John R. Seffrin, PhD

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A Ticking Time Bomb The Global Tobacco Pandemic
Current and Future Scenarios
Global Tobacco-Free Research Initiative Stanford,
California May 15, 2008

• John R. Seffrin, PhD
• National Chief Executive Officer
• American Cancer Society

2
A Ticking Time Bomb The Global Tobacco Pandemic
Current and Future Scenarios
Global Tobacco-Free Research Initiative Stanford,
California May 15, 2008

• John R. Seffrin, PhD
• National Chief Executive Officer
• American Cancer Society

3
Global Smoking Prevalence

• There are currently 1.3 billion smokers in the
  world.
• Asia Central and Eastern Europe and the former
  Soviet Union have the highest smoking rates in
  the world with overall country rates as high as
  47.
• One-third of the global population age 15 and
  older smokes.

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Nearly 2/3 of the Worlds Smokers Live in Just 10
Countries
More than 40 live in just two countries.
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Smoking and Secondhand Smoke Damage Every Part of
the Body
Secondhand Smoke
Smoking
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Global Smoking Deaths

• More than 600 million people alive today will die
  from smoking-related causes half of them
  children.
• Cigarettes kill half of all lifetime users. Half
  of all deaths from smoking occur in middle age
  between 35 and 69 years old, when individuals are
  most productive.

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Economic Effects of Tobacco Use

• The WHO estimates the annual global cost of
  tobacco to be US500 billion a figure higher
  than the GDP of 174 of the 192 UN members.

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Economic Effects of Tobacco Use (continued)

• For nearly 50 of the worlds population, a pack
  of Marlboros costs approximately half of a
  familys daily income.
• Smoking-related costs can contribute up to 15 of
  total health care costs in high-income countries.

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Global Tobacco Control is Underfunded
Globally, tobacco tax revenues are 500 times
higher than spending on tobacco control. In low-
and middle-income countries, tax revenues are
5,000 times higher.
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Only 5 of World Covered by Effective Tobacco
Control Policies
5 or less benefit from effective interventions
to reduce use
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Four Stages of the Tobacco Pandemic
STAGE 1 STAGE 2 STAGE 3
STAGE 4

• Sub-
• Saharan
• Africa

• Western
• Europe, UK
• USA
• Canada
• Australia

• China
• Japan
• Southeast Asia
• Latin America
• North Africa

• Eastern Europe
• Southern Europe

Countries in each stage
Adapted from Lopez AD, Collishaw NE, Piha T. A
descriptive model of the cigarette epidemic in
developed countries. Tobacco Control, 1994,
3242-247.
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Tobacco Deaths in the Industrialized and
Developing World, 2000 and 2030
While tobacco-related deaths will only increase
slightly in the industrialized world during the
next 30 years, they will more than triple in the
developing world.

• Industrialized countries
• Developing countries

WHO World Health Report 1999.
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World Tobacco Deaths -if Current Smoking
Patterns Continue
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Reversing this entirely preventable epidemic
must now rank as a top priority for public health
and for potential leaders in every country of
the world.

• Dr. Margaret Chan, WHO Director-General

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Tobacco Control A Global Remedy

• We know what to do NOW
• Educate the public about the dangers of tobacco
  use.
• Reduce the number of physicians who smoke.

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Tobacco Control A Global Remedy (continued)

• Make health care facilities smoke-free.
• Protect all nonsmokers from secondhand smoke.
• Regulate tobacco and other dangerous products.
• Raise cigarette excise taxes.
• Implement and enforce the Framework Convention on
  Tobacco Control.

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California An Anti-Tobacco Pioneer With Work
to be Done

• Successes
• Tobacco taxes
• Smoke-free laws
• Lower adult smoking rates

• Needed improvements
• Tobacco taxes
• Youth smoking rates

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California An Anti-Tobacco Pioneer With Work
to be Done

• Successes
• Tobacco taxes
• Smoke-free laws
• Lower adult smoking rates

• Needed improvements
• Tobacco taxes
• Youth smoking rates

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WHO Recommendations for Global Tobacco Control
Monitor tobacco use and prevention
policies Protect people from tobacco smoke Offer
help to quit tobacco use Warn about the damages
of tobacco use Enforce advertising/promotion/spons
orship bans Raise taxes on tobacco
Source MPOWER, WHO 2008
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Good News

• What will the effects of turning the tide be?
• Hundreds of millions of lives could be saved.
• Lung cancer could virtually disappear as a public
  health menace.
• Global heart disease risks could be reduced by as
  much as 25 percent.
• Trillions of dollars will be saved from
• health care expenditures and redirected
• to research and public health.

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Thank you.