a year — equivalent to 0.3 per cent of the country’s gross domestic product — the government has still refused to sign the WHO convention.
Much of the resistance is linked to the influence tobacco companies wield at a governmental level, where they are a source of significant revenues, and in the media, which they support through lucrative advertising.
Still, the government has shown some initiative, mainly by curtailing the scope for cigarette advertising and raising some duties on tobacco-related products.
In China, the world’s largest tobacco consumer and producer, more cigarettes are smoked than in the next top 29 consumer countries combined.
The country signed the convention in 2006 but has only just begun to implement it in earnest after being warned that a third of young Chinese men would die prematurely from smoking.
In the Arab world, the spread of tobacco is eliciting a minimal response at the public health and policy levels. In Jordan, the proportion of smokers has risen from 25 per cent in 2000 to 40 per cent in 2015, and in Bahrain from 12 per cent to nearly 30 per cent.
The increase can be traced back to the 1990s when waterpipe smoking became popular again, thanks in part to the introduction of ma’ assel, or flavoured tobacco. A café culture that has become increasingly dependent on waterpipe smoking is presenting a challenge to advocates of smoking bans.
Outright bans and higher taxes are the most effective means to curb smoking, says the WHO, which adds that studies show that populations tend to approve of higher taxes when the beneficiary is public healthcare. Without these steps, poorer countries will stand to bear the health, environmental and economic costs of increased smoking-related deaths, a price they can ill-afford.
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