The Tobacco Atlas

The Tobacco Atlas

Foreword
Dr Gro Harlem Brundtland,
Director-General, World Health Organization
Preface
Acknowledgments
Photo Credits
About the Authors

1 The History of Tobacco

The global spread of tobacco from the Americas to the rest of the world. Historical highlights of
key events and action taken to curb the epidemic.

Part One: PREVALENCE AND HEALTH

2 Types of Tobacco Use

Different forms of smoking and other forms of tobacco, including cigarettes, pipes, bidis, reteks.

3 Male Smoking
Smoking prevalence among men. Trends in selected countries. Smoking among physicians. Top
10 countries. Tobacco industry quote.

4 Female Smoking
Smoking prevalence among women. Trends in selected countries. Where women smoke as much
as men. Where men smoke ten times as much as women. Tobacco industry quote.

5 Youth
Tobacco use prevalence among male and female youth. Passive smoking. Youth perception of
smoking. Tobacco industry quotes.

6 Cigarette Consumption
Annual cigarette consumption per person. Top 5 countries. Global increases from 1880 to 2000.
Increases in the average number of cigarettes smoked in China between 1952 and 1996.

7 Health Risks
How smoking harms you. Smoking in pregnancy. Deadly chemicals. Proportion of lung cancer,
COPD and ischaemic heart disease. Tobacco industry quotes.

8 Passive Smoking
Harm caused by passive smoking. Children exposed to passive smoking. Numbers affected by
passive smoking. Tobacco industry quotes.
9 Deaths
Deaths from tobacco use in men and women. Dying in your prime: 35- to 69-year-olds who die
from tobacco. Past and future deaths from tobacco: 1950 to 2030. Deaths in developed and
developing countries. Number of people alive today who will eventually die from tobacco.
Tobacco industry quote.

Part Two: THE COSTS OF TOBACCO

10 Costs to the Economy

Health care costs attributable to tobacco. Working days lost due to tobacco. Costs of fires and
litter collection. Tobacco industry quotes.

11 Costs to the Smoker

Cost of a pack of Marlboro cigarettes or equivalent international brand. Minutes of labour
worked to buy a packet of cigarettes. The cost of a pack of Marlboro cigarettes or equivalent
international brand compared with food or clothing.

Part Three: THE TOBACCO TRADE

12 Growing Tobacco
Land devoted to growing tobacco by country. Leading producers of tobacco leaves.
Deforestation due to tobacco.

13 Manufacturing Tobacco
Number of tobacco workers by country. Where the tobacco dollar goes. Less tobacco per
cigarette. Additives.

14 Tobacco Companies
Leading manufacturers by country. The Big Five: revenue and market share of leading
transnational tobacco companies. Tobacco industry quote.

15 Tobacco Trade
Cigarette exports by country. Top 10 cigarette importers. Top 10 leaf importers and exporters.
US import and export of tobacco leaves and cigarettes.

16 Smuggling
Estimated smuggled cigarettes as a percentage of domestic sales. Major recent or current
smuggling routes. Global smuggling. Tackling tobacco smuggling in the UK: projected
percentage of market share if action is or is not taken. Lost revenue in EU. Tobacco industry
quote.
Part Four: PROMOTION

17 Tobacco Industry Promotion

Most popular cigarette brand by country. World’s most popular brands. How the advertising
dollar is spent in the USA. Changes in cigarette marketing expenditure. Tobacco industry quote.

18 Internet Sales
Internet sales. Internet search for sites. Internet cigarette vendors in the USA. Test ordering from
12 websites. HM Customs and Excise quote. User comment posted on website.

19 Politics
Buying influence: expenditure on lobbying in the USA. Buying favours: tobacco companies’
contributions to federal candidates in the USA. Tobacco industry quotes.

20 Smokers' Rights Organisations

Location of smokers’ rights groups worldwide. Tobacco industry quotes.

21 Tobacco Industry Documents

Number of documents found on the Legacy website by country. Tobacco industry quotes.

Part Five: TAKING ACTION

22 Research
Global Youth Tobacco Surveys completed by country. Current foundation grant recipients.
Comparative National Institute of Health expenditure on tobacco compared with other health
problems. Published research: PubMed search for tobacco compared with other journal topics.
Journals devoted to tobacco control.

23 Tobacco Control Organisations

WHO, international and regional tobacco control organisations. Locations of all World
Conferences. Tobacco industry quote.

24 Legislation: Smoke-free Areas

Where smoking is prohibited or restricted in some areas at work, and where employers
voluntarily prohibit or restrict smoking. Sales before and after smoking bans in restaurants and
bars in California. Nicotine concentration in public places in Barcelona, Spain. The cost of
workplace smoking. Tobacco industry quote.

25 Legislation: Advertising Bans

Increases and decreases in adult cigarette consumption, and countries with comprehensive
advertising bans in the same period. Effect of advertising bans. Tobacco industry quotes.

26 Legislation: Health Warnings

Where health warnings are required by law.
Impact on smokers of Canadian warnings. Public support for visible health warnings. Tobacco
industry quote.
27 Health Education
World No Tobacco Day: participating countries, and themes from 1988 to 2002. Quit & Win
campaigns. Tobacco industry quotes.

28 Quitting
Percentages of ex-smokers. Quitting calendar:
the benefits of stopping smoking. Effects on deaths if smokers quit. Effect of smoking
restrictions at home and at work. Impact of interventions on quitting.

29 Price Policy
Tobacco tax as a proportion of cigarette price. Cigarette price increases compared with
consumption in the UK. Government income from tobacco. Cigarette tax as a proportion of price
in the USA. Tobacco industry quote.

30 Litigation
Legal action against the tobacco industry: personal injury, public interest, non-smokers’
and government lawsuits. Cases brought by the tobacco industry. Smuggling litigation. Tobacco
industry quote.

31 Projections by Industry
Projected rates of growth and decline of tobacco consumption by country 1998-2008. Regional
projections.

32 The Future
Epidemiology, health, economics, the tobacco industry, action taken projected to 2050.

Part Six: WORLD TABLES

Table A: The Demographics of Tobacco

Population. Adult prevalence. Youth smoking. Youth exposed to passive smoking. Cigarette
consumption. Quitting.

Table B: The Business of Tobacco

Land area devoted to growing tobacco; quantity produced. Number of tobacco workers; number
of cigarettes manufactured. Cigarette imports and exports; tobacco leaf imports and exports. Cost
of a pack of Malboro cigarettes or equivalent international brand; minutes of labour needed to
buy a pack of cigarettes. Tax as a proportion of cigarette price; tobacco tax revenues as a
percentage of total tax revenue. Tobacco industry documents.
 T h e To b a c c o A t l a s

“When one has a thorough knowledge of both the enemy and

oneself, victory is assured. When one has a thorough knowledge
of both heaven and earth, victory will be complete.”

— General Sun Tzu

The Art of War: A Treatise on Chinese Military Science
c. 500 B.C.
Publications of the World Health Organization
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The designations employed and the presentation of

the material in this publication do not imply the
expression of any opinion whatsoever on the part
of the World Health Organization concerning the
legal status of any country, territory, city or area or
of its authorities, or concerning the delimitation of
its frontiers or boundaries. Dotted lines on maps
represent approximate border lines for which there
may not yet be full agreement.
The mention of specific companies or of certain
manufacturers’ products does not imply that they
are endorsed or recommended by the World
Health Organization in preference to others of a
similar nature that are not mentioned. Errors and
omissions excepted, the names of proprietary
products are distinguished by initial capital letters.
The World Health Organization does not
warrant that the information contained in this
publication is complete and correct and shall not
be liable for any damages incurred as a result of its
use.
The authors alone are responsible for the views
expressed in this publication.
The Tobacco Atlas © World Health Organization 2002
All rights reserved
First published 2002
10 9 8 7 6 5 4 3 2 1
ISBN 92 4156 209 9
Produced for the World Health Organization by
Myriad Editions Limited
6–7 Old Steine, Brighton BN1 1EJ, UK
http://www.MyriadEditions.com
Edited and co-ordinated for Myriad Editions by
Paul Jeremy and Candida Lacey
Design and graphics by Paul Jeremy
and Corinne Pearlman
Maps created by Isabelle Lewis
Printed and bound in Hong Kong
Produced by Phoenix Offset Limited
under the supervision of Bob Cassels,
The Hanway Press, London
This book is sold subject to the condition that it shall not by
way of trade or otherwise, be lent, re-sold, hired out, or
otherwise circulated without the publisher’s prior consent
in any form of binding or cover other than that in which it
is published and without a similar condition including this
condition being imposed on the subsequent purchaser
Foreword 9 6 Cigarette Consumption
Dr Gro Harlem Brundtland,
Director-General, World Health Organization
Preface
Acknowledgments
Photo Credits
About the Authors
1 The History of Tobacco
The global spread of tobacco from the Americas
to the rest of the world. Historical highlights of
key events and action taken to curb the epidemic.
Part One: PREVALENCE AND HEALTH
2 Types of Tobacco Use
Different forms of smoking and other forms
of tobacco, including cigarettes, pipes, bidis,
kreteks.
3 Male Smoking 24
Smoking prevalence among men. Trends in
selected countries. Smoking among physicians.
Top 10 countries. Tobacco industry quote.
4 Female Smoking 26
Smoking prevalence among women. Trends in
selected countries. Where women smoke as
much as men. Where men smoke ten times
as much as women. Tobacco industry quote.
5 Youth 28
Tobacco use prevalence among male and female
youth. Passive smoking. Youth perception of
smoking. Tobacco industry quotes.
CONTENTS
30
Annual cigarette consumption per person.
Top 5 countries. Global increases from 1880 to
2000. Increases in the average number of cigarettes
11 smoked in China between 1952 and 1996.
13 7 Health Risks 32
How smoking harms you. Smoking in pregnancy.
15 Deadly chemicals. Proportion of lung cancer,
COPD and ischaemic heart disease. Tobacco
17 industry quotes.
8 Passive Smoking 34
18 Harm caused by passive smoking. Children exposed
to passive smoking. Numbers affected by passive
smoking. Tobacco industry quotes.
9 Deaths 36
Deaths from tobacco use in men and women.
Dying in your prime: 35- to 69-year-olds who die
from tobacco. Past and future deaths from tobacco:
22 1950 to 2030. Deaths in developed and developing
countries. Number of people alive today who will
eventually die from tobacco. Tobacco industry
quote.
Part Two: THE COSTS OF TOBACCO
10 Costs to the Economy 40
Health care costs attributable to tobacco.
Working days lost due to tobacco. Costs of fires
and litter collection. Tobacco industry quotes.
11 Costs to the Smoker 42
Cost of a pack of Marlboro cigarettes or equivalent
international brand. Minutes of labour worked to
buy a packet of cigarettes. The cost of a pack of
Marlboro cigarettes or equivalent international
brand compared with food or clothing.
Part Three: THE TOBACCO TRADE
12 Growing Tobacco 46
Land devoted to growing tobacco by country.
Leading producers of tobacco leaves. Deforestation
due to tobacco.
13 Manufacturing Tobacco 48
Number of tobacco workers by country. Where
the tobacco dollar goes. Less tobacco per cigarette.
Additives.
14 Tobacco Companies 50
Leading manufacturers by country. The Big Five:
revenue and market share of leading transnational
tobacco companies. Tobacco industry quote.
15 Tobacco Trade 52
Cigarette exports by country. Top 10 cigarette
importers. Top 10 leaf importers and exporters.
US import and export of tobacco leaves and
cigarettes.
16 Smuggling 54
Estimated smuggled cigarettes as a percentage
of domestic sales. Major recent or current
smuggling routes. Global smuggling. Tackling
tobacco smuggling in the UK: projected percentage
of market share if action is or is not taken. Lost
revenue in EU. Tobacco industry quote.
Part Four: PROMOTION
17 Tobacco Industry Promotion 58
Most popular cigarette brand by country. World’s
most popular brands. How the advertising dollar is
spent in the USA. Changes in cigarette marketing
expenditure. Tobacco industry quote.
18 Internet Sales 60
Internet sales. Internet search for sites. Internet
cigarette vendors in the USA. Test ordering from
12 websites. HM Customs and Excise quote. User
comment posted on website.
19 Politics 62
Buying influence: expenditure on lobbying in the
USA. Buying favours: tobacco companies’
contributions to federal candidates in the USA.
Tobacco industry quotes.
20 Smokers' Rights Organisations 64
Location of smokers’ rights groups worldwide.
Tobacco industry quotes.
21 Tobacco Industry Documents 66
Number of documents found on the Legacy
website by country. Tobacco industry quotes.
Part Five: TAKING ACTION
22 Research 70
Global Youth Tobacco Surveys completed by
country. Current foundation grant recipients.
Comparative National Institute of Health
expenditure on tobacco compared with other
health problems. Published research: PubMed
search for tobacco compared with other journal
topics. Journals devoted to tobacco control.
23 Tobacco Control Organisations 72
WHO, international and regional tobacco control
organisations. Locations of all World Conferences.
Tobacco industry quote.
24 Legislation: Smoke-free Areas 74
Where smoking is prohibited or restricted in some
areas at work, and where employers voluntarily
prohibit or restrict smoking. Sales before and after
smoking bans in restaurants and bars in California.
Nicotine concentration in public places in
Barcelona, Spain. The cost of workplace smoking.
Tobacco industry quote.
25 Legislation: Advertising Bans 76
Increases and decreases in adult cigarette
consumption, and countries with comprehensive
advertising bans in the same period. Effect of
advertising bans. Tobacco industry quotes.
26 Legislation: Health Warnings 78 31 Projections by Industry 88
Where health warnings are required by law. Projected rates of growth and decline of tobacco
Impact on smokers of Canadian warnings. Public consumption by country 1998-2008. Regional
support for visible health warnings. Tobacco projections.
industry quote.
32 The Future 90
27 Health Education 80 Epidemiology, health, economics, the tobacco
World No Tobacco Day: participating countries, industry, action taken projected to 2050.
and themes from 1988 to 2002. Quit & Win
campaigns. Tobacco industry quotes.
Part Six: WORLD TABLES 92
28 Quitting 82
Percentages of ex-smokers. Quitting calendar: Table A: The Demographics of Tobacco 94
the benefits of stopping smoking. Effects on deaths Population. Adult prevalence. Youth smoking.
if smokers quit. Effect of smoking restrictions at Youth exposed to passive smoking. Cigarette
home and at work. Impact of interventions on consumption. Quitting.
quitting.
Table B: The Business of Tobacco 102
29 Price Policy 84 Land area devoted to growing tobacco; quantity
Tobacco tax as a proportion of cigarette price. produced. Number of tobacco workers; number of
Cigarette price increases compared with cigarettes manufactured. Cigarette imports and
consumption in the UK. Government income from exports; tobacco leaf imports and exports. Cost
tobacco. Cigarette tax as a proportion of price in of a pack of Malboro cigarettes or equivalent
the USA. Tobacco industry quote. international brand; minutes of labour needed to
buy a pack of cigarettes. Tax as a proportion of
30 Litigation 86 cigarette price; tobacco tax revenues as a
Legal action against the tobacco industry: percentage of total tax revenue. Tobacco industry
personal injury, public interest, non-smokers’ documents.
and government lawsuits. Cases brought by the
tobacco industry. Smuggling litigation. Tobacco Glossary 110
industry quote.
Sources 113
Useful Contacts 125
Index 126

A message from
Dr Gro Harlem Brundtland
Director-General
World Health Organization
“M ore people smoke today than at any other
time in human history. One person dies every ten
seconds due to smoking-related diseases.
Research evidence in the past five years shows a
bleaker picture of the health danger of smoking
than previously realised. Tobacco is the biggest
killer, much bigger in dimension than all other
forms of pollution.
Children are the most vulnerable. Habits start in
youth. The tobacco industry knows it and acts
accordingly. This is a medical challenge, but also a
cultural challenge. Let us all speak out: tobacco is a
killer. It should not be advertised, subsidised or
glamourised.
Adolescents should not be allowed to mortgage
their lives to the seductive advertisements of the
industry. Girls and women are being targeted all
over the world by expensive and seductive tobacco
advertising images of freedom, emancipation,
slimness, glamour and wealth. Tobacco companies
should be accountable for the harm caused by
tobacco use.
The day I took office I launched the Tobacco
Free Initiative (TFI) to spearhead the struggle to
reverse the worsening trends in health caused by
tobacco and to add momentum to a critical public
health struggle. The initiative aims at heightening
global awareness of the need to address tobacco
consumption. It also seeks to build new
partnerships and strengthen existing partnerships
for action against tobacco; to commission policy
research to fill gaps; and, to accelerate national and
global policy to implement strategies.
The way it works illustrates the way we wish
WHO to work in the future making the most of
our own resources and knowledge and drawing
heavily on the knowledge and experience of others.
FOREWORD
Our goals are to:
• build “a vibrant alliance” between WHO,
UNICEF, the World Bank, and “partnerships with a
purpose” with non governmental organisations, the
private sector, academic/research institutions and
donors.
• try to get more people to work on and
support tobacco control activities and ensure that
more resources are committed to tobacco
research, policy and control.
• develop the Framework Convention on
Tobacco Control (FCTC), the world's first public
health treaty. The treaty will only be effective if it
works in conjunction with, and builds upon, sound
domestic interventions.
The good news is that the epidemic does not have
to continue this way. There is a political solution to
tobacco – a solution routed through ministries of
finance and agriculture as well as health and
education.
We know that tobacco control measures can
lead to a reduction in smoking as witnessed among
some member states. WHO, the World Bank and
public health experts have identified a combination
of the following as having a measurable and
sustained impact on tobacco use:
• increased excise taxes;
• bans on tobacco advertising, sponsorship and
9
marketing;
• controls on smoking in public places and
workplaces;
• expanded access to effective means of
quitting;
• tough counteradvertising;
• tight controls on smuggling.
These must all be implemented if the predicted
PREFACE
expansion of the epidemic as outlined in this atlas is
to be prevented.
The picture is far from bleak. Globally, we have “When I was young, I kissed my first woman and smoked
seen a sea change over the past few years. A my first cigarette on the same day. Believe me, never since
groundswell of local, national and global actions is have I wasted any more time on tobacco.”
moving the public health agenda ahead.
— Arturo Toscanini (1867-1957)
DR GRO HARLEM BRUNDTLAND
Geneva
June 2002

T his book is intended for anyone concerned with

personal or political health, governance, politics,
economics, big business, corporate behaviour, smuggling,
tax, religion, internet, allocation of resources, human
development and the future.
The atlas maps the history, current situation and some
predictions for the future of the tobacco epidemic up to
the year 2050.
It illustrates how tobacco is not just a simple health
issue, but involves economics, big business, politics, trade
and crimes such as smuggling, litigation and deceit.
The atlas also shows the importance of a multifaceted
approach to reducing the epidemic – by WHO, other UN
agencies, NGOs, the private sector and, in fact, the whole
of civil society.
The publication of this atlas marks a critical time in the
epidemic. We stand at a crossroads, with the future in our
hands. We can choose to stand aside; or to take weak and
ineffective measures; or to implement robust and enduring
measures to protect the health and wealth of nations.

JUDITH MACKAY, Hong Kong

MICHAEL ERIKSEN, Geneva
June 2002

10 11
 ACKNOWLEDGEMENTS
We would like to thank the Centers for Disease
Control and Prevention (CDC), USA, for
providing financial support for this atlas.
Many people have helped in the preparation of
this atlas. Firstly our thanks to all those at the
World Health Organization:
Headquarters, Geneva:
Joyce Bleeker, Noncommunicable Disease
Prevention and Health Promotion (NPH),
Noncommunicable Diseases and Mental Health
Cluster (NMH);
Douglas Bettcher, Tobacco Free Initiative (TFI),
Noncommunicable Diseases and Mental Health
Cluster (NMH);
David Bramley, Health Information
Management and Dissemination (IMD), Evidence
and Information for Policy Cluster (EIP);
Gian Luca Burci, Office of the Legal Counsel
(LEG);
Vera Luiza da Costa e Silva, Tobacco Free
Initiative (TFI), Noncommunicable Diseases and
Mental Health Cluster (NMH);
Emmanuel Guindon, Tobacco Free Initiative
(TFI) Noncommunicable Diseases and Mental
Health Cluster (NMH);
Ewa Carlsson Höpperger, Office of the Legal
Counsel (LEG);
Prabhat Jha, Commission on Macroeconomics
and Health (CMH), Evidence and Information for
Policy Cluster (EIP);
Alan Lopez, Evidence and Information for
Policy Cluster (EIP);
Garrett Mehl, Noncommunicable Disease
Prevention and Health Promotion (NPH),
Noncommunicable Diseases and Mental Health
Cluster (NMH);
Diana Munoru, Noncommunicable Disease
Prevention and Health Promotion (NPH),
Noncommunicable Diseases and Mental Health
Cluster (NMH);
El Atifi Mustapha, Tobacco Free Initiative (TFI),
Noncommunicable Diseases and Mental Health
Cluster (NMH);
Pekka Puska, Noncommunicable Disease
Prevention and Health Promotion (NPH),
Noncommunicable Diseases and Mental Health
Cluster (NMH);
Leanne Riley, Noncommunicable Disease
Prevention and Health Promotion (NPH),
Noncommunicable Diseases and Mental Health
Cluster (NMH);
Paula Soper, Tobacco Free Initiative (TFI),
Noncommunicable Diseases and Mental Health
Cluster (NMH);
Derek Yach, Noncommunicable Diseases and
Mental Health Cluster (NMH).
Regional offices:
Karen Klimowski, Charles Maringo, AFRO;
Fatimah M S El Awa, EMRO;
Patsy Harrington, Haik Nikogosian, Ionela Petrea,
EURO;
Heather Selin, Armando Peruga, PAHO;
Martha Osei, SEARO;
Harley Stanton, WPRO.
For their advice on particular maps and subjects,
we would like to thank the following:
2. Types of Tobacco Use
Samira Asma, CDC, USA; Prakash Gupta, Tata
Institute of Fundamental Research, India;
3. Male Smoking and 4. Female Smoking
Marlo Corrao, American Cancer Society, USA;
Amanda Sandford, ASH UK;
5. Youth
GYTS Coordinators; Wick Warren, CDC, USA;
6. Cigarette Consumption
Tom Capehart, Economic Research Service,
USDA; Prakash Gupta, Tata Institute of
Fundamental Research, India;
7. Health Risks
Gary Giovino, Roswell Park Cancer Institute, USA;
Corinne Pearlman, Comic Company, UK;
Jonathan Samet, Johns Hopkins Institute for Global
Tobacco Control, USA; Stan Shatenstein,
Communications consultant, Canada;
8. Passive Smoking
Clive Bates, ASH UK; Corinne Pearlman, Comic
Company, UK; Jonathan Samet, Johns Hopkins
Institute for Global Tobacco Control, USA; Wick
Warren, CDC, USA;
13
9. Deaths
Majid Ezzati, Resources for the Future, USA;
11. Costs to the Smoker
Luk Joossens, Belgium; Kenneth E Warner,
University of Michigan, USA; Anna White,
Partnership Programme, Essential Action's Taking
on Tobacco campaign; Ayda A. Yurekli, The World
Bank;
12. Growing Tobacco and 15. Tobacco Trade
Tom Capehart, USDA;
14. Tobacco Companies
Gene Borio, New York City, USA;
16. Tobacco Smuggling
Campaign for Tobacco Free Kids, USA; Luk
Joossens, Belgium; Eric LeGresley, Tobacco
Control Consultant, Ottawa, Canada;
18. Internet Sales
Chris Banthin, NorthEastern University, Boston,
USA; Greg Connolly, Mass Dept of Public Health,
USA; Kurt M. Ribisl, University of North Carolina
at Chapel Hill, USA; Kenneth Warner, University
of Michigan, USA;
19. Politics
Sibylle Fleitmann, European Network for Smoking
Prevention, Belgium; Anne Landman, Doc-Alert,
Colorado, USA;
21. Tobacco Industry Documents
Lisa Bero, University of California, San Francisco,
USA; Anne Landman, Colorado, USA; Jonathan
Liberman, VicHealth Centre for Tobacco Control,
Australia;
22. Research
Linda Waverly Brigden, IDRC, Ottawa, Canada;
Sibylle Fleitmann, European Network for Smoking
Prevention, Belgium; Rowena Jacobs, University of
York, UK; Rosemary Kennedy, IDRC, Ottawa,
Canada; Gerald Keusch, Fogarty International
Center, NIH, USA; Aron Primack, Fogarty
International Center, NIH, USA; Anthony So,
Rockefeller, NYC, USA; Jacob Sweiry, Wellcome
Trust, London, UK;
14
23. Tobacco Control Organisations
PHOTO CREDITS
Sibylle Fleitmann, European Network for Smoking
front cover:
Prevention, Belgium; Belinda Hughes, Framework
Boy smoking, Seychelles
Convention Alliance, Australia; Ruben Israel,
Credit: Harry Anenden © WHO
GLOBALink, International Union Against Cancer
(UICC); Yussuf Saloojee, INGCAT, South Africa;
back cover:
David Simpson, International Agency on Tobacco
Boy in the road selling packs to drivers and
and Health, UK;
passengers, Philippines
Credit: Daniel Tan
24. Smoke-free Areas
Melanie Wakefield, Anti-Cancer Council of
Woman tobacco worker, Vietnam
Victoria, Australia;
Credit: Judith Mackay
27. Health Education
Men smoking water pipes, Saudi Arabia
Patrick Sandstrom, Quit & Win, Finland; Eeva
Photo: Garrett Mehl © WHO
Riitta Vartiainen, Quit & Win, Finland;
Part 1 Prevalence and Health
28. Quitting
Man and child smoking, China
Marlo Corrao, American Cancer Society, USA;
Credit: Carol Betson
GlaxoSmithKline; David Graham, World Self
Medication Industry; Pharmacia; Jerry Reinstein,
Part 2 The Cost of Tobacco
World Self Medication Industry; Pharmacia;
Tobacco leaves, Thailand
Credit: Judith Mackay
29. Price Policy
Gene Borio, NYC, USA; Frank Chaloupka,
Part 3 The Tobacco Trade
University of Illinois, USA; Anne Jones, ASH,
Woman tagging tobacco, tobacco factory,
Australia; Amanda Sandford, ASH UK; Michele
Virginia, USA
Scollo, VicHealth Centre for Tobacco Control,
Credit: Ken Hammond © USDA
Australia; Joy Townsend, London School of
Hygiene and Tropical Medicine, University of
Part 4 Promotion
London, UK.
Boy in the road selling packs to drivers and
passengers, Philippines
For their general contributions, we would like to
Credit: Daniel Tan
thank Kjell Bjartveit, John Crofton, Nigel Gray,
Ruth Roemer, Michael Pertschuk and Weng
Part 5 Taking Action
Xinzhi; and, especially, John Mackay.
“Smoking is Ugly” poster,
created by Christy Turlington and reprinted
For their creative and editorial expertise, diverse
courtesy of the Centers for Disease Control and
talents, and individual as well as collective
Prevention (CDC)
contributions, we would like to thank the team at
Myriad Editions: Candida Lacey, Paul Jeremy,
Part 6 World Tables
Isabelle Lewis and Corinne Pearlman.
Old Man, Sri Lanka
Credit: Garrett Mehl
Finally, we want to thank our respective families
for their support during the preparation of this
atlas.
15
ABOUT THE AUTHORS
Dr Judith Mackay is a medical doctor
and Senior Policy Advisor to the
World Health Organization. She is
based in Hong Kong where she is the
Director of the Asian Consultancy on
Tobacco Control. After an early career
as a hospital physician, she became a
health advocate. She is a Fellow of the
Royal Colleges of Physicians of Edinburgh and London and
the Hong Kong Academy of Medicine and author of The
State of Health Atlas and The Penguin Atlas of Human Sexual
Behavior. Dr Mackay has received many international
awards including the WHO Commemorative Medal, the
Fries Prize for Improving Health, the Luther Terry Award
for Outstanding Individual Leadership, the International
Partnering for World Health Award, and the Founding
International Achievement Award from the Asia Pacific
Association for the Control of Tobacco.

Dr Michael Eriksen is former Director

of the U.S. Office on Smoking and
Health and is currently
a Distinguished Consultant at the
Centers for Disease Control and
Prevention in Atlanta. Since 2000,
Dr. Eriksen has served as an Advisor
to the World Health Organization in
Geneva. He is a recipient of the WHO Commemorative
Medal. He is a Past President and Distinguished Fellow
of the Society for Public Health Education and is a thirty-
year member of the American Public Health Association.

17
 18-19 Tobacco History CYAN MAGENTA YELLOW BLACK

Europe and Middle East

1 The History of Tobacco
Americas UK First Report 1962 2000 1901 UK Imperial Tobacco
of the British Company and British
Royal College of American Tobacco
Physicians of founded
“In ancient times, when the land was
barren and the people were starving, the Asia USA Surgeons 1964
2000 1994 USA CEOs of
cigarette companies
London Smoking
1950s China State and Health 1840 France Frederic
Great Spirit sent forth a woman to save General’s Report testify before
humanity. As she travelled over the world monopoly takes Chopin’s mistress,
determines that Congress that it is the Baroness de
everywhere her right hand touched the 2000 control of the smoking causes their opinion that 1900
UK First major 1950 Dudevant, became
soil, there grew potatoes. And everywhere tobacco business lung cancer in men nicotine is not
and foreign reports on the first woman to
her left hand touched the soil, there grew addictive
companies had smoking (Doll smoke in public
corn. And in the place where she had sat, USA Reader’s Digest 1953
to leave 1900 and Hill)
there grew tobacco.” Huron Indian myth publishes Cancer by 1913 USA Birth of the 1833 UK Phosphorus
the Carton article “modern” cigarette: Germany friction matches
“The Spaniards upon their journey met 1900 China almost 1795
RJ Reynolds Sammuel Thomas introduced on
with great multitudes of people, men and 1900 entirely USA Major report 1950 introduces the 1800
Japan First major 1981 penetrated by von Soemmering commercial scale,
women with firebrands in their hands and on smoking (Wynder Camel brand
report on dangers of foreign tobacco reports cancers making smoking
herbs to smoke after their custom.” and Graham)
passive smoking companies of the lip in pipe more convenient
Christopher Columbus’ journal, 1881 USA Invention of
(Hirayama) 1939 smokers
6 November 1492 USA First link 1800 cigarette machine
1858 China Treaty of c.1710 Russia Peter the
between smoking England First 1761 Great encourages
“Smoking is a custom loathsome to the China Philosopher 1600s Tianjin allows and lung cancer 1800 Canada study of effects his courtiers to
eye, hateful to the nose, harmful to the Fang Yizhi points cigarettes to be
1800 (Ochsner) Tobacco first grown of tobacco (John 1700 smoke tobacco and
brain, dangerous to the lungs, and in the out long years of imported into
smoking “scorches commercially Hill); snuff users drink coffee, seen as
black, stinking fume thereof nearest China duty-free USA First federal 1862
one’s lung” warned they risk fashionable and
resembling the horrible Stygian smoke tobacco tax 1612 Americas
1603 Japan Use of nasal cancers pro-European
of the pit that is bottomless.” introduced to help Tobacco first grown
tobacco well- 1700
James I of England finance Civil War commercially
A Counterblaste to Tobacco 1604 established 1614 England 7000
tobacco shops open
1531 Santo Domingo Turkey Death 1633 with first sale of
“I say, if you can’t 1700 1600 India Tobacco 1600
European settlers penalty for Virginia tobacco
send money, send tobacco.” introduced begin tobacco smoking
first US President George Washington’s cultivation
request to help finance 1530–China 1566 France Jacques
1600 Tobacco 1600 England 1604 Nicot sends snuff to
the American Civil War, 1776 1492 Cuba Columbus
introduced via King James I Queen Catherine de
discovers tobacco writes Medici to treat her
Japan or the smoking and takes A Counterblaste migraine
Within 150 years of Columbus’s 1600 Philippines it to Europe to Tobacco 1500
finding “strange leaves” in the 1558 Europe Tobacco
circa Indigenous plant brought to
New World, tobacco was being 1BC Americans begin Europe. Attempts
used around the globe. Its rapid 1500 smoking and using at cultivation fail
spread and widespread acceptance
tobacco enemas Africa Early Middle East
characterise the addiction to the 6000 Americas First 1500s Tobacco first
BC cultivation of the introduced
plant Nicotina tobacum. Only the Oceania tobacco plant when the Turks took
mode of delivery has changed. In it to Egypt
2000
the 18th century, snuff held sway; Africa provides 2002
global leadership in
the 19th century was the age of drafting a WHO
2000
the cigar; the 20th century saw Framework
Convention on
the rise of the manufactured Australia Victoria 1987 Tobacco Control
first place to use
cigarette, and with it a greatly tobacco tax to
1700s Africa-US African
South Africa 1993 slaves initially used
increased number of smokers. establish health passes Tobacco to work in tobacco
foundation to 1700
At the beginning of the 21st counter tobacco
Products Control fields, not on cotton
Amendment Act plantations
century about one third of adults 1800
in the world, including increasing 1650s South Africa
1788 Australia European settlers
numbers of women, used tobacco. Tobacco arrives grow tobacco and use
Despite thousands of studies with the First it as a form of
Fleet 1600 currency
showing that tobacco in all its
forms kills its users, and smoking 1700 1769 New Zealand 1560 Africa Portuguese
Captain James and Spaniards ship
cigarettes kills non-users, people Cook arrives tobacco to East
continue to smoke, and deaths smoking a pipe, Africa, where it
and is promptly spread to Central and
from tobacco use continue to doused in case West Africa
increase. he is a demon

18 19
 02/Types CYAN MAGENTA YELLOW BLACK
2 Types of Tobacco Use
Smoking tobacco
Manufactured cigarettes
consist of shredded or
reconstituted tobacco processed
with hundreds of chemicals. Often
with a filter, they are
manufactured by a machine, and
are the predominant form of
tobacco used worldwide.
Bidis consist of a small amount of
tobacco, hand-wrapped in dried
temburni leaf and tied with string.
Despite their small size, their tar
and carbon monoxide deliveries
can be higher than manufactured
cigarettes because of the need to
puff harder to keep bidis lit.
Cigars are made of air-cured and
fermented tobaccos with a tobacco
wrapper, and come in many
shapes and sizes, from cigarette-
sized cigarillos, double coronas,
cheroots, stumpen, chuttas and
dhumtis. In reverse chutta and
dhumti smoking, the ignited end
of the cigar is placed inside the
mouth. There was a revival of
cigar smoking at the end of the
20th century, among both men
and women.
Kreteks are clove-flavoured
cigarettes. They contain a wide
range of exotic flavourings and
eugenol, which has an
anaesthetising effect, allowing for
deeper smoke inhalation.
Pipes are made of briar, slate,
clay or other substance – tobacco
is placed in the bowl and inhaled
through the stem, sometimes
through water.
Sticks are made from sun-cured
tobacco known as brus and
wrapped in cigarette paper.
22
Whether it is inhaled, sniffed, sucked or
chewed, or whether it is mixed with
other ingredients, there is no safe
way of using tobacco.
The water pipe, also known as
shisha or hubbly bubbly,
is commonly used in
north Africa, the Kreteks are
Mediterranean clove flavoured
region and cigarettes
parts of Asia. widely smoked
in Indonesia.
Bidis are found
Cigarettes are available
thoughout south-east
throughout the world.
Asia, and are India’s
Filter-tipped cigarettes are
usually more popular than
most used type of
tobacco.
unfiltered cigarettes. Hand
rolled cigarettes are also
widely smoked in many
countries.
In Southeast Asia clay pipes
known as suipa, chilum and
hookli are widely used.
Other tobacco
Cigars are smoked
throughout the world.
Chewing tobacco is also known Moist snuff is taken orally. A Dry snuff is powdered tobacco
Regional variations include as plug, loose-leaf, and twist. small amount of ground tobacco is that is inhaled through the nose or
cheroots and stumpen Pan masala, or betel quid consists held in the mouth between the taken by mouth. Once
(western and central of tobacco, areca nuts and staked cheek and gum. Increasingly widespread, its use is now in
Europe) and dhumtis lime wrapped in a betel leaf. They manufacturers are pre-packaging decline.
(conical cheroots) used
Tobacco is used orally can also contain other sweetenings moist snuff into small paper or
in India.
throughout the world, but and flavouring agents. Varieties of cloth packets, to make the product
principally in Southeast Asia.
pan include kaddipudi,hogesoppu, easier to use. Other products
In Mumbai, India, 56% of
women chew tobacco. gundi, kadapam, zarda, pattiwala, include khaini, shammaah and nass
kiwam, mishri, and pills. or naswa.
23
 3 Male smoking CYAN MAGENTA YELLOW BLACK

Smoking prevalence for men

3 Male Smoking ICELAND

NORWAY
FINLAND
Smoking among males aged 15 and over
latest available data
SWEDEN
ESTONIA 60% and above 30% – 39% no data
RUSSIAN
Smoking has been portrayed by its LATVIA
FED.
UNITED DENMARK 50% – 59% 20% – 29%
sellers as a manly, masculine KINGDOM
LITHUANIA

habit, linked to health, happiness, GREENLAND

IRELAND
NETH. POLAND
BELARUS 40% – 49% below 20%
GERMANY
fitness, wealth, power and sexual BELGIUM
CZECH UKRAINE Top ten
REPUBLIC
success. In reality, it leads to LUX. SLOVAKIA
REP. highest overall smoking rates
AUSTRIA HUNGARY MOLDOVA
sickness, premature death and FRANCE SWITZ.
ITALY SLOVENIA
ROMANIA of men and women combined
C A N A D A CROATIA 44%
sexual problems. SAN
MARINO
B-H YUGOSLAVIA
BULGARIA RUSSIAN FEDERATION
ANDORRA
Almost one billion men in the 48% ALBANIA
FYR MACEDONIA

SPAIN
world smoke – about 35 percent PORTUGAL
47%
of men in developed countries GREECE
KAZAKHSTAN
47% MONGOLIA
and 50 percent of men in UNITED STATES MOROCCO TUNISIA
UZBEKISTAN
MALTA KYRGYZSTAN
JAPAN
developing countries. Trends in OF AMERICA ALGERIA GEO
AR AZER
M TURKMEN
TURKEY REP.
both developed and developing SYRIAN
KOREA
CYPRUS ARAB REPUBLIC CHINA
countries show that male smoking TUNISIA LEBANON
ISRAEL
IS L. REP .
MOROCCO JOR IRAQ IRAN
rates have now peaked and, WEST BANK
& GAZA KUWAIT
BAHAMAS ALGERIA LIBYAN PAKISTAN
NEPAL
slowly but surely, are declining. MEXICO
ARAB
JAMAHIRIYA
BAHRAIN
QATAR
EGYPT
However, this is an extremely CUBA DOMINICAN
UAE
INDIA BANGLADESH Hong Kong
REPUBLIC SAUDI ARABIA MYANMAR LAO SAR
slow trend over decades, and in HONDURAS
HAITI
PUERTO RICO OMAN PDR VIETNAM
GUATEMALA PHILIPPINES
THAILAND
the meantime men are dying in EL SALVADOR
NICARAGUA
ST VINCENT & GRENADINES
SENEGAL
GAMBIA CHAD SUDAN
YEMEN
45%
BARBADOS CAMBODIA
their millions from tobacco. In COSTA RICA TRINIDAD & TOBAGO
DJIBOUTI

VENEZUELA 52% GUINEA NIGERIA

GHANA
PANAMA CÔTE
general, the educated man is PALAU


D’IVOIRE MALDIVES SRI LANKA

 
BRUNEI DAR.
COLOMBIA
giving up the habit first, so that  
 
MALAYSIA


SAO TOME UGANDA

     

over
& PRINCIPE
smoking is becoming a habit of ECUADOR
KENYA SINGAPORE

    
DEM. REP. RWANDA 49% SEYCHELLES
poorer, less educated males. CONGO

   UNITED REP.


PAPUA
44%
China deserves special mention 
I N D O N E S I A
 
 
TANZANIA NEW
BRAZIL GUINEA

because of the enormity of the    


problem. Comprising over 300   PERU MALAWI


ZAMBIA


 
million male smokers, this huge 50% ZIMBABWE


BOLIVIA MAURITIUS

market is, according to Philip 

PARAGUAY NAMIBIA
CHILE
AUSTRALIA KIRIBATI
Morris, “the most important S
TOKELAU
SOUTH
feature on the landscape.” AFRICA L 54%
NAURU
SAMOA
TUVALU
URUGUAY
50 FIJI
NIUE
ARGENTINA VANUATU
COOK

Smoking trends TONGA

percentage of male smokers Physicians who smoke NEW

ZEALAND
1960–2000 selected countries
Smoking prevalence among physicians
12
2000 or latest available data 32
24 selected countries
81% 61% 52% 61 percentages
1960 1960 1965
78% 55% 44%
1970
55 women 13 16
1970 1970

Lao People’s Democratic Republic

70% 42% 38% men 1
1980 1979 20

million
1980 28%
61% 31% 22 43
1990 1990 1990 26% 40 41
54% 28% 38 37
Bosnia and Herzegovina

2000 1998 1999 5

men in China 0

Syrian Arab Republic

30
Ð equal to the
29

Russian Federation
28

Republic of Korea
entire population 21
0

Saudi Arabia
1
of the USA Ð 18
Bangladesh

Indonesia
are smokers Colombia
Australia

Denmark

Morocco
14 6

Sweden
Iceland
2 2 6
China

Spain
0 8
Chile

India
8 6

UK
Japan UK USA 4 4 3
24 15 and over 16 and over 18 and over 25
 Tobacco CYAN MAGENTA YELLOW BLACK

Smoking prevalence for women

4 Female Smoking ICELAND

NORWAY
FINLAND
Smoking among females aged 15 and over
latest available data
ESTONIA RUSSIAN 50% and above 20% – 29% no data
SWEDEN FED.
“…the current lower level of tobacco use LATVIA
among women in the world…does not DENMARK 40% – 49%
reflect health awareness, but rather social
UNITED LITHUANIA 10% – 19%
KINGDOM
traditions and women’s low economic IRELAND
resources.” Dr. Gro Harlem Brundtland, GREENLAND NETH. POLAND BELARUS
30% – 39% below 10%
GERMANY
Director General, WHO, 1998 BELGIUM
CZECH UKRAINE
REPUBLIC SLOVAKIA
LUX. women smoke men smoke ten or more
HUNGARY REP.
About 250 million women in the FRANCE SWITZ.
AUSTRIA
SLOVENIA ROMANIA MOLDOVA as much as men times more than women
C A N A D A CROATIA
world are daily smokers. About SAN MARINO YUGOSLAVIA BULGARIA RUSSIAN FEDERATION
22 percent of women in SPAIN
ANDORRA ITALY
ALBANIA FYR MACEDONIA

developed countries and 9 percent PORTUGAL

GREECE
KAZAKHSTAN
of women in developing countries MONGOLIA

smoke tobacco. In addition, many UNITED STATES MOROCCO MALTA UZBEKISTAN

KYRGYZSTAN
TUNISIA GEO JAPAN
women in south Asia chew OF AMERICA ALGERIA AZER
ARMENIA TURKMEN REP.
KOREA
tobacco. CHINA

Cigarette smoking among TUNISIA

see inset
ISL. REP.
women is declining in many BAHAMAS MOROCCO LIBYAN
IRAN
BAHRAIN PAKISTAN
ALGERIA NEPAL
developed countries, notably MEXICO
ARAB
JAMAHIRIYA
QATAR

UAE INDIA
Australia, Canada, the UK and the CUBA DOMINICAN
REPUBLIC
BANGLADESH
MYANMAR
Hong Kong
SAR
PUERTO RICO LAO VIETNAM
USA. But this trend is not found GUATEMALA
HONDURAS
HAITI OMAN PDR
THAILAND PHILIPPINES
in all developed countries. In EL SALVADOR
NICARAGUA
ST VINCENT & GRENADINES
BARBADOS
SENEGAL YEMEN
CAMBODIA
several southern, central and COSTA RICA
VENEZUELA
TRINIDAD & TOBAGO GAMBIA
GUINEA NIGERIA SUDAN
DJIBOUTI

GHANA
PANAMA CÔTE PALAU
eastern European countries D’IVOIRE MALDIVES SRI LANKA
BRUNEI DAR.
COLOMBIA
cigarette smoking is either still UGANDA MALAYSIA

increasing among women or has ECUADOR

DEM. REP.
KENYA

SEYCHELLES
TURKEY SINGAPORE
RWANDA
not shown any decline. CONGO
UNITED REP.
CYPRUS SYRIAN
ARAB REP.
I N D O N E S I A PAPUA
The tobacco industry promotes BRAZIL
TANZANIA LEBANON
ISRAEL
IRAQ NEW SOLOMON
GUINEA ISLANDS
cigarettes to women using MALAWI WEST BANK
JORDAN
PERU & GAZA
seductive but false images of ZAMBIA
KUWAIT

vitality, slimness, modernity, BOLIVIA

ZIMBABWE MAURITIUS
EGYPT SAUDI
NAMIBIA
ARABIA
emancipation, sophistication, and CHILE PARAGUAY
KIRIBATI

sexual allure. In reality, it causes AUSTRALIA

TOKELAU

SOUTH SWAZILAND TUVALU

disease and death. Tobacco AFRICA NAURU
SAMOA
URUGUAY
companies have now produced a


   
LESOTHO NIUE
FIJI
ARGENTINA VANUATU
range of brands aimed at women.       TONGA
COOK

Most notable are the “women-     

only” brands: these “feminised”       Smoking trends
cigarettes are long, extra-slim,      percentage of female smokers 42% 34%
1965
low-tar, light-coloured or      1960–2000 selected countries
1960
44% 32% NEW
ZEALAND
  
    1970
37%
1970
30%
menthol.      1980 1979
16% 14% 14% 29% 23%
     13% 1970 14%
1960 1980 1990 2000 1990 1990
   26%
1998
22%
1999


   
! "  #


Japan UK USA
26 15 and over 16 and over 18 and over 27
 05 Youth CYAN MAGENTA YELLOW BLACK

5 Youth
POLAND
BOYS
UKRAINE
“If younger adults turn away from C A N A D A RUSSIAN FEDERATION

smoking, the industry will decline, just as Over 40% of young people in Fiji,
a population which does not give birth Ghana, Malawi, Nigeria, South Africa,
will eventually dwindle.” Fewer than 5% of young people
RJ Reynolds researcher, 1984 Sri Lanka and Zimbabwe think
in Bahamas, Barbados, Costa Rica,
boys who smoke have UNITED STATES
Indonesia, Malawi, Montserrat, OF AMERICA
more friends. C H I N A
The overwhelming majority of Poland, Russia, Singapore, Ukraine
smokers begin tobacco use before and Venezuela think girls who BAHAMAS
JORDAN
NEPAL
NORTHERN
smoke look more attractive. MEXICO CUBA MARIANA
they reach adulthood. Among JAMAICA
HAITI ANTIGUA & BARBUDA INDIA
ISLANDS

those young people who smoke, MONSERRAT DOMINICA PHILIPPINES

GRENADA BARBADOS
PALAU
nearly one-quarter smoked their COSTA RICA TRINIDAD & TOBAGO

GHANA
VENEZUELA GUYANA NIGERIA
SRI LANKA
first cigarette before they reached SURINAME
KENYA
SINGAPORE
the age of ten.
Several factors increase the risk COMOROS
I N D O N E S I A
MALAWI
of youth smoking. These include PERU Tobacco users
MADAGASCAR
BOLIVIA ZIMBABWE
tobacco industry advertising and of young people CHILE
MAURITIUS
Percentage of 13–15 year olds
promotion, easy access to tobacco who continue to using tobacco
smoke will die
SOUTH
products, and low prices. Peer URUGUAY AFRICA
2001 or latest available FIJI

pressure plays an important role from smoking ARGENTINA

national, regional or city data
Early smokers
through friends’ and siblings’ Over 30% of children 30% and over
smoking. Other risk factors smoked their first whole
associated with youth smoking cigarette before age 10 20% – 29%
include having a lower self-image in Ghana, Grenada, Guyana,
India, Jamaica, Palau, Poland, 10% – 19%
than peers, and perceiving that
N Mariana Islands and St Lucia.
s
w a
tobacco use is normal or “cool” . under 10%
o kno enage
Many studies show that parental t te
ant
variable 3% – 60%
ut
smoking is associated with higher
m p ort e abo s and r is
i bl tern nage ar
is ssi no data
ÒIt as po ng pat Õs tee regul ing
youth smoking.
h i y l m
muc smok . Todatentia erwhel begin
While the most serious effects POLAND
UKRAINE
of tobacco use normally occur e s
d Õs p he o o v t
RUSSIAN FEDERATION

itu irs heir

after decades of smoking, there att morrow and t kers f in t s of
to omer, f smo stil ttern y l
are also immediate negative t o a l
cus rity while king p icular s.Ó
o e o t i
maj smok he sm e par Morr
health effects for young smokers. UNITED STATES

to sÉ T rs ar hilip
OF AMERICA
Most teenage smokers are already .
n
tee eenage t to P Inc
C H I N A
addicted while in adolescence.
t n n i es
ort
a pa
Com
BAHAMAS JORDAN
NEPAL NORTHERN

imp
The younger a person begins to MEXICO
is 81
CUBA MARIANA

r r ISLANDS

Mo 19
HAITI
JAMAICA
smoke, the greater the risk of
lip
ANTIGUA & BARBUDA INDIA

Phi
MONSERRAT DOMINICA PHILIPPINES
eventually contracting smoking- COSTA RICA
GRENADA BARBADOS
TRINIDAD & TOBAGO PALAU

GHANA
VENEZUELA GUYANA NIGERIA
caused diseases such as cancer or SURINAME
SRI LANKA

heart disease. KENYA SINGAPORE

The highest youth smoking rates

I N D O N E S I A
can be found in Central and MALAWI
PERU
Eastern Europe, sections of India, BOLIVIA ZIMBABWE

and some of the Western Pacific CHILE

islands. SOUTH
AFRICA
URUGUAY

GIRLS
FIJI

of children ARGENTINA

worldwide are
exposed to passive
smoking at home
28 29
 Cigarette consumption CYAN MAGENTA YELLOW BLACK

Annual cigarette consumption

6 Cigarette Consumption ICELAND

NORWAY
FINLAND
per person
1998 or latest available data
SWEDEN
ESTONIA
2,500 and above
“Short, snappy, easily attempted, easily RUSSIAN
completed or just as easily discarded DENMARK
FED. 1,500 – 2,499
UNITED
before completion – the cigarette is the KINGDOM
symbol of the machine age." IRELAND 500 – 1,499
NETH. BELARUS
New York Times, 1925 GERMANY POLAND
BELGIUM 1 – 499
CZECH UKRAINE
REPUBLIC SLOVAKIA
REP.
Global consumption of cigarettes SWITZ.
AUSTRIA HUNGARY MOLDOVA
RUSSIAN
no data
FRANCE SLOVENIA ROMANIA FEDERATION
has been rising steadily since C A N A D A CROATIA

manufactured cigarettes were ITALY

YUGOSLAVIA BULGARIA

SPAIN
introduced at the beginning of the
PORTUGAL
20th century. While consumption GREECE
KAZAKHSTAN
is levelling off and even
MOROCCO TUNISIA
UNITED STATES MALTA
decreasing in some countries, ALGERIA
UZBEKISTAN
KYRGYZSTAN
JAPAN
OF AMERICA AR AZER
worldwide more people are TURKEY
M TURKMEN
REP.
KOREA
smoking, and smokers are SYRIAN ARAB
AFGHANISTAN
C H I N A
TUNISIA REPUBLIC
ISRAEL ISL. REP.
smoking more cigarettes. MOROCCO WEST BANK
& GAZA
IRAQ IRAN China
JORDAN
The numbers of smokers will BAHAMAS LIBYAN KUWAIT PAKISTAN One in three
ALGERIA NEPAL
MEXICO
ARAB BAHRAIN cigarettes smoked
increase mainly due to expansion CUBA
JAMAHIRIYA EGYPT
in the world today are
DOMINICAN BANGLADESH
of the world’s population. By JAMAICA REPUBLIC SAUDI ARABIA
LAO
Hong Kong smoked in China.
BELIZE HAITI MAURITANIA
INDIA PDR
SAR

2030 there will be at least another GUATEMALA

HONDURAS MALI THAILAND
VIET NAM

EL SALVADOR SENEGAL
2 billion people in the world. China NICARAGUA BARBADOS GAMBIA
BURKINA
CHAD SUDAN
PHILIPPINES
1,643 billion COSTA RICA TRINIDAD & TOBAGO GUINEA-BISSAU FASO
Even if prevalence rates fall, the VENEZUELA NIGERIA

GHANA
PANAMA GUYANA CÔTE

TOGO
SURINAME SIERRA LEONE D’IVOIRE ETHIOPIA MALDIVES SRI LANKA
absolute number of smokers will COLOMBIA CAMEROON
CAR
LIBERIA MALAYSIA
increase. The expected UGANDA
KENYA SINGAPORE
continuing decrease in male ECUADOR GABON
DEM. REP. R
CONGO CONGO B
smoking prevalence will be offset UNITED REP.
TANZANIA I N D O N E S I A
by the increase in female smoking BRAZIL ANGOLA India SOLOMON
ISLANDS
rates, especially in developing Top 5 countries PERU MALAWI
Seven bidis
ZAMBIA are sold for every one
countries. Billions of cigarettes consumed MADAGASCAR
cigarette.
ZIMBABWE
BOLIVIA MAURITIUS
The consumption of tobacco has 1998
reached the proportions of a CHILE PARAGUAY
 MOZAMBIQUE
SAMOA

global epidemic. Tobacco AUSTRALIA FIJI

SOUTH
companies are cranking out USA URUGUAY
AFRICA

cigarettes at the rate of five and a 451 billion 5,419 5,500

ARGENTINA
half trillion a year – nearly 1,000
cigarettes for every man, woman, 
and child on the planet.
  Rising numbers
NEW
4,388 Average number of
Cigarettes account for the 
    ZEALAND

largest share of manufactured   manufactured cigarettes

smoked per man per day
Japan in China
tobacco products, 96 percent of 328 billion
3,112 1996
total value sales. Asia, Australia
and the Far East are by far the 1 4 10 15
largest consumers (2,715 billion Global cigarette 2,150
cigarettes), followed by the consumption
Russia 1,686
Americas (745 billion), Eastern 258 billion
Billions of sticks
Europe and Former Soviet 1880–2000
1,000
Economies (631 billion) and
600
Western Europe (606 billion). Indonesia
300 1952 1972 1992 1996
215 billion 10 20 50 100

30 1880 1890 1900 1910 1920 1930 1940 1950 1960 1970 1980 1990 2000 31
 07/health Risks CYAN MAGENTA YELLOW BLACK

7 Health Risks Deadly chemicals

Tobacco smoke contains over 4,000 chemicals,
HAIR
• Smell and staining
How smoking harms you
Parts of the body
some of which have marked irritant properties EYES especially affected
and some 60 are known or suspected carcinogens. BRAIN AND MENTAL EFFECTS • Eyes sting, water and blink more by tobacco use
Tobacco is packed with harmful • Strokes (cerebrovascular accidents) • Blindness (macular degeneration)l
Tobacco smoke includes as found in • Addiction / withdrawal • Cataracts
and addictive substances. Acetone paint stripper • Altered brain chemistry
Scientific evidence has shown SKIN
Ammonia floor cleaner • Anxiety about harm caused by smoking
• Wrinkles,
conclusively that all forms of Arsenic ant poison
premature ageing
Butane lighter fuel
tobacco cause health problems
Cadmium car batteries NOSE
throughout life, frequently Carbon monoxide car exhaust fumes • Less sense of smell
resulting in death or disability. DDT insecticide
Hydrogen cyanide gas chambers TEETH HANDS
Smokers have markedly • Poor circulation (cold fingers):
Methanol rocket fuel • Discoloration and stains
increased risks of multiple Babes in the womb Napthalene moth balls peripheral vascular disease
• Plaque
cancers, particularly lung cancer, Smoking in pregnancy Toluene industrial solvent • Loose teeth • Tar stained fingers
and are at far greater risk of heart Vinyl chloride plastics • Gum disease (gingivitis)
disease, strokes, emphysema and Increased risks:
Spontaneous abortion / miscarriage MOUTH AND THROAT
many other fatal and non-fatal Ectopic pregnancy • Cancers of lips, mouth, throat and larynx
diseases. If they chew tobacco, Abruptio placentae • Sore throat
they risk cancer of the lip, tongue Placenta praevia • Reduced sense of taste
Premature rupture of the membranes HEART
and mouth. • Breath smells of smoke
Premature birth • Harms, blocks and weakens
Women suffer additional health RESPIRATION AND LUNGS
arteries of the heart
risks. Smoking in pregnancy is Foetus: • Heart attack
• Lung cancer
dangerous to the mother as well Smaller infant (for gestational age) • Cough and sputum, shortness of breath
Stillborn infant CHEST
as to the foetus, especially in poor • Colds and flu, pneumonia, asthma
Birth defects, eg congenital limb reduction • Cancer of oesophagus
• Chronic obstructive pulmonary disease
countries where health facilities Increased nicotine receptors in baby’s brain Time and emphysema
are inadequate. Increased likelihood of ABDOMEN
ticks away • Complicates tuberculosis
• Stomach and duodenal ulcers
Maternal smoking is not only infant smoking as a teenager
Possible physical and mental • Cancer of stomach, pancreas, colon
harmful during pregnancy, but LIVER
long-term effects • Aortic aneurysm
• Cancer
has long-term effects on the baby Every cigarette
after birth. This is often takes 7 minutes
KIDNEYS and BLADDER
off your life BONES
compounded by exposure to • Cancer
• Osteoporosis
passive smoking from the mother, • Spine and hip fractures
MALE REPRODUCTION
father or other adults smoking. • Sperm: deformity, loss of motility,
FEMALE REPRODUCTION
While tobacco kills millions reduced number
• Period pains
more than it helps, research is • Infertility
• Earlier menopause
• Impotence WOUNDS AND SURGERY
underway examining any possible • Cancer of cervix
• Wounds take longer to heal • Infertility and delay in conception
health benefits of nicotine and • Operation wounds take longer to heal
also trying to find a safe use for • Longer to recuperate from surgery BLOOD
tobacco, particularly in the field • Leukaemia
of genetic modification. The aim DIABETES
nt Sworn • Noninsulin dependent diabetes mellitus
is to produce vaccines or human ateme testi BURNS
te st mony (Type 2, adult-onset)
Priva • From fires caused by tobacco
proteins for medical use, or even 
 
 

  
to clean up soil that has been
     
smoking is responsible for
LEGS and FEET IMMUNE SYSTEM

  
   
contaminated with explosives. • Increased leg pain and gangrene: • Weakened

 

90%
  peripheral vascular disease

 !"
 • Buerger’s Disease
    

of all lung cancer
   
 #  


$

75%
of chronic bronchitis and emphysema

32 25%
of cases of ischaemic heart disease 33
 08/ Passive smoking CYAN MAGENTA YELLOW BLACK

8 Passive Smoking Harm caused

by passive smoking
Health effects on adults
HAIR Harm caused
“An hour a day in a room with a smoker is
nearly a hundred times more likely to • Smell by passive smoking
cause lung cancer in a non-smoker than Health effects on children
20 years spent in a building containing BRAIN AND
asbestos.” Sir Richard Doll, 1985 MENTAL EFFECTS
nly" HAIR
use o • Strokes
internal • Smell
The first conclusive evidence on "For  


EYES


  
 
the danger of passive smoking BRAIN
• Sting, water and blink more
     • Possible association with brain tumours
   
came from Takeshi Hirayama’s
   
and long-term mental effects
study in 1981 on lung cancer in NOSE
non-smoking Japanese women 
• Irritation

EYES
married to men who smoked.   
  !!" Secre • Sting, water and blink more
    t pol
l for RESPIRATION AND LUNGS

 
Although the tobacco industry Tobac
co In the U
S • Lung cancer
stitu EARS
immediately launched a multi- te • Worsening of pre-existing

# • Middle ear infections
million dollar campaign to $  $
 chest problems, such as
(chronic otitis media)

discredit the evidence, dozens of   $  
 
asthma, chronic obstructive
 

 $
  
pulmonary disease
RESPIRATION AND LUNGS
further studies have confirmed
  $

 and emphysema
  $   % 

• Respiratory infections
the link. Research then broadened    (including bronchitis and
  HEART
into other areas and new scientific &
 $
     • Harms, clogs weakens arteries
pneumonia)

evidence continues to accumulate. &

$    

 • Heart attack, angina
• Asthma induction
A complex mixture of chemicals   
  
  and exacerbation
  
• Chronic respiratory symptoms
is generated from the burning and
    UTERUS
(wheezing, cough, breathlessness)
  • Low birthweight or
smoking of tobacco. As a passive '
 small for gestational age
• Decreased lung function
( 
smoker, the non-smoker breathes )
• Cot death or Sudden Infant
 !*+ Death Syndrome (SIDS)
HEART
“sidestream” smoke from the • Deleterious effects on oxygen,
burning tip of the cigarette and after birth
arteries
“mainstream” smoke that has been • Increased nicotine receptors
BURNS
inhaled and then exhaled by the • From fires caused by tobacco
BLOOD
smoker. • Possible association
The risk of lung cancer in non- with lymphoma
smokers exposed to passive Children exposed to passive smoking at home
smoking is increased by between BURNS
selected countries • From fires caused by tobacco
20 and 30 percent, and the excess 2001 or latest available data
risk of heart disease is 23 percent. 69% 68% 7% percentages ROLE MODEL
6
Children are at particular risk 63% • Greater likelihood of becoming
Numbers affected by passive smoking a smoker as a teenager
from adults’ smoking. Adverse 57% 5%
5
health effects include pneumonia 53% in the USA
49% % annual 1990s
and bronchitis, coughing and 46% 45.5
wheezing, worsening of asthma, Lung cancer 3,000
middle ear disease, and possibly 34% 34% Ischaemic heart disease 35,000 to 62,000
neuro-behavioural impairment 31% 9%
2
Infants and children
Russian Federation

and cardiovascular disease in

adulthood. Low birthweight 9,700 to 18,600
A pregnant woman’s exposure Cot death (SIDS) 1,900 to 2,700
Argentina

Indonesia

Ukraine

Mexico

Nigeria

Bronchitis or pneumonia in infants 150,000 to 300,000

Bolivia

to other people’s smoking can

Poland

China
Cuba

Chile

India

Haiti

Peru

harm her foetus. The effects are

Respiratory effects in children
compounded when the child is Middle ear infection 700,000 to 1,600,000
exposed to passive smoking Asthma induction (new cases) 8,000 to 26,000
after birth. Asthma exacerbation 400,000 to 1,000,000

34 35
 09/Deaths CYAN MAGENTA YELLOW BLACK



 
9 Deaths
 


  


   
 
   

 
    




Cigarettes kill half of all lifetime  


 

users. Half die in middle age – women    
  
between 35 and 69 years old. industrialised countries  
0.5 million  
No other consumer product is !"#  
as dangerous, or kills as many 
people. Tobacco kills more than men
AIDS, legal drugs, illegal drugs, developing countries
road accidents, murder, and 1.8 million
suicide combined.
Tobacco already kills more men
men
in developing countries than in industrialised countries
industrialised countries, and it is women 1.6 million

MEN
likely that deaths among women developing countries
will soon be the same. 0.3 million Deaths from tobacco use
While 0.1 billion people died Total deaths as percentage of total deaths
from tobacco use in the 20th Premature deaths among men and women over 35
century, ten times as many will from tobacco 2000 regional estimates
die in the 21st century. Maternal worldwide
over 25% 10% – 14%
2000
smoking during pregnancy is
20% – 24% 5% – 9%
responsible for many foetal deaths total deaths
and is also a major cause of 4.2 million 15% – 19% under 5%
Sudden Infant Death Syndrome.
men Dying in your prime
Passive smoking in the home, 3.4 million more than 25% of
workplace, or in public places 35 – 69 year olds
also kills, although in lower women living above these lines
numbers. However, those killed 0.8 million will die from tobacco use
do not die from their own habit,
but from someone else’s.
Children are at particular risk of everyone alive today
from adults smoking, and even
smoking by other adults around
a pregnant woman has a harmful
effect on a foetus.

Past and future will eventually be killed by tobacco 7

Annual deaths due to tobacco million
estimated worldwide projected
1950–2030 projected
3
million
projected
2.1 2.1 2025
1.3 million million to
million
2025 2030

WOMEN
0.3
2000 to 0.2 2000
million 1975 2030 million
1950 negligible 1975
1950
industrialised countries developing countries
36 37
 10/Costs to the Economy CYAN MAGENTA YELLOW BLACK

10 Costs to the Economy

The tobacco industry uses     UK $2.25 billion
economic arguments to persuade    Canada $1.6 billion
governments, the media and the China 1987:
Germany $14.7 billion
general population that smoking World’s worst
benefits the economy. It claims forest fire
that if tobacco control measures caused by
are introduced, tax revenues will cigarettes
fall, jobs will be lost and there
     300 killed
will be great hardship to the       5,000 made homeless
economy.   1.3 million hectares of
land destroyed
But the industry greatly
exaggerates the economic losses,
if any, which tobacco control USA $76 billion
measures will cause and they Health-care costs
never mention the economic costs
China $3.5 billion
which tobacco inflicts upon every Health care costs
country. attributable to tobacco
2002 or latest
Tobacco’s cost to governments,
available estimates Philippines
to employers and to the selected countries $600 million
environment includes social, Average days off sick


6.16
welfare and health care spending, per year in the USA  

loss of foreign exchange in 2001

4.53
importing cigarettes; loss of land 3.86
  

that could grow food; costs of    
never-smokers

fires and damage to buildings   

ex-smokers

caused by careless smoking;


smokers

Australia $6 billion
environmental costs ranging from
  
deforestation to collection of  
smokers’ litter, absenteeism,
decreased productivity, higher
numbers of accidents and higher
insurance premiums.


     
  

 
 
  
New Zealand $84 million
 
    

     

Trash collected

 

 
 

        

     Annual cost of loss
    
 
from time off work
in the USA $16.5 million
        Telecom Australia
)
% 
43 states 1996

    !  employees
*  $  &
cigarette butts
  

  
     1994
20%
,
  Cost of fires caused by smoking
 
      +
  " Australian $
$  -    annual global estimates
 
   # 
 .   2000 $5.5 million
 
 '(
Wal 
   ' !
l S • percentage of all fire deaths: 10%
   tre
"  
 et
Jou • total killed by fires caused by smoking: 300,000
other    &

 
" % '' rnal • total cost of fires caused by smoking: US$27 billion
80% (

40 41
tobacco alcohol
 11 Cost to the smoker CYAN MAGENTA YELLOW BLACK

The cost of smoking

11 Costs to the Smoker ICELAND

NORWAY
FINLAND
Cost of a pack of 20 Marlboro cigarettes
or an equivalent international brand
SWEDEN
US$ selected countries 2001 or latest available data
RUSSIAN
The economic costs of smoking to FED. $5 and above
DENMARK
UNITED
smokers and their families include KINGDOM $4 – $4.99
IRELAND
money spent on buying tobacco, NETH. GERMANY POLAND
GLOBAL TOBACCO

$3 – $3.99
which could otherwise be used on BELGIUM
CZECH G O V E R N M E N T H E A LT H WA R N I N G : S M O K I N G C A N S E R I O U S LY D A M A G E Y O U R H E A LT H

food, clothing and shelter, family LUX. REPUBLIC UKRAINE REP. 20 imported
MOLDOVA $2 – $2.99
AUSTRIA HUNGARY
RUSSIAN
cigarettes costs
holidays or a car. FRANCE SWITZ. ROMANIA
more than half
C A N A D A CROATIA FEDERATION $1 – $1.99 GLOBAL TOBACCO

As smoking kills a quarter of all YUGOSLAVIA BULGARIA average daily

ITALY D A M A G E Y O U R H E A LT H
S M O K I N G C A N S E R I O U S LY
H E A LT H WA R N I N G :
G O V E R N M E N T

smokers in their working years, SPAIN less than $1 income

smoking deprives the smoker’s PORTUGAL
GREECE no data
family of many years of income.
Smokers also suffer loss of income UNITED STATES
MOROCCO TUNISIA
GEORGIA
through illness. Following a OF AMERICA JAPAN
AZERBAIJAN
TURKEY REP.
smoker’s premature death, a SYRIAN ARAB C H I N A
KOREA

REPUBLIC
partner, children or elderly TUNISIA
ISRAEL JORDAN
ISL. REP.
MOROCCO
IRAN
parents can be left destitute. KUWAIT
PAKISTAN
GLOBAL TOBACCO

LIBYAN
MEXICO
Family members of smokers ARAB
JAMAHIRIYA
BAHRAIN G O V E R N M E N T H E A LT H WA R N I N G : S M O K I N G C A N S E R I O U S LY D A M A G E Y O U R H E A LT H

EGYPT UAE BANGLADESH

lose income through time taken PUERTO RICO SAUDI ARABIA Hong Kong
INDIA SAR
looking after smokers when they GLOBAL TOBACCO
VIET NAM
GUATEMALA GLOBAL TOBACCO

THAILAND PHILIPPINES
are sick, and time lost taking SENEGAL
G O V E R N M E N T H E A LT H WA R N I N G : S M O K I N G C A N S E R I O U S LY D A M A G E Y O U R H E A LT H
GLOBAL TOBACCO

G O V E R N M E N T H E A LT H WA R N I N G : S M O K I N G C A N S E R I O U S LY D A M A G E Y O U R H E A LT H

CAMBODIA
them to hospital. In some COSTA RICA
VENEZUELA
G O V E R N M E N T H E A LT H WA R N I N G : S M O K I N G C A N S E R I O U S LY D A M A G E Y O U R H E A LT H

GHANA
CÔTE NIGERIA
developing countries a hospital PANAMA
D’IVOIRE
BRUNEI DAR.
COLOMBIA SRI LANKA
visit can take days. CAMEROON
UGANDA
MALAYSIA
GLOBAL TOBACCO

Smokers also have to shoulder ECUADOR GABON

KENYA SINGAPORE
G O V E R N M E N T H E A LT H WA R N I N G : S M O K I N G C A N S E R I O U S LY D A M A G E Y O U R H E A LT H

higher health insurance

premiums, and many other  
 I N D O N E S I A
PAPUA
NEW

miscellaneous costs, such as

BRAZIL

 
 GUINEA

    


PERU
increased wear and tear on their ZAMBIA

home, as well as increased fire ZIMBABWE

risk. CHILE PARAGUAY

AUSTRALIA
158
URUGUAY
SOUTH
AFRICA  
   
A hard day’s smoke
 
ARGENTINA

 
Minutes of labour worked international
brand NEW
to purchase 20 cigarettes 102 ZEALAND
2000 selected cities local brand 92
A pack of Marlboro or equivalent international brand will buy…
77
62 62 62
56 56

38 40
33
20 23 23 20 20 19 16
11

…one and a half …a dozen …one kilogram

Abu Dhabi Copenhagen Jakarta Johannesburg Montréal Mumbai Nairobi Santiago Shanghai Warsaw
For the price of kilograms of …four pairs of coconuts in of fish in France, …six kilograms
United Arab Denmark Indonesia South Africa Canada India Kenya Chile China Poland
20 Marlboro cucumbers in …a dozen eggs cotton socks in Papua New Ghana or of rice in
Emirates
you could buy… Georgia… in Panama… China… Guinea… Moldova… Bangladesh.

42 43
 12/Growing Tobacco CYAN MAGENTA YELLOW BLACK

Land devoted to growing tobacco

12 Growing Tobacco ICELAND

NORWAY
FINLAND
Area in hectares
2000
SWEDEN 1,000 – 4,999
ESTONIA over 100,000
RUSSIAN
LATVIA
Tobacco is grown in over 125 UNITED DENMARK
FED.
10,000 – 99,999 under 1,000
LITHUANIA
countries, on over 4 million KINGDOM
IRELAND
BELARUS 5,000 – 9,999 no tobacco grown
hectares of land, a third of which NETH. GERMANY POLAND
BELGIUM
is in China alone. The global GREENLAND CZECH
REPUBLIC SLOVAKIA
UKRAINE
LUX.
tobacco crop is worth AUSTRIA HUNGARY
REP.
MOLDOVA tobacco is grown on more
FRANCE SWITZ. ROMANIA
approximately US$20 billion, a SLOVENIA RUSSIAN
C A N A D A CROATIA B-H FEDERATION
than one percent of
small fraction of the total amount YUGOSLAVIA
BULGARIA
agricultural land
ITALY
ALBANIA FYR
generated from the sale of SPAIN
MACEDONIA
PORTUGAL GREECE
manufactured tobacco products.
Tobacco is grown on less than KAZAKHSTAN
MONGOLIA
MOROCCO TUNISIA
one percent of the world’s UNITED STATES
MALTA
UZBEKISTAN DPR
ALGERIA KYRGYZSTAN KOREA
agricultural land, and on a wide OF AMERICA GEO JAPAN
AR AZER
M TURKMEN
TURKEY TAJ
variety of soils and climates. Since REP.
KOREA

TUNISIA
the 1960s, the bulk of production BERMUDA IRAQ
ISL. REP.
AFGHANISTAN
C H I N A
MOROCCO see inset IRAN
has moved from the Americas to KUWAIT PAKISTAN BHUTAN
BAHAMAS LIBYAN
ALGERIA NEPAL
Africa and Asia: land devoted to MEXICO TURKS & CAICOS
ARAB
JAMAHIRIYA
BAHRAIN
QATAR
WESTERN SAHARA EGYPT UAE
tobacco growing has been halved CUBA
JAMAICA
DOMINICAN REP.
PUERTO RICO SAUDI ARABIA
BANGLADESH
MYANMAR
Hong Kong
ANGUILLA INDIA LAO SAR
in the USA, Canada and Mexico, BELIZE
HONDURAS
HAITI
ST KITTS & ANTIGUA & BARBUDA
MAURITANIA
MALI
OMAN PDR VIET NAM
GUATEMALA NEVIS DOMINICA CAPE VERDE NIGER THAILAND
but has almost doubled in China, EL SALVADOR
NICARAGUA
ST VINCENT & GRENAD. ST LUCIA
SENEGAL
GAMBIA CHAD SUDAN
ERITREA YEMEN
GRENADA BARBADOS BURKINA CAMBODIA PHILIPPINES
Malawi and United Republic of
 
GUINEA-BISSAU FASO DJIBOUTI
COSTA RICA TRINIDAD & TOBAGO NIGERIA

BENIN
VENEZUELA GUINEA

GHANA
TOGO
GUYANA CÔTE

LIA
PANAMA
Tanzania. SRI LANKA PALAU
  SURINAME SIERRA LEONE ETHIOPIA

MA
D’IVOIRE MALDIVES
CAR

SO
FRENCH GUIANA (Fr) BRUNEI DAR.
COLOMBIA
The production of tobacco
 
CAMEROON MICRONESIA,
LIBERIA UGANDA MALAYSIA FED. STATES OF
EQUATORIAL
GUINEA
leaves has more than doubled


KENYA CYPRUS SINGAPORE
SYRIAN ARAB
ECUADOR SAO TOME
GABON
DEM. REP. R SEYCHELLES REPUBLIC
LEBANON
since the 1960s, totalling nearly

& PRINCIPE CONGO CONGO IRAQ
B
UNITED REP. ISRAEL
JORDAN PAPUA
TANZANIA
7 million metric tons in 2000. I N D O N E S I A NEW
SOLOMON



BRAZIL ANGOLA
WEST BANK GUINEA ISLANDS
COMOROS
The greater use of fertilisers and & GAZA

MALAWI

 

PERU EGYPT


pesticides, as well as the increased 2,661
ZAMBIA MADAGASCAR SAUDI ARABIA

mechanisation, that have BOLIVIA ZIMBABWE

MAURITIUS
BOTSWANA
produced these higher yields are CHILE PARAGUAY NAMIBIA
MARSHALL KIRIBATI

REUNION
MOZAMBIQUE
environmentally damaging. The S
ISLANDS TOKELAU

AUSTRALIA
problem does not end with SOUTH L
NAURU
SAMOA
AMERICAN
SAMOA
AFRICA
URUGUAY WALLIS AND
growing tobacco: the processes FUTUNA ISLANDS (Fr)
COOK
FIJI NIUE
used in curing tobacco leaves ARGENTINA VANUATU
TONGA
cause massive deforestation. 45%
There are millions of tobacco  
41%
NEW

farmers worldwide. The tobacco   ZEALAND

industry exploits them by  25% 26%

31%

contributing to their debt burden, 16% 18% 19% Leading producers of tobacco leaves
while using their economic plight
lic

Thousands of metric tons

Arab , Syrian
bwe

Repub

to argue against efforts to control 2001

Korea

tobacco. In the USA, the bond 701

Zimba

an
China

adesh

568
Pakist

between the tobacco industry and

n

lic of
i
Jorda

Malaw

ay

the tobacco farmer finally is 450

Bangl

Urugu

Repub

beginning to break down, and 260

175 147 132 130
partnerships are developing Deforestation 120 103 101
between the farmers and the Proportion of total annual deforestation
public health community. attributable to tobacco China India Brazil USA Turkey Zimbabwe Indonesia Italy Greece Malawi Pakistan Argentina
1999 selected countries

46 47
 MANUFACTURING TOBACCO CYAN MAGENTA YELLOW BLACK

Tobacco manufacturing workers

13 Manufacturing Tobacco FINLAND
Number of workers
1999 or latest available data
SWEDEN
over 200,000
RUSSIAN
LATVIA
Each year, over five trillion DENMARK
FED.
UNITED LITHUANIA
cigarettes are manufactured. IRELAND
KINGDOM 10,000 – 100,000
China is by far the largest NETH. GERMANY POLAND
5,000 – 9,999
cigarette manufacturer, followed BELGIUM
CZECH UKRAINE
REPUBLIC
by the USA. Chinese cigarette 1,000 – 4,999
AUSTRIA HUNGARY
production increased from 225 FRANCE ROMANIA RUSSIAN
C A N A D A CROATIA B-H FEDERATION 1 – 999
billion cigarettes annually in 1960 YUGOSLAVIA BULGARIA
ITALY
to 1.7 trillion a year in 1995, a SPAIN ALBANIA FYR MACEDONIA no data
seven-fold increase. The PORTUGAL
GREECE
economic value of tobacco
products is vast, totalling UNITED STATES
MOROCCO TUNISIA
MALTA
ALGERIA KYRGYZSTAN
hundreds of billions of US dollars OF AMERICA AZER
JAPAN
REP.
a year. Very little of this money is TURKEY
KOREA
C H I N A

TUNISIA
CYPRUS
spent on tobacco itself. More is ISRAEL
LEBANON
IRAQ ISL. REP.
MOROCCO
IRAN
spent on paper, filters, and JORDAN
PAKISTAN
LIBYAN
ALGERIA NEPAL
packaging than on tobacco. MEXICO CUBA ARAB
JAMAHIRIYA
EGYPT
Nearly 2 million people are JAMAICA
DOMINICAN
REPUBLIC
BANGLADESH
MYANMAR
Hong Kong SAR
Macau
INDIA LAO SAR
employed in the manufacture of BELIZE HAITI PDR
GUATEMALA CAPE VERDE THAILAND PHILIPPINES
tobacco products, two-thirds of NETH. ANTILLES ST VINCENT & GRENADINES SENEGAL
GAMBIA SUDAN
YEMEN
GRENADA BARBADOS BURKINA CAMBODIA
whom are working in China, COSTA RICA TRINIDAD & TOBAGO FASO
VENEZUELA

GHANA
India and Indonesia. Job losses
PANAMA GUYANA
SURINAME SIERRA LEONE
CÔTE
ETHIOPIA India:
D’IVOIRE SRI LANKA
COLOMBIA
6 million children,
which would result from a LIBERIA
CAMEROON
UGANDA SOMALIA ages 4 to 14, MALAYSIA

reduction in tobacco consumption ECUADOR GABON

KENYA
work full time in SINGAPORE
DEM. REP.
are estimated to be fairly small. CONGO CONGO BURUNDI the bidi industry.
UNITED REP. PAPUA
Technological advances in both BRAZIL
TANZANIA
I N D O N E S I A NEW
GUINEA
farming and manufacturing have a ANGOLA
PERU MALAWI
much larger impact on jobs than ZAMBIA
MADAGASCAR FIJI
tobacco control efforts. BOLIVIA
ZIMBABWE
MAURITIUS

Hundreds of chemicals are CHILE PARAGUAY

added to tobacco in the AUSTRALIA

manufacture of cigarettes. SOUTH
AFRICA
URUGUAY
Additives make smoke easier to
inhale into the lungs and allow for ARGENTINA

less tobacco to be used in each
cigarette. Today’s cigarettes are
highly engineered, exquisitely
Where the tobacco dollar goes 2.28 Less tobacco per cigarette
ADDITIVES
For every dollar spent on tobacco in the USA… estimated lbs of leaf used NEW
2.05 Selected additives and effects ZEALAND
per 1,000 cigarettes
21¢ is for wholesale, retail & transport

designed “nicotine delivery 1.81 in the USA Ammonia changes pH and may
1960–1999 increase nicotine absorption
devices”.
7¢ is for non-tobacco materials

1.58 Flavourings enhance taste

15¢ is for state and local tax

Besides using less tobacco per Because of the Sweeteners make more palatable
4¢ is for the tobacco itself

1.33 1.29 1.31

43¢ is for manufacturing

cigarette, the composition of the use of additives Eugenol and numb throat and
and other 1.15 Menthol facilitate inhalation
cigarette is also changing.
11¢ is for federal tax

technologies, such 0.91 Cocoa dilate airways

Manufacturers are using more as “fluffing” and Others mask smell and invisibility
reconstituted tobacco, which the use of of sidestream smoke
makes it easier to add chemicals reconstituted other additives: ammonia, ammonium
tobacco, tobacco hydroxide, beta-carotene, gentian root
and to include leaf stems and dust companies use extract, levulinic acid, patchouli oil, urea,
which had previously been less and less methylcyclopentenolene, snakeroot oil
discarded. tobacco per
cigarette. 1960 1965 1970 1975 1980 1985 1990 1995 2000

48 GOVERNMENT HEALTH WARNING: SMOKING CAN SERIOUSLY DAMAGE YOUR HEALTH

49
 14/TOBACCO COMPANIES CYAN MAGENTA YELLOW BLACK

14 Tobacco Companies ICELAND

NORWAY
FINLAND

SWEDEN ESTONIA
British American
RUSSIAN
Tobacco LATVIA
Philip Morris is the world’s UNITED DENMARK LITHUANIA
FED.

largest transnational tobacco KINGDOM

IRELAND BELARUS
company, whose Marlboro brand NETH. POLAND

is the world leader. In 1999 the BELGIUM Reemsta CZECH UKRAINE

LUX. GERMANY REPUBLIC
company had sales of over FRANCE AUSTRIA HUNGARY
SWITZ. ROMANIA
US$47 billion. However, CROATIA
RUSSIAN FEDERATION
C A N A D A
excluding the US domestic Altadis BULGARIA
ITALY
market, BAT sells the most SPAIN

PORTUGAL
cigarettes worldwide and has the GREECE
KAZAKHSTAN
largest network in the most
TUNISIA
Japan Tobacco
countries. Philip Morris MOROCCO
International
UZBEKISTAN DPR
ALGERIA
The tobacco industry is a UNITED STATES KOREA JAPAN
OF AMERICA
TURKEY REP.
mixture of some of the most KOREA
CYPRUS LEBANON
powerful transnational Philip Morris TUNISIA
ISRAEL IRAQ ISL. REP.
C H I N A
$47.1 billion
MOROCCO
IRAN R J Reynolds
commercial companies in the JORDAN
PAKISTAN
LIBYAN BAHRAIN
ALGERIA
world. Tobacco companies, MEXICO
ARAB
JAMAHIRIYA EGYPT UAE
which frequently merge, own CUBA
JAMAICA
DOMINICAN
REPUBLIC SAUDI ARABIA BANGLADESH
MYANMAR
Hong Kong SAR
INDIA
other huge industries and run an HONDURAS
OMAN VIET NAM
GUATEMALA THAILAND PHILIPPINES
intricate variety of joint ventures. EL SALVADOR
NICARAGUA BARBADOS
State tobacco monopolies have COSTA RICA TRINIDAD &
TOBAGO
VENEZUELA

GHANA
PANAMA NIGERIA
been in decline since the 1980s. GUYANA
SURINAME
SIERRA LEONE
SRI LANKA
COLOMBIA
About 7,000 medium to large CAMEROON
MALAYSIA
ÒWe see the new
UGANDA

state-owned enterprises were KENYA

markets opening up
SINGAPORE
ECUADOR DEM. REP.
privatised in the 1980s and a in Central Asia and CONGO
UNITED REP.
BAT
further 60,000 in the 1990s after the Commonwealth of BRAZIL
TANZANIA I N D O N E S I A
$31.1 billion
the collapse of the former Soviet Independent States
Union. From the late 1990s, the as really being the PERU ZAMBIA
MALAWI

IMF has pressurised countries future of BAT well BOLIVIA ZIMBABWE

into the next FIJI

such as the Republic of Korea, the century.Ó CHILE

MAURITIUS

Republic of Moldova, Thailand AUSTRALIA

and Turkey to privatise their state BAT, 1994 SOUTH
AFRICA
URUGUAY
tobacco industry as a condition of JTI
loans. ARGENTINA $21.6 billion
16.4%
The remaining monopolies Leading manufacturer by country 15.4%
represent a combined NEW
ZEALAND
consumption of 2 billion cigarettes
headquarters location of The Big Five
or 40 percent of the world’s total
major transnational
cigarette consumption. tobacco companies Leading transnational tobacco companies
Since the early 1990s, the
1999
cigarette companies have
Philip Morris Austria Tabak
massively increased their 7.2% Reemsta
manufacturing capacity in British American Tobacco (BAT) Gallaher $6.1 billion
developing countries and eastern
Japan Tobacco International (JTI) state monopoly percentage of global
Europe. Where once the rich
Altadis market share
countries exported “death and Reemsta other $2.3 billion
disease”, increasingly these are 2.6%
Altadis no data 1.9%
manufactured locally.
revenue
US$ billions
50 Philip Morris BAT JTI Reemsta Altadis 51
 15/Tobacco Trade CYAN MAGENTA YELLOW BLACK

Cigarette exports
15 Tobacco Trade million of cigarettes 2000
Cigarette imports
over 100,000 1,000 – 4,999 below 100 Top 10
cigarette importing countries
343

Tobacco trade is big business, for Manufactured cigarettes are also 10,000 – 99,999 100 – 999 no data 2000 numbers of cigarettes
both the raw material (tobacco traded globally. Again, the USA is
leaves) and the finished product the largest exporter of 5,000 – 9,999
(manufactured cigarettes). manufactured cigarettes,
Brazil is the largest exporter of accounting for nearly 20 percent 33.6bn
IRELAND
45bn DENMARK

Top 10 tobacco leaf, and the Russian of the world total. Japan is the UNITED
KINGDOM NETH. NORWAY

Leaf exporters Federation and the USA are the largest importer of cigarettes. BELGIUM
GERMANY CZECH RUSSIAN
CANADA
191

LUX. REPUBLIC FINLAND

thousand metric tons largest importers. Some countries According to government FRANCE AUSTRIA SWEDEN
FEDERATION
SWITZ.
1999 67.6bn
164

that grow tobacco, such as the reports, 846 billion cigarettes CROATIA
POLAND 20bn
ITALY SLOVAKIA KAZAKHSTAN
USA, also import foreign tobacco were exported, but only SPAIN
132
129

PORTUGAL HUN REP.

120

U S A MOLDOVA
as well as exporting their own 619 billion were reported to be ALB
YUG BUL
AZERBAIJAN
UZBEKISTAN
JAPAN
101

TURKEY
Argentina 73

REP.
94

tobacco leaves. Interestingly, the imported. Statistics such as these GREECE

Malawi 93

25.2bn 56.5bn CYPRUS

SYRIAN ARAB
REPUBLIC
24.2bn KOREA
83.5bn
ISRAEL
Zimbabwe

MALTA
USA exports approximately the provide a sense of the size of the JORDAN
PAKISTAN
C H I N A
EGYPT
Greece

MEXICO
Turkey

same amount of tobacco that it cigarette smuggling problem.

China
Brazil

CUBA
India

DOMINICAN
Italy
USA

REP. SAUDI INDIA Hong

MYANMAR Kong SAR
imports. Because US tobacco is China is quietly emerging as a GUATEMALA
BELIZE JAMAICA
HONDURAS SENEGAL 20bn
ARABIA
THAILAND
YEMEN
popular globally, and tends to be significant cigarette exporter, VENEZUELA
BARBADOS PHILIPPINES
Russian Federation
USA
Germany
UK
113 Netherlands
Japan
71 France
70 Ukraine
60 Poland
55 Egypt

CÔTE d’
more expensive than tobacco increasing from virtually no COLOMBIA
SIERRA LEONE IVOIRE
SRI LANKA

CAMEROON MALAYSIA
from other countries, the value of exports in 1980 to over ECUADOR KENYA SINGAPORE
CONGO
US tobacco leaf exports are about 20 billion cigarettes exported in UNITED REP. 49.3bn INDONESIA
TANZANIA
BRAZIL
double that of the same quantity 2001, worth about US$320
99

MALAWI
of imports. million. In 2005 the value of ZIMBABWE
129

SAMOA
REUNION
China’s export trade in cigarettes PARAGUAY
Top 10 AUSTRALIA
190

Leaf importers is predicted to be US$600 CHILE SOUTH

FIJI

AFRICA
URUGUAY
thousand metric tons million.
241

ARGENTINA
1999 ssia
u
to R
263

NEW ZEALAND

to Denm
7,111 ark
an ermany
CANADA
to Netherlan 28,868 CANADA Jap to G
7,138 8,946 ds RUSSIAN to 5,134 ep. 4,681
1,130
FEDERATION eaR
9,252 r
Ko
an
y 873
man
UNITED
ium
Ger to Belg to
Ja p KINGDOM
NETHERLANDS DENMARK
to to Belgium
t 6,691 1,232 GERMANY
o

GERMANY
10,520 BELGIUM BELGIUM

U S A 77,133 SWITZERLAND
39,039 to Italy ITALY JAPAN USA SPAIN AND
7,181 TURKEY C H I N A 2,121 LIECHTENSTEIN REP.
CYPRUS KOREA
JAPAN
C hina to Cyprus LEBANON
from Turkey from 7,093 3,880 ISRAEL
an
876 ap
7,113
34,217 6,995
r ael from J
to Is
y

SAUDI
rk e

to 4,227 ARABIA
sia
one
from

DOMINICAN 4,437
sia Ind
Tu

REPUBLIC fro ne Lebanon

m t do m
o

M In ia fro
ra b
A

from

ala iA
rgen

m
wi 12,218 S a ud 743
fro

7,696 10,637 to
Tobacco leaves Cigarettes re
tina

Brazil

apo
metric tons 2000 metric tons 2000 t o Sing SINGAPORE

INDONESIA
3,388
BRAZIL I N D O N E S I A

MALAWI
total imported: 196, 597 total imported: 15,274
total exported: 182, 519 total exported: 148,533
52,786 13,743
13,997
US imports US imports
ARGENTINA

US exports US exports

US imports and exports

52 53
 16/ Smuggling CYAN MAGENTA YELLOW BLACK

Smuggled cigarettes
16 Smuggling Estimated smuggled cigarettes as percentage of
domestic sales 1995
SWEDEN 30% or more
ESTONIA
“…price is only one of many factors that RUSSIAN recent or current
LATVIA 20% – 29%
FED.
influence smuggling rates. Other more UNITED
smuggling routes
LITHUANIA
important factors include: the tobacco KINGDOM where known
industry’s own role in facilitating IRELAND NETH. 10% – 19%
BELARUS
smuggling; the lack of appropriate GERMANY POLAND
controls on tobacco products in BELGIUM
CZECH
5% – 9%
UKRAINE
international trade; and the existence of LUX. REPUBLIC SLOVAKIA
RUSSIAN
entrenched smuggling networks, FRANCE
AUSTRIA HUNGARY FEDERATION 1% – 4%
unlicensed distribution, lax anti- ROMANIA
smuggling laws, weak enforcement and C A N A D A
official corruption.” WHO, 2000 YUGOSLAVIA BULGARIA
no data
ITALY
Andorra ALBANIA

SPAIN
Between 300 and 400 billion Montréal GREECE
KAZAKHSTAN
cigarettes were smuggled in Vladivostok

1995, equal to about one third of UNITED STATES UZBEKISTAN

OF AMERICA AZER
all the legally imported cigarettes. TURKEY TURKMEN
REP.
KOREA
Cigarettes are the world’s most CYPRUS AFGHANISTAN
LEBANON C H I N A
widely smuggled legal consumer TUNISIA
ISL. REP.
The Chinese government loses

$1.8 billion
Port Said IRAN
product. They are smuggled LIBYAN Dubai
PAKISTAN NEPAL BHUTAN
ARAB
across almost every national JAMAHIRIYA EGYPT UAE
in revenue each year from
BANGLADESH
Hong Kong cigarette smuggling
border by constantly changing ST. MAARTEN
INDIA
MYANMAR
LAO SAR
PDR
routes. Aruba
NIGER
CHAD
THAILAND VIET NAM
Maradi SUDAN
Cigarette smuggling causes BURKINA FASO
CAMBODIA PHILIPPINES

immeasurable harm. International PANAMA

VENEZUELA
GUYANA TOGO NIGERIA DJIBOUTI
GHANA
brands become affordable to low- COLOMBIA
CAR SOMALIA
SRI LANKA
MALAYSIA
income consumers and to image- CAMEROON

SINGAPORE
conscious young people in ECUADOR
EQUATORIAL
GUINEA

developing countries. Illegal I N D O N E S I A

cigarettes evade legal restrictions BRAZIL
Projected share
and health regulations, and while if no action taken PERU
For every
20
the tobacco companies reap their 36% Global smuggling
2003-04 Numbers of smuggled cigarettes 1993
profits, governments lose tax 34% Iquique
2002-03 PARAGUAY 6% of world cigarette sales are smuggled
revenue. 32%

 cigarettes
sold

1
2001-02
Some governments are now Encarnation

 

suing tobacco companies for CHILE 

   rest of the world Eastern Europe
revenue lost due to smuggling    98 billion 85 billion
is smuggled
activities allegedly condoned by 25%
ARGENTINA
   

 global total
2000-01  318 billion
the companies. Measures needed Western Europe Asia-Pacific
to control smuggling should    50 billion 85 billion
include monitoring cigarette
routes, using technologically
sophisticated tax-paid markings 2001-02
2000-01 22%
2002-03 Lost revenue
on tobacco products, printing 21% 21% 2003-04
20% Tax revenue lost for each lorry load
unique serial numbers on all 1999-2000 smuggled into the European Union
Projected share
packages of tobacco 18%
if new measures are taken US$ 1997
products, and and duty increased by 5%
Meat / butter
increasing penalties. Live animals Milk powder $54,000
1998-99 $24,000 $36,000
12% Alcohol Cigarettes
$480,000 $1,200,000
Tackling tobacco smuggling
1997-98 Cigarettes smuggled into the UK
1996-97 6% as percentage of market share
54 4% 1996 – 2004 projected 55
 17/ Tobacco industry promotion CYAN MAGENTA YELLOW BLACK

Most popular cigarette brand by country

17 Tobacco Industry Promotion ICELAND

NORWAY
FINLAND
1999 or latest available data

Marlboro John Player

SWEDEN
RUSSIAN Belmont Prima
Cigarettes are possibly the most FED.
DENMARK LITHUANIA
marketed product in the world. UNITED State Express 555 Prince
KINGDOM Astra
While there is no reliable IRELAND Mocne
NETH. POLAND
Benson & Hedges Sportsman
GERMANY
estimate of global cigarette BELGIUM
CZECH Petra UKRAINE Bristol Winston
REPUBLIC
marketing expenditures, it is LUX.
Sopianae
Players AUSTRIA Carpati
RUSSIAN Casino other brands
clearly in the tens of billions of FRANCE SWITZ. HUNGARY
FEDERATION
US dollars a year.
C A N A D A ÒSponsorship is a Memphis ROMANIA
Delta named where known
form of advertising
Victory
BULGARIA
In the USA alone over which enables us to
Fortuna Red ITALY
SPAIN
introduce glamour
$10 billion is spent a year on SG
PORTUGAL GREECE
marketing cigarettes, and this at a and excitement.Ó Parliament
MONGOLIA
time when advertising is UNITED STATES MOROCCO Mild Seven
prohibited on television and OF AMERICA Michael Whitbread, JAPAN
Gallaher TURKEY
Tekel This
   
radio, when there are limitations International, Rothmans
REP.
KOREA
Hongtashan    
Hong Kong,1986
CYPRUS
on certain types of outdoor


LEBANON
MOROCCO Time
C H I N A
   
Red & White
advertising and sponsorship, and Casa Sports
ISRAEL
KUWAIT PAKISTAN
when cigarette sales are falling. MEXICO CUBA Cleopatra BAHRAIN
QATAR
Nacional



EGYPT UAE
Annual marketing expenditure is JAMAICA
DOMINICAN REPUBLIC SAUDI ARABIA
BANGLADESH Hong Kong
PUERTO RICO INDIA VIET NAM SAR
over $200 per smoker, and over Rubios HONDURAS Craven “A”
OMAN
Wills Gold Flake
46 cents for every pack sold.
GUATEMALA
EL SALVADOR NICARAGUA Embassy
THAILAND Vinataba
Hope   
Viceroy BARBADOS PHILIPPINES    
Promotional allowances, that is COSTA RICA TRINIDAD & TOBAGO Three Rings Krong Thip
VENEZUELA

GHANA
PANAMA GUYANA NIGERIA
payments made to retailers to SIERRA LEONE
Tresor SRI LANKA
Dunhill
COLOMBIA
facilitate sales, account for 41 Diplomat
CAMEROON
UGANDA MALAYSIA

percent of the total expenditure ECUADOR

Stella KENYA SINGAPORE
DEM. REP.
on cigarette marketing. CONGO Commodore
Derby
Cigarette marketing is bolder I N D O N E S I A
BRAZIL
and more aggressive in developing
countries than it is in the

)
Madison

ris
or
developed world. Cigarette ZIMBABWE

M
BOLIVIA MAURITIUS

lip
advertising on television and radio

hi
(P
CHILE Longbeach

o
is common, and a variety of other

or
Peter Stuyvesant

lb
FIJI
AUSTRALIA

ar
venues are exploited. These

M
SOUTH
AFRICA
include sports, arts, pop, fashion
and street events, adventure ARGENTINA 350
billion
tours, contests, give-aways and Holiday

y)
How the marketing $9,575m
Changes in cigarette marketing

ol
the internet.

op
NEW

M n
na a
on
dollar is spent in the USA

hi s h
There are also the hidden expenditure in the USA 1970-99 ZEALAND

(C g t a
2000

n
Ho
advertisements such as the US$ million cigarette consumption per person

y)
placement of cigarette smoking

)
co

ol
advertising on public transport 4

op
ac
speciality item distribution 265

amount spent US $million

entertainment sponsorship 310
promotional allowances 3,914

on
and tobacco products in films. In

To
233
special offers and gifts 3,516

M
direct mail advertising 93
point of sale advertising 347

y)
n
$4,895m
newspaper advertising 52

y)
billion

na
pa

ol
addition there is sponsorship of

ol
op
hi
(Ja
magazine advertising 295

op
internet advertising 0.95

(C

on

on
n
4,095

a
$3,992m

ve
3,969

M
universities, good-will donations 3,858

in

M
Se
outdoor advertising 9

na
Ch

)
na

sta
3,400

hi
ild

hi
d
for community events, and

(C

m
Re

(C
M

ee
2,827

he
ish
sports 128

(R
free samples 22

advertising of other goods and $2,476m 2,482

ng
Ba

a
im
Ho
coupons 705

1,975

Pr
products bearing the cigarette 130 130
$1,242m
name. Such marketing is seen billion billion
$491m 110
throughout both the developed $361m billion 103 100
billion billion
and the developing world. 1970 1975 1980 1985 1990 1995 2000 World’s most popular brands
1999
58 59
 18 INTERNET SALES CYAN MAGENTA YELLOW BLACK

18
BUY CHEAP SPECIALS DISCOUNT CIGARS BIDIS PREMIUM TOBACCO
Internet Sales DUTY
G O V E R N M E N T H E A LT H WA R N IN G : S M O K I N G C A N S E R I O U S LY D A M A G E Y O U R H E A LT H

G O V E R N M E N T H E A LT H WA R N IN G : S M O K I N G C A N S E R IO U S LY D A M A G E Y O U R H E A LTH
FREE
G O V E R N M E N T H E A LT H WA R N I N G: S M O K I N G C A N S E R IO U S LY D A M A G E Y O U R H E A LT H

G O V E R N M E N T H E A LT H WA R N IN G : S M O K IN G C A N S E R IO U S LY D A M A G E Y O U R H E A LT H

G O V E R N M E N T H E A LT H WA R N IN G : S M O K I N G C A N S E R IO U S LY D A M A G E Y O U R H E A LT H
G O V E R N M E N T H E A LT H WA R N IN G : S M O K IN G C A N S E R I O U S LY D A M A G E Y O U R H E A LT H
G O V E R N M E NT H E A LT H WA R N IN G : S M O K IN G C A N S E R I O U S LY D A M A G E Y O U R H E A LT H

G O V E R N M E N T H E A LT H WA R N IN G : S M O K IN G C A N S E R IO U S LY D A M A G E Y O U R H E A LT H

G O V E R N M E N T H E A LT H WA R N I N G : S M O K I N G C A N S E R IO U S LY D A M A G E Y O U R H E A LT H

“The ideal product to sell

online would be easy to pack and ship,
be much cheaper than what’s charged
at the retail counter, and be craved
by tens of millions of people every day. WHERE ARE THE GOODS?

SELLERS
Cigarettes, the internet was made for you.”
David Streitfeld, Washington Post, 2000
INTERNET CIGARETTE SEARCH Google, 2002

WORLDWIDE
Cigarette vendors are very easy to
locate online by the simplest Test ordering from 1 2 websites
search mechanisms. which claim to offer low price cigarettes
This mode of purchase to the UK market 2001 Search term Results found
translates into global penetration

BUYERS
of tobacco products, discount cigarette 9 , 070
unprecedented access of 3 sites sent cigarettes

WORLDWIDE
cigarettes to minors, cheap cheap cigarette 5,510
cigarettes through tax avoidance 1 site charged but did not send cigarettes
and smuggling, and unfettered tax free cigarette 1,540
advertising, marketing and 8 sites took no money and sent no cigarettes
promotion. mail order cigarette 374
It is often impossible to identify
the country of origin of such Prices quoted for 200 cigarettes £10 – £27
vendors. The majority appear to
be in Europe and the USA, but Retail price in UK £38.60
countries as varied as Cyprus and
Panama also offer internet sales. Price in UK if intercepted by Customs £38.15 INTERNET CIGARETTE VENDORS, USA 2000
Strangely, some vendors take
credit card details from
prospective purchasers but then
neither charge nor dispatch any “Wow!!!!!!!!!!!!!!!!
cigarettes. What a great internet cigarette vendor sites 88
The internet is also used by “Most sites offering “Philip Morris admits website for cigs. I
tobacco interests to undertake can’t believe I have sites with Surgeon-General’s warning 24%
cheap cigarettes are a rip being behind Wavesnet
sophisticated public relations, to been looking all
off. All cigarettes bought website, an internet sites selling bidis 8%
denigrate pro-health organisations over the web for
and individuals, to undermine the
via the Internet must company set up to run
bear UK taxes. There are fashion parades and rave cheap cigs and here sites with special promotions 33%
science of tobacco, and to attack
no allowances or loopholes. parties where cigarettes you were all the
tobacco control legislation (see
Cigarettes bought from are sold at a discount.” time..........with a sites with age warning 81%
map 20). Legislation has not yet
caught up with this new threat to sites that do not arrange complete list of
health. payment of UK taxes are Australian Associated companies. Thanks types of age verification required:
Sales of cigarettes and other liable to forfeiture. In Press, 2000 a lot!”
forms of tobacco over the the last year Customs
customer self-reporting they are over 18 49%
internet started in earnest in the have destroyed over 10
mid-1990s, and are predicted to typing in a birth date 15%
million such cigarettes.”
rise in future.
entering driving license information 9%
HM Customs and Excise, UK User comment posted on
2000 discount cigarette site, 2002 US teenagers with internet access over 50%

60 61
 19 Politics CYAN MAGENTA YELLOW BLACK
19
The tobacco industry spends
millions of dollars trying to
influence public policy. It makes
major contributions to elected
officials and political parties,
payments to governments to
support infrastructure such as
mass transit and large investments
in sophisticated public relations
campaigns. The industry also
gives money to civic, educational
and charitable organisations and a
host of others.
Since 1995 US tobacco
companies have donated more
than $32 million in political
contributions to state and federal
candidates and political parties in
the USA, with over 80 percent of
this paid to influence federal
elections and officeholders. From
1995 to 2000 current members of
Smokeless Tobacco Council $1.8m
Tobacco Institute $2.1m
Lorillard-Loews $2.6m
Brown & Williamson (BAT)
US Tobacco Company
“Unless countervailing
steps are taken (such as lobbying),
public decision-making will march
with public opinion.”
RJ Reynolds, 1978
62
Politics
the US Congress have received
over $5 million in contributions
from tobacco companies, and
nearly six out of ten have
accepted tobacco money.
The tobacco industry sought to
delay, and eventually defeat, the
EC directive on tobacco
advertising and sponsorship by
seeking the aid of figures at the
highest levels of European politics
while at times attempting to
conceal the industry’s role.
Parliamentarians in Europe have
accepted money and even senior
positions in tobacco companies.
Tobacco companies also attempt
to influence the political process,
by subsidising the air travel of
candidates and their staff, funding
political conventions and
inaugurations, and hosting
$3.7m $15.8m
Philip Morris
$4.1m
$5.4m
RJ Reynolds
Total: $35.5 million
Small shopkeepers were
enlisted to write
protests to members of We have got the unions
Parliament; the letters to support industry in
fundraisers. As well as campaign
some with deliberate several countries.
contributions, tobacco companies typographical errors to Prominent have been the
conduct direct lobbying and create the aura of efforts they have made
sophisticated public relations authenticity, were on the tax issues in the
prepared by the Philip Morris and the
campaigns, including paid media, UK where they were very
(tobacco) industry for industry are positively
to influence the opinions of involved in a letter
the shopkeepers. impacting the government
writing campaign to
political decision-makers. Members of Parliament.
decisions of Bahrain,
Comprehensive tobacco Philip Morris, 1990 Kuwait, Oman, Qatar, Saudi
Arabia and the UAE through
legislation was defeated in the US Philip Morris, 1985
the creative use of market
Senate in 1998. Those who voted specific studies, position
against the legislation had papers, well briefed
received on average, nearly four distributors who lobby,
times as much money from the media owners and
consultants
tobacco industry in the two years
before their last election, as those Philip Morris, 1987
who voted in favour of the bill.
Buying influence and favours
through political contributions is
common practice; however, most Turning now to primary
countries do not require and passive smoking To
get more favorable
mandatory reporting. press,
we are contemplating
organizing another
journalists conference
similar to the one we
Buying influence put together in Madrid
Expenditure on lobbying by
for Latin American
US tobacco companies
journalists in 1984.
USA 1997
Philip Morris, 1985
Buying favours The International
Philip Morris $10.2m
Top tobacco contributions
$2.9m Brown and Williamson (BAT)
Tobacco Growers
to federal candidates
$3.4m US Tobacco Company
Association could
USA 1995–2000
front for our third
world lobby activities
$0.6m Smokeless Tobacco Council
at WHO, and gain support
$0.2m Pinkerton Tobacco Company
from nations hostile
$1.2m Tobacco Institute
to multinational
$0.4 Swisher International
$0.3m Conwood Company
corporations
$0.6 Lorillard Tobacco
RJ Reynolds $4.7m
INFOTAB,
(tobacco industry
“What are we trying to accomplish? pressure group), 1988
Prevent further deterioration of overall
social, legislative and regulatory climate,
and ultimately, actually improve the
climate for the marketing and use of
tobacco products.”
Philip Morris, 1990
63
 20 smokers rights CYAN MAGENTA YELLOW BLACK

Smokers’ Rights Organisations

20 Smokers’ Rights 2002 where known

Organisations Norway
• Roykringen
FOREST: Freedom Organisation for the Right
to Enjoy Smoking Tobacco

FORCES: Fight Ordinances & Restrictions

to Control & Eliminate Smoking
Denmark Sweden
• Hen-Ry • Smokepeace
Sweden
Netherlands • Vänliga Rökares
• FORCES Internationella
Netherland Germany Förbund
• Stichting Rokers • Raucher Club Russian
Canada Belangen Federation
• FORCES Canada Deutschland
• FORCES RUSSIAN FEDERATION
• Smokers Unity International
C A N A D A Network
United
NORWAY SWEDEN
Kingdom
• FOREST DENMARK
Poland
UK • Towarzystwo
Belgium NETH
POLAND Ochrony
• The Smoking BEL GERMANY
Palacych

 

France FRANCE   

 
• Association SWITZERLAND

 
 

du Calumet de
UNITED STATES la Paix ITALY   
OF AMERICA USA 
 
 

• FORCES International
• American Smokers
SPAIN
GREECE

   
 
Greece
Alliance
Spain
• Club de • Eleftheria

    
• National Smokers  



Alliance
Fumadores por
la Tolerancia Switzerland
Italy
)    +  !  
• FORCES Italiana
• Tobacco • Associazione    

    
Friends Club Italiana Fumatori  
!
  
  
  

• Federazione
 
   
 
 
Tabaccai
-
    
  

 
 
 "
    
  
   #$ # %&'(
The tobacco industry has long company funding. In a 1988

/    
  
 
appreciated the importance and document, the head of Philip
      
 
difficulty of mobilising smokers to Morris said, “Should we strive to   - 
  

 
 
speak out on behalf of smokers’ set up FOREST type 

  


  "
rights. Consequently the tobacco organisations throughout our 
  
 
  
    +  %&&.
companies have investigated ways regions?”.
    
that they could “stimulate” the At the request of Philip Morris 
 
   
development of groups of the public relations firm of  
  


smokers, so as to have the Burson-Marstellar formed the  "

support, or at least the National Smokers Alliance, a
appearance of support from smokers rights group, in 1993.
     +  %&(,
  


smokers and other “natural or Philip Morris initially provided
 ) 
 


third party allies”. the National Smokers Alliance 

*  
 
There are fewer than two dozen with $4 million in seed funding. 
 
  * 
- 0


smokers’ rights organisations in Documents show that Philip 
  
 
  /1# 

   AUSTRALIA
the world, and all are in the Morris formed similar groups  



 *
        
!
developed world. The tobacco throughout Europe. These     "

 

industry documents illustrate that “grassroots” groups, with their  

while many of these organisations facades of “independence” from +  %&(,

"
purport to be independent of the the industry, allowed them to do
tobacco industry, at least some and say things publicly that +  %&(, New Zealand
• FORCES NEW
are dependent on tobacco tobacco companies could not. New Zealand
ZEALAND
• Smokers of
the World Unite

64 65
 21 tobacco Industry documents CYAN MAGENTA YELLOW BLACK

Legacy website
21 Tobacco Industry Documents ICELAND Guildford:
British American
FINLAND
Number of documents relating to each country found
on the Legacy website of tobacco industry documents 2002
Tobacco NORWAY
SWEDEN
ESTONIA
The higher the figure, the more important the country is
LATVIA
RUSSIAN to the industry.
“On May 12, 1994, an unsolicited box FED.
DENMARK
of what appeared to be tobacco company LITHUANIA 5,000 and above
documents was delivered to Professor
IRELAND UNITED
Stanton Glantz…The documents in the box BELARUS
dated from the early 1950’s to the early
KINGDOM NETH. GERMANY POLAND 1,000 – 4,999
BELGIUM
1980’s. They consisted primarily of CZECH UKRAINE
REPUBLIC SLOVAKIA
confidential internal memoranda related LUX.
REP.
500 – 999
HUNGARY
to B&W and BAT. Many of the documents FRANCE SWITZ.
AUSTRIA MOLDOVA
SLOVENIA ROMANIA RUSSIAN
contained internal discussions of the CROATIA 100 – 499
C A N A D A B-H FEDERATION
tobacco industry’s public relations and SAN MARINO
BULGARIA
SPAIN YUGOSLAVIA
legal strategies over the years, and they MONACO ITALY FYR MACEDONIA under 100
ANDORRA ALBANIA
were often labelled “confidential” or
’privileged.’ The return address on the box PORTUGAL no 
data orother countries
GREECE
was simply ‘Mr Butts’.”
KAZAKHSTAN

MOROCCO TUNISIA MONGOLIA

MALTA
JAPAN
So starts The Cigarette Papers, the UNITED STATES Minnesota: ALGERIA GEO
UZBEKISTAN
KYRGYZSTAN
OF AMERICA Philip Morris AR AZER
first report chronicling the release RJ Reynolds TURKEY
M TURKMEN
TAJIKISTAN REP.
KOREA
of previously secret tobacco Brown & Williamson/BAT C H I N A

TUNISIA
AFGHANISTAN
Lorillard see inset IRAQ ISL. REP.

"
industry documents. Public The Tobacco Institute MOROCCO IRAN

release of these documents clearly The Council for Tobacco Research LIBYAN KUWAIT PAKISTAN BHUTAN
ALGERIA NEPAL
BAHAMAS ARAB BAHRAIN
MEXICO
illustrated their power in JAMAHIRIYA
EGYPT
QATAR
UAE
CUBA DOMINICAN
BANGLADESH
exposing tobacco industry JAMAICA
BELIZE
REPUBLIC
PUERTO RICO
SAUDI ARABIA
INDIA
MYANMAR LAO
HAITI ANTIGUA & BARBUDA OMAN PDR VIET NAM
ST KITTS &
corporate behaviour, and they GUATEMALA
HONDURAS
NEVIS DOMINICA CAPE VERDE
MALI NIGER THAILAND
EL SALVADOR SENEGAL ERITREA YEMEN
ST LUCIA
profoundly influenced public NICARAGUA ST VINCENT & GRENADINES
GRENADA BARBADOS
GAMBIA
BURKINA
CHAD SUDAN
CAMBODIA PHILIPPINES
TRINIDAD & TOBAGO GUINEA-BISSAU FASO DJIBOUTI
NIGERIA
opinion. COSTA RICA

BENIN
VENEZUELA GUINEA

GHANA
TOGO
PANAMA GUYANA CÔTE
ETHIOPIA PALAU
SURINAME SIERRA LEONE D’IVOIRE MALDIVES SRI LANKA
Following the release of the COLOMBIA CAMEROON
CAR
BRUNEI DAR.
MICRONESIA,
LIBERIA SOMALIA MALAYSIA
BAT documents and as a result of EQUATORIAL UGANDA FED. STATES OF

million
GUINEA KENYA SYRIAN ARAB
CYPRUS REPUBLIC SINGAPORE
litigation and legal settlement ECUADOR
SAO TOME
GABON
R SEYCHELLES LEBANON
& PRINCIPE B IRAQ
ISRAEL
agreements in the USA,
pages
UNITED REP. PAPUA
WEST BANK JORDAN
TANZANIA I N D O N E S I A NEW
AND GAZA
documents introduced through BRAZIL
COMOROS
GUINEA SOLOMON
ISLANDS

legal discovery have had to be of once secret PERU

ANGOLA
ZAMBIA
MALAWI EGYPT SAUDI ARABIA
made publicly available by the internal tobacco BOLIVIA
ZIMBABWE
MADAGASCAR
MAURITIUS
tobacco industry in physical industry
NAMIBIA
BOTSWANA KIRIBATI
MOZAMBIQUE

documents are
PARAGUAY
depositories in Minneapolis, USA CHILE TOKELAU
TUVALU
and Guildford, UK. now in the public SOUTH
S AUSTRALIA NAURU
SAMOA

domain
L
As a result of the 1998 Master URUGUAY
AFRICA
VANUATU
COOK
FIJI NIUE
Settlement Agreement between
ARGENTINA TONGA
46 states and the tobacco
industry, the documents of the
NEW
Minnesota Depository are to be

7    
ZEALAND

duplicated online via searchable
*  " 
           

websites maintained by each of   #  $      # +    "
the companies. %   
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66 67
 22 Research CYAN MAGENTA YELLOW BLACK

Tobacco control research projects

22 Research completed Global Youth Tobacco Surveys (GYTS)
nationally or in at least one site 2002

Tobacco Control
Current foundation grant recipients selected countries
RUSSIAN
Basic scientific epidemiological (BMJ) FED.
LITHUANIA
International Development Research Centre –
UNITED
research over the last 50 years has European Union:
KINGDOM
Research for International Tobacco Control
In addition to subsidising the
proved the harmfulness of growing of tobacco, the EU GERMANY
POLAND United Nations Foundation
also invests a small, but HQ BELGIUM
tobacco. growing proportion of money EU Community Fund
UKRAINE
in tobacco control and for Research Rockefeller Foundation
Reducing tobacco use requires alternative crops. and Information REP.
knowing what works, and on Tobacco MOLDOVA RUSSIAN
FEDERATION
Fogarty International Center
applying this information C A N A D A

systematically. Building the other foundations

scientific base is a prerequisite for
HQ IDRC
journals devoted to tobacco control
progress. In developed countries, Journal of the Society for Chest
Research on Nicotine Foundation MOROCCO TUNISIA
there has been no shortage of data and Tobacco HQ HQ Rockefeller Foundation
on tobacco use. Thanks in part to U S A HQ United Nations Foundation
KYRGYZSTAN

investments by international HQ Fogarty International Center

see inset

TUNISIA
development agencies and C H I N A
MOROCCO
foundations, tobacco control KUWAIT PAKISTAN
BAHAMAS NEPAL
research in the developing world MEXICO
DOMINICAN
BAHRAIN
Macau SAR
REPUBLIC
UAE
is also beginning to flourish. CUBA
JAMAICA SAUDI ARABIA
Hong Kong SAR

BRITISH VIRGIN ISLANDS MYANMAR

INDIA NORTHERN
While increased funding is HAITI
VIRGIN ISLANDS (US)
ANTIGUA & BARBUDA MAURITANIA
MALI
OMAN
THAILAND
VIET NAM MARIANA
ISLANDS
MONTSERRAT DOMINICA NIGER
important, barriers continue to ST VINCENT & GRENAD.
ST LUCIA
SUDAN PHILIPPINES
GRENADA BARBADOS BURKINA CAMBODIA
exist. A recent report highlighted COSTA RICA TRINIDAD & TOBAGO SENEGAL FASO
NIGERIA
VENEZUELA

GHANA
GUYANA
recurring research themes for SURINAME SRI LANKA PALAU

COLOMBIA
developing countries, including TURKEY MALAYSIA
MICRONESIA,
FED. STATES OF

the lack of standardised data, ECUADOR $156,000

SINGAPORE
KENYA LEBANON
absence of a network for
WEST BANK JORDAN
communication, lack of tobacco AND GAZA
I N D O N E S I A

control research capacity, and the BRAZIL

PERU MALAWI SAUDI ARABIA
need for human and financial EGYPT

resources. BOLIVIA ZIMBABWE

The source of the funding is of CHILE

$116,000 MOZAMBIQUE

equal importance. Historically, S

tobacco companies have SOUTH
URUGUAY
AFRICA
sponsored research, promising How much research? FIJI
complete independence, only to ARGENTINA
Number of times keywords found in search
bury unfavourable findings and of 45,000 medical research papers
delete words such as “cancer.” April 2002
2 3 2
To improve their public image,
7 ,67 ,78 ,24 4 03 37 150 68
43 1 76 1 08 , 70 4,3 5,8 57, 18,2
tobacco companies are once again l 6 8 7 s
ho
l tes cel S1
0 ing s
ite otic ine
co be m ok ras arc Coca
offering substantial research
$47,000 Al Dia Ste AID Sm Pa N
funding to academic institutions
Comparative research expenditure ,52
0
worldwide, promising complete 1
National Institutes of Health spending on
1,40
independence. Academic research funding for major diseases cer
n
researchers should consider this US$ per related death 2001 Ca
option cautiously, given the $15,000
$10,000 $11,000
history of misuse of $8,000
scientific findings. $1,000 $1,400 $2,000
r

a
n
s
ke

is
es
e

er

DS
as ula

er

m
sio
us

os
et
ro

nc

th

AI
ul
se asc

en
ab
o

St

ei
Ca

As
cc

rc
rt
zh
e

Di
v
ba

be
io

pe
Al
rd

Tu
To

Hy
di

70 71
Ca
 23 Tobacco control organisations CYAN MAGENTA YELLOW BLACK

Edinburgh Tobacco control organisations

23 Tobacco Control Tobacco Control Resource Centre,
European Network
of Quitlines
Stockholm
European Nurses
Against Tobacco
World Health Organization and regional
Organisations London
Helsinki
Quit & Win
and associated offices

“To be sure of victory the wise in warfare International Agency Copenhagen

on Tobacco and Health, EURO international organisations
see to it that they first have a strong Helsinki
International Network Towards European Network
moral cause and that the army is well Smoke-Free Hospitals of Young People and Tobacco regional organisations
disciplined.”
General Sun Tzu, The Art of War: A Treatise
on Chinese Military Science, c.500BC
Brussels
European Network
“Tobacco is a killer. We need a broad Paris for Smoking
alliance against tobacco, calling on a wide European Union of Prevention
range of partners to halt the relentless Non-smokers,
increase in global tobacco consumption.” European Network for
Smoke-free Hospitals Geneva Geneva
Dr Gro Harlem Brundtland, Chicago
Director General, WHO, 1998 WHO HQ, European Medical
International Tobacco Lyon Association
Evidence Network UN Ad Hoc
International Agency Interagency Task Force on Smoking
for Research on Cancer on Tobacco Control and Health
The tobacco control network is Middleton, Wisconsin
Society for Research Boston
committed and far-reaching. The on Nicotine and Tobacco Geneva
Network for Accountability Globalink, UICC International
World Health Organization’s of Tobacco Transnationals Union Against Cancer
Washington DC
Tobacco Free Initiative (TFI) is AMRO/PAHO Bangladesh Seoul
Tobacco Free Forum, Asia Pacific Association
conducted from headquarters in New York New York South Asia Association
Washington DC Liaison Office International Network for the Control of Tobacco
Amman for Regional Cooperation
Geneva and the regional and Global Partnerships with the UN, of Women Against Tobacco
for Tobacco Control UN Ad Hoc Cairo Arab Council on
national offices around the world. Interagency Task Force EMRO Smoking Control New Delhi
on Tobacco Control SEARO
There is now a WHO Focal Point Hong Kong
Asian Consultancy
on Tobacco or Health in all on Tobacco Control
countries, and the TFI is Manila
Bamako Bangkok
supported by a number of other L’Observatoire du Tabac Southeast Asian Tobacco
WPRO
international agencies such as en Afrique Francophone Control Alliance
Unicef, the World Bank, IARC Kuala Lumpur
and the UN Foundation. Network for Islamic
Approach Against Tobacco
The non-governmental
organisations (NGOs) highlighted
on this map are those whose Lima
remit is 100 percent tobacco- Latin American
Coordinating
related. There are dozens more Committee on Harare
Tobacco Control AFRO
international NGOs which
address tobacco control as part of
their activities, ranging from the Johannesburg
International
World Medical Association to Non Governmental Coalition
Perth
Framework Convention
Consumers International. Against Tobacco Alliance
in a
Academia is also a valuable to win
e c an n ot hope ti o n. Our
partner, as many universities time on tobacco issues. W
c on fronta ver
o n s c o
carry out research and promote head- to di
Numerous other partners include
ct i cs must be ak n es s es,
ta we
policy initiatives in tobacco organisations involved with onents lar
our opp h o se particu
control. women, youth, environment, t ch
attack a s m u
i n ts , cause e , and
There are also many national law, economics, human rights, po ossibl World conferences on tobacco or health
on f us i on as p e ls e w hile
tobacco control organisations religion and development. c
somewhe
re
attack is
whose impact is not restricted to Most tobacco control i r a tt ention 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th
the te d
that country but also felt organisations are seriously under- distrac ment.
is a key ele 1967 1971 1975 1979 1983 1987 1990 1992 1994 1997 2000 2003
worldwide. These include ASH in funded given the scope of the ur p r is e
S New York London New York Stockholm Winnipeg Tokyo Perth Buenos Aires Paris Beijing Chicago Helsinki
the UK, ThaiHealth in Thailand, tobacco epidemic. The better 1978
Morris, USA UK USA Sweden Canada Japan Australia Argentina France China USA Finland
and the Campaign for Tobacco financed, such as ThaiHealth, are Philip
Free Kids in the USA. In addition, funded by a percentage of
many national NGOs work part tobacco tax.
72 73
 24 Smoke free areas CYAN MAGENTA YELLOW BLACK

Smoke-free areas at work

24 Legislation: Smoke-free Areas Some, partial or all areas 2000
smoking is prohibited
in some areas
ICELAND
Banning smoking in public places NORWAY
FINLAND
smoking is restricted
is a sound public health measure in some areas
SWEDEN
ESTONIA
to protect the health of non- RUSSIAN
LATVIA
FED. employers voluntarily prohibit or restrict smoking
smokers. UNITED DENMARK
LITHUANIA
KINGDOM
The issue of workplace bans is IRELAND
no bans or no data
BELARUS
primarily one of labour legislation NETH. GERMANY POLAND
BELGIUM 90% public support for restrictions
to protect the health of workers, CZECH
REPUBLIC SLOVAKIA
UKRAINE
on where people can smoke
REP.
who are exposed to passive SWITZ.
AUSTRIA HUNGARY MOLDOVA 2001 percentages in selected countries
FRANCE SLOVENIA ROMANIA RUSSIAN
smoking for long periods during C A N A D A CROATIA B-H FEDERATION
SAN MARINO
their work shifts, whether this be BULGARIA

SPAIN
in public or office buildings,
PORTUGAL
restaurants or public transport. GREECE

Workplace smoking bans are MONGOLIA

MOROCCO TUNISIA 79%
effective in reducing exposure to UNITED STATES
KYRGYZSTAN
OF AMERICA JAPAN
passive smoking. Smokers who TURKEY
REP.
are employed in workplaces with SYRIAN ARAB
REPUBLIC C H I N A
KOREA

CYPRUS LEB
smoking bans are likely to TUNISIA
ISRAEL
IRAQ
MOROCCO
1729 Bhutan
consume fewer cigarettes per KUWAIT BHUTAN First documented
NEPAL
day, are more likely to consider MEXICO
98%
legislation
EGYPT
quitting, and quit at a greater CUBA BANGLADESH bans tobacco use in
BELIZE MALI
LAO
all religious places,
rate, than smokers employed in GUATEMALA
HONDURAS DOMINICAN
REPUBLIC INDIA
PDR
THAILAND which is still observed
EL SALVADOR
workplaces with no or weaker GRENADA
BARBADOS
85% SUDAN
CAMBODIA today.
PHILIPPINES
policies. COSTA RICA TRINIDAD & TOBAGO

BENIN
PANAMA VENEZUELA
NIGERIA
A total ban works better than SRI LANKA

MICRONESIA,
a partial ban. Most airlines are UGANDA MALAYSIA FED. STATES OF

now smoke-free and the global ECUADOR SINGAPORE

d
trend is towards a safer, cleaner anne
re b es,
UNITED REP. 1970 Singapore
w e TANZANIA The cost of workplace smoking
ing rkplac rage
indoor environment in the home Smoking banned in buses, SOLOMON

smok
BRAZIL Euros 2000 ISLANDS
o e cinemas, theatres
and in public and work places. ÒIf n all w ryÕs av uld and other specified
i s t w o PERU

indu
ZAMBIA a company has 10,000 employees
ion he buildings.
the onsumpt É and t uld of which 3,000 smoke
c ine e wo is each smoker smokes 6 cigarettes per day at work
decl ing rat rly, it
BOTSWANA
CHILE a cigarette break lasts 5 minutes KIRIBATI

t a r
quit seÉ Cle tant fo o
each smoker wastes 30 minutes every working day TOKELAU

t an employee on Û8.64 per hour

ea or AUSTRALIA
incr ost imp ontinue ation
12.4 94%
costs the company Û1,037 per annum
SOUTH SAMOA

m o c mmo d AFRICA COOK

PM t t acco in the
the 3,000 smokers cost the company FIJI NIUE

r s Û3.1 million per annum

p o r
sup r smoke lace.Ó
ARGENTINA TONGA
9.5
fo workp $2.7bn
992
s, 1
NEW
7.9
o r r i No loss of restaurant and bar sales $2.6bn ZEALAND

ip M
Phil
First quarter sales before and after
smoking bans in restaurants and bars smoking smoking 2001
serving food and alcohol banned banned $2.3bn 2000
California 1992-2001 in restaurants in bars
US$ billions
2.8 $2.1bn
2.2 1999
$2.0bn $2.0bn
0.9 $1.8bn $1.8bn $1.8bn $1.8bn
0.7 Polluted spaces 1998
0.0 Nicotine concentration in public places 1996 1997
restaurants secondary household large underground medical hospitals household Barcelona, Spain 2000
school smokers stores subway stations school non-smoking micrograms per cubic metre 1992 1993 1994 1995

74 75
 25 Advertising Bans CYAN MAGENTA YELLOW BLACK

25 Legislation: Advertising Bans ICELAND

NORWAY FINLAND
2.0%
SWEDEN p.a.
The tobacco industry denies that
advertising plays a role in DENMARK anti-tobacco
UNITED
encouraging people to smoke or KINGDOM advertising messages
IRELAND 15% of total tobacco
increasing the amount smoked, NETH. GERMANY
advertising messages
BELGIUM
but the research suggests
LUX. 6.3%
otherwise. As governments AUSTRIA
FRANCE SWITZ. Percentage reduction
acknowledge the harm caused by comprehensive set in smoking
C A N A D A ITALY
tobacco and the need to of advertising bans 2000
discourage its use, restrictions SPAIN ALBANIA

and outright bans on tobacco PORTUGAL Effect of Ad bans

GREECE

advertising are becoming

MOROCCO TUNISIA
common. Partial restrictions are UNITED STATES
ALGERIA
OF AMERICA JAPAN
notorious for leading to other
TURKEY REP.
forms of marketing supplanting AFGHANISTAN
KOREA

TUNISIA
the restriction. Because of the MOROCCO ISRAEL IRAQ ISL. REP.
IRAN
shift of marketing dollars from PAKISTAN
ALGERIA NEPAL
one medium to another, the MEXICO
JORDAN
EGYPT
evidence suggests that JAMAICA
DOMINICAN
REPUBLIC SAUDI ARABIA
BANGLADESH
MYANMAR
INDIA LAO
comprehensive bans on all forms GUATEMALA
HONDURAS
PDR VIET NAM
NIGER THAILAND PHILIPPINES
of tobacco promotion can be EL SALVADOR
NICARAGUA
SENEGAL
SUDAN
YEMEN
CAMBODIA
effective in reducing tobacco use, COSTA RICA TRINIDAD & TOBAGO NIGERIA

BENIN
VENEZUELA

GHANA
TOGO
PANAMA CÔTE
while partial restrictions have SIERRA LEONE D’IVOIRE ETHIOPIA SRI LANKA
COLOMBIA
limited or no effect. CAMEROON
UGANDA MALAYSIA

Cigarette packaging plays an ECUADOR

KENYA SINGAPORE

increasingly important role as CONGO

UNITED REP.
I N D O N E S I A
advertising restrictions are BRAZIL
TANZANIA

implemented. Packet design plays

PERU MALAWI
an important role in establishing ZAMBIA
MADAGASCAR
brand imagery and competing for BOLIVIA
ZIMBABWE
MAURITIUS

potential customers. Many CHILE PARAGUAY

MOZAMBIQUE

countries are advocating plain AUSTRALIA

packaging. Some also propose the SOUTH
AFRICA
URUGUAY
banning of certain words such as
“Light” or “Mild” as these may ARGENTINA

convey the impression that the

cigarettes are less harmful or Changes in adult smoking rates
o.3:
NEW

contain fewer harmful P l an n ns of ZEALAND

on io Increases and decreases in adult cigarette consumption

Acti coalit dairy, It is
constituents. ew t , 1991 compared with 1981
m n
For ries (m
e a ) to felt t
s t r , etc. ery the co
nseque
hat gi
ven
in d u b e e li p
p nces o
try, on s total f a Decreases Increases
poul issue . advert ban on
y eory i
lobb lope th should sing, a pac more than 20% decrease less than 10% increase
s k
give t be designed
lds, he pro
R eyno lan impact duct v to 10% – 20% decrease more than 10% increase
R J isual
on P as wel
Acti bat ad l
imager as brand less than 10% decrease no data
c om , y.
to ons
s t r icti no change
re 1989 BAT, 1
986
comprehensive advertising bans
during this period
76 77
 26 Labels and Health warnings CYAN MAGENTA YELLOW BLACK

Health warnings
26 Legislation: Health Warnings ICELAND

NORWAY
FINLAND
health warnings on packs of cigarettes
SWEDEN
required by law
ESTONIA
LATVIA
RUSSIAN no health warnings required
“Plain packaging is important because it FED.
DENMARK
eliminates the positive imagery associated UNITED LITHUANIA
public support for visible
KINGDOM
with the brand and potentially disrupts
the process of smoking initiation whereby IRELAND
BELARUS
health warning messages
NETH. POLAND
child smokers become brand loyal.” GERMANY 2001 percentages
BELGIUM
Rob Cunnigham and GREENLAND CZECH
REPUBLIC SLOVAKIA
UKRAINE in selected countries
LUX. 88%
Ken Kyle, 1995 REP.
AUSTRIA HUNGARY MOLDOVA
FRANCE SWITZ. SLOVENIA ROMANIA
Health warnings about tobacco C A N A D A SAN MARINO CROATIA B-H RUSSIAN FEDERATION
YUGOSLAVIA BULGARIA
have been in existence for four ANDORRA
MONACO ITALY
ALBANIA
FYR
SPAIN MACEDONIA
hundred years, starting with King PORTUGAL
GREECE
James I in England and Fang Yizhi KAZAKHSTAN
78%
in China, both in the 17th century MOROCCO TUNISIA MALTA
MONGOLIA

(see map 1). UNITED STATES UZBEKISTAN DPR

ALGERIA KYRGYZSTAN KOREA
OF AMERICA GEO JAPAN
AR AZER
Cigarette packs first carried TURKEY
M TURKMEN
TAJ REP.
KOREA
health warnings in the 1960’s SYRIAN ARAB
REPUBLIC C H I N A

TUNISIA
CYPRUS AFGHANISTAN
LEB IRAQ ISL. REP.
following scientific reports on the BERMUDA
MOROCCO
ISRAEL
WEST BANK IRAN
JORDAN
hazards of smoking in the USA BAHAMAS ALGERIA LIBYAN
& GAZA KUWAIT PAKISTAN NEPAL
BHUTAN
ARAB BAHRAIN
MEXICO
and the UK. These early warnings DOMINICAN WESTERN SAHARA
JAMAHIRIYA
EGYPT
QATAR
UAE 98%
CUBA REPUBLIC BANGLADESH Hong Kong
were weak and inconspicuous. JAMAICA
BELIZE
ANGUILLA MALI
SAUDI ARABIA MYANMAR LAO SAR
HAITI ANTIGUA & BARBUDA MAURITANIA NIGER OMAN PDR VIET NAM
ST KITTS &
Contemporary Canadian warnings GUATEMALA
HONDURAS
NEVIS DOMINICA CAPE VERDE
INDIA
THAILAND PHILIPPINES
EL SALVADOR ST LUCIA
SENEGAL 83% ERITREA YEMEN
are the most vivid in the world NICARAGUA ST VINCENT & GRENADINES
GRENADA BARBADOS GAMBIA
BURKINA
CHAD SUDAN
CAMBODIA
TRINIDAD & TOBAGO GUINEA-BISSAU FASO DJIBOUTI
and are serving as the model for COSTA RICA

BENIN
VENEZUELA GUINEA

GHANA
TOGO
PANAMA GUYANA CÔTE

LIA
NIGERIA ETHIOPIA PALAU
SURINAME SIERRA LEONE

MA
D’IVOIRE MALDIVES SRI LANKA
other countries, such as Brazil. FRENCH GUIANA (Fr) CAR

SO
BRUNEI DAR.
COLOMBIA CAMEROON MICRONESIA,
LIBERIA MALAYSIA
While many countries have some EQUATORIAL
GUINEA
UGANDA
KENYA
FED. STATES OF

SINGAPORE
type of health warning on the ECUADOR SAO TOME
GABON
DEM. REP. R SEYCHELLES
& PRINCIPE CONGO CONGO B
pack, these are not universal and UNITED REP.
I N D O N E S I A
PAPUA
TANZANIA NEW
many that do exist are not as BRAZIL
COMOROS
GUINEA SOLOMON
ISLANDS
ANGOLA EAST TIMOR
unequivocal, simple and stark as PERU MALAWI
ZAMBIA
is necessary; some are not in the MADAGASCAR
MARSHALL
ZIMBABWE
BOLIVIA ISLANDS
local language nor on all tobacco NAMIBIA
BOTSWANA
MAURITIUS
MOZAMBIQUE KIRIBATI
PARAGUAY TOKELAU
products. CHILE
AUSTRALIA NAURU

ect
AMERICAN

ey rej
Reports from Canada and S
TUVALU SAMOA

ÒIf th ack, they

93% SOUTH L SAMOA
Australia suggest that plain
your p ct your
AFRICA COOK
URUGUAY VANUATU FIJI NIUE

packaging may increase both reje d.Ó TONGA

bran
ARGENTINA
prominence and believability of Health warnings in Canada
health warnings. That is, no use and
Brown son, Impact on smokers of the new Canadian NEW
of colour, logo or graphic design, a m
Willi 02
ZEALAND
health warnings 2002
but simply a generic pack of 20

90%

43%

44%

cigarettes, with the brand name.
Health authorities now
recommend that cigarette
packages should not contain tar
and nicotine levels as measured
by smoking machines, as these do
not reflect the actual inhalation of
tar and nicotine due to cigarette
design (primarily ventilation
holes), and individual smoker
behaviour (a tendency for
78
21%
Canadian warnings are the most vivid in the world
and serve as the model for other countries
noticed were more concerned felt increased motivation resisted
the new warnings about health effects to quit smoking temptation to smoke
of smoking on one occasion or more
smokers to compensate to get
more nicotine from each
cigarette) and are thus to include this information on the
misleading. Others suggest that a pack of cigarettes in a section on
range of values should be toxic constituents, which also
presented that better resembles includes levels of carcinogens and
how smokers actually smoke, and carbon monoxide exposure.
79
 27 Health education CYAN MAGENTA YELLOW BLACK

Anti-tobacco campaigns
27 Health Education ICELAND

NORWAY
FINLAND
2002
Countries participating in :
SWEDEN
ESTONIA World No Tobacco Day
RUSSIAN
LATVIA
Education is essential for UNITED DENMARK
FED.
Quit & Win
LITHUANIA
sustained progress in tobacco GREENLAND
KINGDOM as well as World No Tobacco Day
IRELAND
BELARUS
control. Many legislative or tax NETH. GERMANY POLAND The Quit & Win programme, in addition to helping
BELGIUM
interventions will not be CZECH UKRAINE smokers quit, is also an excellent vehicle for
nt:
stateme LUX. REPUBLIC SLOVAKIA
communicating the hazards of smoking, and often
effective if there is no public public
not old e
private statement: HUNGARY
REP.

e
AUSTRIA
r
MOLDOVA

ÒIf y o u Õ Õ r ÒYouth programs support

FRANCE SWITZ. serves as an opportunity for public advocacy
ive, you
ROMANIA RUSSIAN
understanding, support and SLOVENIA

demand for such changes. People enough to dr nough to

C A N A D A CROATIA B-H FEDERATION against smoking.
[our] objective of
e
BULGARIA

not old y not wait

YUGOSLAVIA

support tax increases when they discouraging unfair ITALY

ALBANIA
FYR MACEDONIA
h
SPAIN

smoke. W re 18 before and counterproductive

Õ
PORTUGAL
understand that the rationale is to
ntil y o u o r n o t federal, state and GREECE
u whethe r
deciding nt to smoke.Ó
reduce youth smoking: an average local
KAZAKHSTAN
MONGOLIA

you wa
MOROCCO TUNISIA
of 87 percent of respondents in restrictions on MALTA
UZBEKISTAN DPR

cigarette advertisingÉÓ
ALGERIA KYRGYZSTAN

orris
KOREA
Argentina, India, Japan, Nigeria, GEO JAPAN
Philip M ong Kong,
U S A AR AZER
M TURKMEN

d, H
TURKEY TAJ REP.
and the Russian Federation were
billboar 1990.
KOREA
US Tobacco Institute,
SYRIAN ARAB
REPUBLIC C H I N A

TUNISIA
CYPRUS
in favour of international efforts AFGHANISTAN

1991
BERMUDA ISRAEL LEB IRAQ ISL. REP.
MOROCCO
IRAN
to create a set of rules and WEST BANK
AND GAZA
JORDAN
KUWAIT PAKISTAN BHUTAN
BAHAMAS LIBYAN
ALGERIA NEPAL
regulations to curb tobacco use. MEXICO
ARAB
JAMAHIRIYA
BAHRAIN
QATAR
TURKS & CAICOS EGYPT
WESTERN SAHARA UAE
Schools can provide an ideal CUBA
JAMAICA
DOMINICAN
REP. PUERTO RICO SAUDI ARABIA
BANGLADESH
MYANMAR
Hong Kong
INDIA LAO SAR
venue not only to teach about the BELIZE
HONDURAS
HAITI
ST KITTS &
ANGUILLA
ANTIGUA & BARBUDA
MAURITANIA
MALI
OMAN PDR VIET NAM
GUATEMALA NEVIS DOMINICA CAPE VERDE NIGER THAILAND
harmful effects of smoking, but EL SALVADOR
NICARAGUA ST VINCENT & GRENAD.
ST LUCIA
SENEGAL
GAMBIA CHAD SUDAN
ERITREA YEMEN
GRENADA BARBADOS BURKINA CAMBODIA PHILIPPINES
also to teach students refusal skills COSTA RICA TRINIDAD & TOBAGO GUINEA-BISSAU FASO
NIGERIA
DJIBOUTI

BENIN
VENEZUELA GUYANA GUINEA

GHANA
TOGO
PANAMA CÔTE

LIA
and an understanding of the to quit smoking, and ideally SURINAME SIERRA LEONE ETHIOPIA PALAU

MA
D’IVOIRE MALDIVES SRI LANKA
FRENCH GUIANA (Fr) CAR

SO
BRUNEI DAR.
COLOMBIA
behaviour of the tobacco making the course part of a LIBERIA
EQUATORIAL
CAMEROON
UGANDA MALAYSIA
MICRONESIA,
FED. STATES OF
GUINEA
industry. This includes analysing coordinated school health ECUADOR GABON
KENYA SINGAPORE
SAO TOME DEM. REP. R SEYCHELLES
the manipulation of young people programme, reinforced by & PRINCIPE CONGO CONGO B
UNITED REP. PAPUA
by marketing which equates community-wide efforts. BRAZIL
TANZANIA I N D O N E S I A NEW
GUINEA SOLOMON
ANGOLA ISLANDS
COMOROS
smoking with growing up, To improve its public image, EAST TIMOR

t & Win Camp

PERU MALAWI
freedom and being cool. the tobacco industry has recently ZAMBIA

The first step with school become active in smoking BOLIVIA

ZIMBABWE
MADAGASCAR
Qui ipants are off to aign AUSTRALIA
programmes is to increase prevention programmes for BOTSWANA
MAURITIUS a r t ic bacc
of p oa
NAMIBIA MOZAMBIQUE
PARAGUAY
CHILE fte KIRIBATI
5%
MARSHALL
r on
knowledge about the harm caused young people. These programmes –2
ISLANDS TOKELAU
e
S % NAURU

ye
15
by smoking and to change beliefs, portray smoking as an adult SOUTH TUVALU AMERICAN

ar
L SAMOA
AFRICA
URUGUAY WALLIS AND
attitudes and intentions. This decision, and that young people FUTUNA ISLANDS (Fr) SAMOA COOK
FIJI NIUE
alone is not sufficient to change should wait until they are grown ARGENTINA
VANUATU TONGA
behaviour. A school tobacco up to decide to smoke. Since
control programme must also young people aspire to be young

60,0 0 0 p
NEW
ZEALAND
incorporate prohibiting tobacco adults, this type of message may

s
use at all school facilities and actually make smoking more

7 0,0

rie
art

nt
events, helping students and staff appealing to youth. ip u

ic
00
an co

20
ts 1

es
9 9 4 1 3 u n tri

pa
rti

0,0
cip
0
World No Tobacco Day: 31st May annual themes a n ts 1 9 9 6 2 5 co

0
pa es
rtic tri

42
0, i pan un
00 ts 1 9 9 8 4 8 c o
1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 0p s
70 a rt rie
0,0 icip u nt
Tobacco Women Growing up Tobacco in Tobacco Health The Media The Sports and The United Growing up Cessation The Secondhand Tobacco 00
a nts 2
0 0 0 71 co ie s
p a r ti ntr
or Health: and without Public at the Services, against Economics The Arts Nations and without Entertainment smoke kills. Free Sports: cipa cou
n ts 2 0 0 2 a b o u t 1 0 0
Choose Tobacco Tobacco Places and Workplace including Tobacco of Tobacco without Specialized tobacco Industry Let's clear Play it
Health on Public Health Tobacco Agencies the air clean
Transport Personnel, Against
against Tobacco
Tobacco "United for
a Tobacco-
80 Free World" 81
 28 Quitting CYAN MAGENTA YELLOW BLACK

NORWAY
Ex-smokers

28 Quitting ICELAND
FINLAND
Percentage of people who used to smoke
who have quit smoking latest available data
40% or more
SWEDEN
ESTONIA

“Every nicotine patch sold means LATVIA RUSSIAN 30% – 39%

FED.
200 cigarettes not sold.” Clive Bates, UNITED DENMARK LITHUANIA
KINGDOM 20% – 29%
ASH UK, 2002 NRT
GERMANY
NETH. (nicotine
In the UK, NRT is available IRELAND BELGIUM POLAND
UKRAINE 10% – 19%
The main dangers of smoking to all citizens under the CZECH replacement
REP.
National Health Service LUX.
REPUBLIC SLOVAKIA
MOLDOVA therapy) available
decrease when smokers quit, even and is reimbursed HUNGARY fewer than 10%
as any other AUSTRIA over-the-counter
RUSSIAN
in those who have smoked for 30 medicine. FRANCE SLOVENIA
ROMANIA
FEDERATION no data 2002
C A N A D A
or more years. SWITZ. ITALY
YUGOSLAVIA BULGARIA

Smokers move through stages in SPAIN

relation to quitting: of pre- PORTUGAL

GREECE
contemplation, contemplation,
GIBRALTAR
readiness then action, followed by UNITED STATES MALTA
ALGERIA
OF AMERICA JAPAN
maintenance or relapse. Many
TURKEY
move through this cycle several C H I N A
times before they finally quit, CYPRUS
ISRAEL
ISL. REP.
IRAN
while others report they found it BAHAMAS
KUWAIT
ALGERIA
easier to quit than they expected. MEXICO
EGYPT
These stages are influenced by JAMAICA
DOMINICAN
REPUBLIC SAUDI ARABIA Hong Kong
SAR
increased costs from tax increases HONDURAS
THAILAND
or reduction of smuggling, illness SUDAN

in the smoker, family or friends available in all parts of the world: VENEZUELA TRINIDAD & TOBAGO

GHANA
CÔTE
dying from tobacco, the media, social support, clinics, quitlines, COLOMBIA
D’IVOIRE

health profession, bans on internet sites; skills training;

promotion, creation of smoke- nicotine replacement therapy ECUADOR
SINGAPORE

free areas and, while most (NRT) and other pharmaceutical

smokers still quit on their own, treatments. BRAZIL
availability of support and If interventions only focus on
PERU MALAWI
treatment. prevention of initiation, and do ZAMBIA

There are now techniques to not address cessation, then

assist those who want to quit 160 million additional smokers CHILE
smoking, although these are not will die before 2050 (see below). AUSTRALIA
TUVALU
SOUTH
AFRICA
URUGUAY

Quitting Calendar TONGA

The benefits of stopping smoking Effect of Impact of interventions on
smoking restrictions starting to smoke and quitting NEW

1 day later Heart, blood pressure, and the blood at home and at work ZEALAND

show improvements USA 1992–93 percentages Type of Quitting

intervention
Excess risk of coronary heart attempted quitting
1 year later disease is half that of a continuing still not smoking six months later More than 10% 3% increase in quitting
smoker price increase
Effects of starting and quitting smoking on deaths 72%
5 to 15 years Risk of a stroke is reduced to that Total accumulated tobacco deaths Anti-smoking media Increased number of attempts
later of never-smokers 2000, 2025 and 2050 projected at home at work and success
millions 52% 51%
Risk of lung cancer is reduced to Bans on promotion Complete ban reduces
10 years 45% consumption by 6%
less than half that of continuing if present smoking patterns if youth uptake if adult consumption
later smokers; risks of many other continue… halves… halves… 35%
cancers decrease 520m 500m Restrictions on no evidence
340m youth access
Risk of coronary heart disease is 220m 220m 16% 13%
15 years similar to that of never-smokers, 150m 9% 11% 10% Smoking restrictions Work and household
later and the overall risk of death almost 70m 70m 70m restrictions most effective
the same, especially if the smoker
quits before illness develops no ban partial total ban in ban in NRT Higher number of attempts to quit
82 ban ban work area all areas 83
 29/Price Policy CYAN MAGENTA YELLOW BLACK

Tax as a proportion of cigarette price

29 Price Policy ICELAND

NORWAY FINLAND
2000 or latest available data
75% or more
SWEDEN
ESTONIA 50% – 74%
“Sugar, rum and tobacco are commodities DENMARK LATVIA
which are nowhere necessaries of life, which UNITED 25% – 49%
are become objects of almost universal KINGDOM
IRELAND
consumption, and which are therefore POLAND
extremely proper subjects of taxation.” NETH. GERMANY
24% or less
Adam Smith An Inquiry into the Nature and BELGIUM
CZECH
Causes of the Wealth of Nations 1776 51%
REPUBLIC SLOVAKIA no data
AUSTRIA
47% FRANCE HUNGARY ROMANIA
41% SWITZ. SLOVENIA countries or states with tobacco taxes dedicated
The price of tobacco is the single C A N A D A
33% 31% 32% to tobacco control, health promotion
BULGARIA
largest factor influencing short ITALY or general health care
26% 24% SPAIN ALBANIA
term consumption patterns. More PORTUGAL
countries with tax of $2 or more for 20 cigarettes
importantly, price plays a major

1965
1970
1975
1980
1985
1990
1995
2000
UNITED STATES GREECE
MONGOLIA
role in determining how many OF AMERICA
young people will start smoking, Tax down – but prices up ARMENIA JAPAN
and thus profoundly influences Declining cigarette tax in the USA TURKEY
REP.
KOREA
various
states as a percentage of retail price C H I N A
longterm consumption trends. Smokers often assume that cigarettes Chongqing
There is a clear inverse have become so expensive because
of increased taxes. In fact, in the USA, PAKISTAN
relationship between tobacco NEPAL
MEXICO while the price of cigarettes has increased,
taxes and tobacco consumption. the proportion going to tax is half of what
EGYPT
INDIA BANGLADESH
JAMAICA
For every 10 percent increase in it was in 1965. VIET NAM

cigarette taxes, there is on EL SALVADOR

THAILAND PHILIPPINES

average a four percent reduction CAMBODIA

COSTA RICA VENEZUELA

in consumption. Youth, MALDIVES
SRI LANKA

minorities, and low-income COLOMBIA

MALAYSIA
smokers are two to three times
ECUADOR SEYCHELLES
more likely to quit or smoke less I N D O N E S I A
than other smokers in response to small, less than 10 percent in all
BRAZIL
price increases. countries, and less than 2 percent
PERU
Tobacco taxes are an important in most countries. Higher tobacco ZAMBIA

source of revenue for countries, taxes are also easy to implement, BOLIVIA
ZIMBABWE

but the percentage of total and nearly always provide more

CHILE AUSTRALIA
government revenues accounted government revenue, despite the FRENCH
POLYNESIA

for by tobacco taxes is relatively fact that people are smoking less. £2.60 SOUTH
AFRICA GUAM
URUGUAY

ARGENTINA
Smoking goes down 9.05%
as prices go up 16,200
NEW ZEALAND
Real cigarette prices 7.72%
and cigarette consumption
14,900
in the UK 1971–95 14,600
£2.14 £2.20 ÒOf all
13,900 the conc
expenditure on cigarettes there erns,
5.40%
in millions of pounds sterling £2.01 is on
Ð taxati e
4.88%
that ala on Ð
12,400
4.00% rms
11,500 the most us
price of £1.80
11,300 .Ó
Philip M

Argentina
20 cigarettes £1.75 10,500
£1.84
orris,
Greece

Nepal 1985
China

9,900

Brazil
£1.55
£1.50 Government income from tobacco
Countries with the highest percentage of tobacco tax
1971 1974 1977 1980 1983 1986 1989 1992 1995 as a proportion of total government revenue 2000
84 85
 30 Litigation CYAN MAGENTA YELLOW BLACK

Lawsuits
30 Litigation Netherlands

(sued tobacco FINLAND

EU

(sued EU)
Legal action against the tobacco industry 2002

control NORWAY Sweden personal injury lawsuits

organisation) SWEDEN
“Litigation will keep coming until UNITED
RUSSIAN
(sued tobacco public interest lawsuits
KINGDOM control organisation)
the industry goes belly-up.” FED.
DENMARK non-smokers’ lawsuits
Professor Richard Daynard,
Northeastern University, USA, 2002 IRELAND
NETH. GERMANY POLAND government lawsuits
Tobacco litigation began with a C A N A D A
no lawsuits
Switzerland
personal injury lawsuit in the SWITZ.
RUSSIAN
Canada FRANCE
USA in 1954. For more than (sued tobacco
FEDERATION

40 years, the tobacco industry ITALY control activists) cases brought by the tobacco industry 2002
(sued government)
boasted it had not lost a single SPAIN

case, but this has changed. One

case in Minnesota that began in USA
1994 ruled that millions of pages JAPAN
(sued government
of internal tobacco industry and individuals) USA TURKEY REP.
KOREA
documents (see map 21) be put C H I N A

into the public domain. These ISRAEL

showed that the industry has PAKISTAN

concealed information on the true

BANGLADESH Hong Kong
harmfulness of smoking and INDIA SAR

misled governments, the media MALI NIGER PHILIPPINES


and their clients – smokers.
Litigation has put the industry 
SRI LANKA
on the political defensive, forced
UGANDA
tobacco companies to the
bargaining table, and has resulted
in some large settlements, with
the industry paying US states BRAZIL

billions of dollars a year. Columbia

Outside the USA, tobacco Canada
litigation is a new phenomenon, European Union
and clear patterns do not yet
 CHILE and member states
Ecuador AUSTRALIA
exist. However, some recent  
   
 
cases show the potential for
 
    
litigation to advance tobacco ARGENTINA
control. Australia has seen a Smuggling litigation
major ruling on the dangers of Cases brought by national governments against the
tobacco industry to recover lost tax from smuggling


passive smoking. Public interest constitutional requirements;
writ litigation in India has     
 
governments suing for tobacco-
 

prompted the Supreme Court of attributable health care costs or   
 
 
India to require nationwide for lost taxation due to 
 

 
    
  
  


implementation of broad smuggling; to cases brought by
 

  
restrictions on public smoking. the tobacco industry against discovered in that category
Cases now vary from smokers individuals, organisations or even (pharmacological effects of 

and non-smokers filing for governments. nicotine) the implication seems 


  
damage to health; public interest The judge in an Australian overwhelming that discovery has 

   


  !"#$
law suits seeking to force the lawsuit against BAT in 2002 been fundamentally thwarted
industry or government to found “that given the fact that not under this category by virtue of 

comply with legal or a single document was in fact the 1998 destruction programme.”

86 87
 31 projections CYAN MAGENTA YELLOW BLACK

Cigarette consumption
31 Projections by Industry
NORWAY
FINLAND
Projected rates of growth and decline
2008 compared with 1998
SWEDEN
ESTONIA
increase decrease
RUSSIAN
The tobacco industry predicts a LATVIA FED. over 30% under 10%
DENMARK
UNITED LITHUANIA
global expansion of the tobacco KINGDOM 20% – 29% 10% – 19%
IRELAND
epidemic in the next few years. NETH. GERMANY POLAND
BELARUS
10% – 19% over 20%
The increases in consumption lie BELGIUM CZECH UKRAINE
REPUBLIC SLOVAKIA under 10% other countries
principally in the developing HUNGARY
REP.
MOLDOVA
AUSTRIA
nations, while consumption in the FRANCE SWITZ. ROMANIA RUSSIAN
C A N A D A FEDERATION
industrialised countries will be BULGARIA
ITALY
static or in decline. SPAIN

In all the countries surveyed, PORTUGAL

GREECE
the biggest growth between 1998 KAZAKHSTAN

and 2008 is expected to be in UNITED STATES

MOROCCO TUNISIA
UZBEKISTAN
KYRGYZSTAN
Zimbabwe, followed by Côte OF AMERICA ALGERIA GEO JAPAN
AR AZER
M TURKMEN
TURKEY TAJ REP.
d’Ivoire, Brazil, Morocco, KOREA
SYRIAN ARAB C H I N A
Venezuela, Pakistan, United TUNISIA
ISRAEL
REPUBLIC
MOROCCO
Republic of Tanzania and PAKISTAN
ALGERIA
Bangladesh. MEXICO
EGYPT
The greatest decline is expected SAUDI ARABIA INDIA BANGLADESH Hong Kong SAR

in New Zealand, followed by the VIET NAM

THAILAND PHILIPPINES
UK, South Africa, Hong Kong,
Australia, Singapore and Finland.
VENEZUELA NIGERIA

GHANA
CÔTE
In Africa, only the South African D’IVOIRE
COLOMBIA
market is expected to decrease. MALAYSIA

In the Americas, growth in KENYA SINGAPORE

DEM. REP.
Latin America is expected to CONGO
UNITED REP.
compensate for declines in the BRAZIL
TANZANIA I N D O N E S I A

USA and Canada, with the

PERU
greatest increases in Brazil, tops the growth charts, while
Venezuela, Mexico, Peru, Chile New Zealand, Hong Kong, ZIMBABWE

and Uruguay. Australia and Singapore show the CHILE

In Europe, the forecast is greatest decline. AUSTRALIA
mixed, with increases in some This transfer of the epidemic SOUTH
AFRICA
URUGUAY
markets and decreases in others. from rich to poor countries, with
The biggest increase is expected its health and economic ARGENTINA

in Norway, and the greatest consequences, is one that

decline in the UK. developing countries can ill The best of times and the worst of times NEW
ZEALAND
In the Middle East region, the afford. As long ago as 1986, the
highest growth is expected for World Health Organization Projected regional increases and decreases
Morocco, followed by Pakistan predicted that the differential in for cigarette consumption +16.1%
and Tunisia. No country in this 2008 compared with 1998
wealth between rich and poor
percentages
region is expected to experience a countries would widen further as +8.7%
+6.5%
decline in consumption. a result of tobacco, leading to
Americas Western Europe
In South East Asia, Bangladesh compromise in sustainable
will see the highest growth, development. no change Africa and Eastern Europe Asia,
followed by Thailand, while These projections are not Middle East and former Australasia
Soviet Union and Far East
consumption remains static in inevitable; tobacco control -8.0%
India. interventions can make a
In the Western Pacific, Vietnam difference. Largest predicted Brazil +40.2% Norway +30.5% Zimbabwe 55.7% Latvia +26.5% Pakistan +35.9%
regional increase / decrease USA -13.0% UK -21.6% South Africa -17.3% Czech Republic -2.5% New Zealand -24.9%
88 89
 32/The Future of Tobacco CYAN MAGENTA YELLOW BLACK
32
“The use of tobacco, which has made its
way thanks to the spirit of imitation, as
well as to its peculiar effects, has
vanquished humanity and will continue to
reign until the end of the world.”
Louis Lewin, Phantastica: Narcotic and
Stimulating Drugs, 1924
“There will be 1 billion deaths from
tobacco in the 21st century unless strong
and sustained action is taken now.”
Richard Peto and Alan Lopez, 2002
Future predictions are by their
nature speculative but some
things are certain: the tobacco
epidemic, with its attendant
health and economic burden, is
both increasing and also shifting
from developed to developing
nations nations; and more women
are smoking.
The industry is consolidating,
and also shifting from the west to
developing regions, where there
may be less government control
and public debate about the role
of transnational tobacco
companies.
The future looks bleak; the
global tobacco epidemic is worse
today than it was 50 years ago.
And it will be even worse in
another 50 years unless an
extraordinary effort is made now.
Several countries have already
shown that smoking rates can be
reduced. These successes can be
reproduced by any responsible
nation, but only through
immediate, determined, and
sustained governmental and
community action. The future
epidemic depends on
understanding of the issue, and
policies, politics and actions
taken today.
90
The Future
2000–2010 2010–2020 2020–2030 2030–2040 2040–2050
2.2 billion
Number of smokers 2.0 billion
assuming constant
prevalence and medium variant
1.8 billion
projected population
1.6 billion
Number of smokers
assuming reduced 1.4 billion
1.6 billion
prevalence of 1.5 billion
–1.0% p.a., medium 1.4 billion 1.4 billion
variant projected 1.3 billion
population
Health Tobacco’s share of global death Individuals genetically prone to tobacco- Tobacco’s share of global death and disability New global virus pandemic temporarily Number of cumulative deaths from
and disability is 3%. related diseases can be identified at birth. increases to 9%. pushes tobacco issues completely off the tobacco:
700 million children exposed to Cancers, currently untreatable, could be 85% of smokers live in poor countries.
agenda. • if present trends continue: 520 million
passive smoking at home. treated. Spectacular advances in investigation,
770 million children exposed to passive • if proportion of young adults taking up
smoking at home. smoking halves by 2020: 500 million
82% of smokers live in developing New technology for diagnosis and treatment diagnosis and treatment of tobacco-related
• if adult consumption halves by 2020:
countries. will be expensive and have little impact on diseases, but unlikely to affect global mortality.
global mortality statistics.
340 million
Economics Global annual economic costs of Tobacco-related illnesses rise to top health The gap between rich and poor countries Global annual economic costs of tobacco:
tobacco: expenditure in many countries. grows as health services in poor US$1 trillion a year.
US$500 billion a year by 2010. countries collapse under the strain of
Many governments conclude the economic
costs of tobacco outweigh any benefit. tobacco disease and deaths.
A severe economic depression and/or a major
international security crisis cause tobacco
issues to temporarily diminish in importance.
Tobacco Attempts to produce genetically Industry consolidation leads to 2 or 3 huge Much of the developed world moves to a The tobacco industry is fully regulated, with New, commercially profitable uses of
industry modified tobacco with lower conglomerates accounting for the bulk of managed tobacco industry, with licensing of nicotine as an addictive drug, and tobacco are found.
nicotine. global sales. tobacco-attributable health care costs manufacture, promotion and sale under strict
reimbursed and compensation paid to regulatory control by government agencies.
Continued privatisation sees end of state-run
Some tobacco companies buy
tobacco companies. individual smokers and non-smokers Huge advances are made in genetics. The
pharmaceutical companies. harmed by tobacco.
Niche markets still exist for smaller players tobacco plant becomes key to producing
(e.g. cigars, snuff). Cigarettes only available on prescription vaccines and other beneficial medical
The industry tries to re-position its
in rich countries. products.
public image as a responsible Liberalisation of global trade rules welcomed
corporation. by the industry. World’s top tobacco companies now
based in Asia.
Smuggled cigarettes overtake legal sales.
The industry seeks regulation on its Almost no tobacco is grown in the USA.
own terms.
Action Framework Convention on Tobacco Elimination of tobacco advertising and Tobacco control funded from a
taken Control ratified. promotion worldwide. percentage of tobacco tax in many
Vaccine produced to switch off nicotine countries.
Some countries ban smoking. receptors. “Duty Free” tobacco no longer exists.
Medical schools globally introduce systematic Health education messages are more
Incentives for quitting include
teaching on tobacco.
monetary savings through rebates skilful, hard-hitting, and disseminated
re is uncert
and lower health insurance Smoke-free areas will be exchanged for non- more effectively. utu ain ay n
ever occ
ef … ur…
premiums. smoking being the norm. In every country tax on tobacco is 75% Th S tsm
om n
of retail price. eo ve
Doubts about new “less hazardous”
Cigarette packets will be plain black and f th ese e
white and contain only brand name and
products increases. explicit health warnings.
In developed countries, there is a Tobacco dependent economies are assisted in
gradual shift in the perception of diversifying.
smoking as it comes to be seen as
anti-social.
Nicotine Replacement Therapy sold over the
counter worldwide.
91
Ta bl e A T h e D e m o g r ap h i c s o f To b a c c o
1 2 3 4 5 6
Countries Population Adult smoking Youth smoking 1 Youth exposed to Cigarette Quitting Countries
passive smoking at home 2 consumption percentages of people
thousands percentages percentages who quit smoking
total male female total male female percentages annual per person by 2002

Afghanistan 21,765 – – – – – – – 98 – Afghanistan

Albania 3,134 39.0% 60.0% 18.0% – – – – - – Albania
Algeria 30,291 25.2% 43.8% 6.6% – – – – 1,021 29% Algeria
Andorra 86 35.9% 43.7% 28% – – – – – – Andorra
Angola 13,134 – – – – – – – 571 – Angola
Antigua and Barbuda 65 – – – 13.0% 13.8% 11.8% 17.4% – – Antigua and Barbuda
Argentina 37,032 40.4% 46.8% 34.0% 28.1% 25.7% 30.0% 68.2% 1,495 – Argentina
Armenia 3,787 32.5% 64.0% 1.0% – – – – 1,095 – Armenia
Australia 19,138 19.5% 21.1% 18.0% – – – – 1,907 – Australia
Austria 8,080 24.5% 30.0% 19.0% – – – – 2,073 18% Austria
Azerbaijan 8,041 15.7% 30.2% 1.1% – – – – 1,150 – Azerbaijan
Bahamas 304 11.5% 19.0% 4.0% 16.0% 20.0% 12.6% 28.7% 613 15% Bahamas
Bahrain 640 14.6% 23.5% 5.7% – – – – 2,179 – Bahrain
Bangladesh 137,439 38.7% 53.6% 23.8% – – – – 245 – Bangladesh
Barbados 267 9.0% – – 16.9% 15.9% 17.7% – 542 - Barbados
Belarus 10,187 29.8% 54.9% 4.6% – – – – 2,571 - Belarus
Belgium 10,249 28.0% 30.0% 26.0% – – – – 2,428 – Belgium
Belize 226 – – – – – – – 1,092 – Belize
Benin 6,272 37.0% – – – – – – – – Benin
Bhutan 2,085 – – – – – – – – – Bhutan
Bolivia 8,329 30.4% 42.7% 18.1% 26.4% 31.0% 22.0% 46.0% 274 – Bolivia
Bosnia and Herzegovina 3,977 48.0% – – – – – – – – Bosnia and Herzegovina
Botswana 1,541 21.0% – – – – – – – – Botswana
Brazil 170,406 33.8% 38.2% 29.3% – – – – 858 – Brazil
Brunei Darussalam 328 27.0% 40.0% 14.0% – – – – – - Brunei Darussalam
Bulgaria 7,949 36.5% 49.2% 23.8% – – – – 2,574 – Bulgaria
Burkina Faso 11,535 – – – – – - – 221 – Burkina Faso
Burundi 6,356 – – – – – – – 86 – Burundi
Cambodia 13,104 37.0% 66.0% 8.0% – – – – – – Cambodia
Cameroon 14,876 35.7% – – – – – – 652 – Cameroon
Canada 30,757 25.0% 27.0% 23.0% – – – – 1,976 – Canada
Cape Verde 427 – – – – – – – – – Cape Verde
Central African Rep. 3,717 – – – – – – – 329 - Central African Rep.
Chad 7,885 – 24.1% – – – – – 160 – Chad
Chile 15,211 22.2% 26.0% 18.3% 37.9% 34.0% 43.4% 57.0% 1,202 35% Chile
China 1,282,437 35.6% 66.9% 4.2% 10.8% 14.0% 7.0% 53.0% 1,791 10% China
Colombia 42,105 22.3% 23.5% 21.0% – – – – 521 – Colombia
Comoros 706 – – – – – – – – – Comoros
Congo 3,018 – – – – – – – 476 – Congo
Congo, Dem. Rep. 50,948 – – 5.5% – – – – 135 – Congo, Dem. Rep.
Cook Islands 20 28.5% 40.0% 17.0% – – – – – – Cook Islands
Costa Rica 4,024 17.6% 28.6% 6.6% 20.8% 20.6% 21.0% 32.8% 690 – Costa Rica
Côte d’Ivoire 16,013 22.1% 42.3% 1.8% – – – – 580 11% Côte d’Ivoire
Croatia 4,654 33.0% 34.0% 32.0% – – – – 1,995 – Croatia
Cuba 11,199 37.2% 48.0% 26.3% 19.2% 18.0% 20.0% 68.9% 1,343 – Cuba
Cyprus 784 23.1% 38.5% 7.6% – – – – – 11% Cyprus
Czech Republic 10,272 29% 36.0% 22.0% – – – – 2,306 24% Czech Republic
Denmark 5,320 30.5% 32.0% 29.0% – – – – 1,919 20% Denmark
94 Sources: see page 124 1 For some countries, data are based on youth surveys in major cities or provinces, 2 For some countries, data are based on youth surveys in major cities or provinces, 95
and are not necessarily representative of the entire country. and are not necessarily representative of the entire country.
Ta bl e A T h e D e m o g r ap h i c s o f To b a c c o
1 2 3 4 5 6
Countries Population Adult smoking Youth smoking 1 Youth exposed to Cigarette Quitting Countries
passive smoking at home 2 consumption percentages of people
thousands percentages percentages who quit smoking
total male female total male female percentages annual per person by 2002
Djibouti 632 31.1% 57.5% 4.7% – – – – – – Djibouti
Dominica 71 – – – 19.3% 23.8% 14.5% 27.4% – – Dominica
Dominican Republic 8,373 20.7% 24.3% 17.1% – – – – 754 11% Dominican Republic
East Timor –– – – – – – – – – East Timor
Ecuador 12,646 31.5% 45.5% 17.4% – – – – 232 31% Ecuador
Egypt 67,884 18.3% 35.0% 1.6% – – – – 1,275 5% Egypt
El Salvador 6,278 25.0% 38.0% 12.0% – – – – 429 – El Salvador
Equatorial Guinea 457 – - – – – – – – – Equatorial Guinea
Eritrea 3,659 – – – – – – – – – Eritrea
Estonia 1,393 32.0% 44.0% 20.0% – – – – 1,983 – Estonia
Ethiopia 62,908 15.8% – – – – – – 87 – Ethiopia
Fiji 814 20.5% 24.0% 17.0% 15.1% 19.3% 10.9% 49.4% 976 – Fiji
Finland 5,172 23.5% 27.0% 20.0% – – – – 1,351 16% Finland
France 59,238 34.5% 38.6% 30.3% – – – – 2,058 – France
Gabon 1,230 – – – – – – – 487 – Gabon
Gambia 1,303 17.8% 34.0% 1.5% – – – – 171 – Gambia
Georgia 5,262 37.5% 60.5% 15.0% – – – – – – Georgia
Germany 82,017 35.0% 39.0% 31.0% – – – – 1,702 18% Germany
Ghana 19,306 16.0% 28.4% 3.5% 16.8% 16.2% 17.3% 22.2% 161 3% Ghana
Greece 10,610 38.0% 47.0% 29.0% – – – – 4,313 – Greece
Grenada 94 – – - 14.4% 17.0% 11.9% 28.9% – – Grenada
Guatemala 11,385 27.8% 37.8% 17.7% – – – – 609 – Guatemala
Guinea 8,154 51.7% 59.5% 43.8% – – – – – – Guinea
Guinea-Bissau 1,199– – – – – – – – 90 – Guinea-Bissau
Guyana 761 – – – 15.3% 21.6% 11.1% 31.6% 590 – Guyana
Haiti 8,142 9.7% 10.7% 8.6% 20.7% 21.0% 20.0% 31.3% 172 – Haiti
Honduras 6,417 23.5% 36.0% 11.0% – – – – 595 40% Honduras
Hungary 9,968 35.5% 44.0% 27.0% – – – – 3,265 – Hungary
Iceland 279 24.0% 25.0% 23.0% – – – – 1,915 – Iceland
India 1,008,937 16.0% 29.4% 2.5% variable variable variable 34.3% 129 – India
Indonesia 212,092 31.4% 59.0% 3.7% 22.0% 38.0% 5.3% 63.0% 1,742 – Indonesia
Iran, Isl. Rep. 70,330 15.3% 27.2% 3.4% – – – – 765 20% Iran, Isl. Rep.
Iraq 22,946 22.5% 40.0% 5.0% – – – – 1,430 – Iraq
Ireland 3,803 31.5% 32.0% 31.0% – – – – 2,236 – Ireland
Israel 6,040 28.5% 33.0% 24.0% – – – – 2,162 10% Israel
Italy 57,530 24.9% 32.4% 17.3% – – – – 1,901 – Italy
Jamaica 2,576 14.6% – – 19.3% 24.4% 14.5% – 735 – Jamaica
Japan 127,096 33.1% 52.8% 13.4% – – – – 3,023 – Japan
Jordan 4,913 29.0% 48.0% 10.0% 20.6% 27.0% 13.4% 67.4% 1,832 – Jordan
Kazakhstan 16,172 33.5% 60.0% 7.0% – – – – 2,160 – Kazakhstan
Kenya 30,669 49.4% 66.8% 31.9% 13.0% 16.0% 10.0% – 200 – Kenya
Kiribati 83 42.0% 56.5% 32.3% – – – – – – Kiribati
Korea, Republic of 46,740 35.0% 65.1% 4.8% – – – – 2,918 – Korea, Republic of
Korea, Dem. People’s Rep. of 22,268 – – – – – – – – – Korea, Dem. People’s Rep. of
Kuwait 1,914 15.6% 29.6% 1.5% – – – – 3,062 9% Kuwait
Kyrgyzstan 4,921 37.8% 60.0% 15.6% – – – – 1,886 – Kyrgyzstan
Lao People’s Dem. Rep. 5,279 38.0% 41.0% 15.0% – – – – 400 – Lao People’s Dem. Rep.
Latvia 2,421 31.0% 49.0% 13.0% – – – – – – Latvia
96 Sources: see page 124 1 For some countries, data are based on youth surveys in major cities or provinces, 2 For some countries, data are based on youth surveys in major cities or provinces, 97
and are not necessarily representative of the entire country. and are not necessarily representative of the entire country.
Ta bl e A T h e D e m o g r ap h i c s o f To b a c c o
1 2 3 4 5 6
Countries Population Adult smoking Youth smoking 1 Youth exposed to Cigarette Quitting Countries
passive smoking at home 2 consumption percentages of people
thousands percentages percentages who quit smoking
total male female total male female percentages annual per person by 2002

Lebanon 3,496 40.5% 46.0% 35.0% - - - - – – Lebanon

Lesotho 2,035 19.8% 38.5% 1.0% - - - - – – Lesotho
Liberia 2,913 – – – - - - - 89 – Liberia
Libyan Arab Jamahiriya 5,290 4.0% – – - - - - 1,482 – Libyan Arab Jamahiriya
Lithuania 3,696 33.4% 51.0% 16.0% - - - - – – Lithuania
Luxembourg 437 33.0% 39.0% 27.0% - - - - – – Luxembourg
Macedonia, Former Yugos. Rep. of 2,034 36.0% 40.0% 32.0% - - - - – – Macedonia, Former Yugos. Rep. of
Madagascar 15,970 – – – - - - - 315 – Madagascar
Malawi 11,308 14.5% 20.0% 9.0% 16.8% 18.0% 15.0% - 123 11% Malawi
Malaysia 22,218 26.4% 49.2% 3.5% - - - - 910 – Malaysia
Maldives 291 26.0% 37.0% 15.0% - - - - 1,441 – Maldives
Mali 11,351 – – – - - - - 223 – Mali
Malta 390 23.9% 33.1% 14.6% - - - - 2,668 – Malta
Marshall Islands 51– - – - - - - – – Marshall Islands
Mauritania 2,665 – – – - - - - 317 – Mauritania
Mauritius 1,161 23.9% 44.8% 2.9% - - - - 1,284 – Mauritius
Mexico 98,872 34.8% 51.2% 18.4% 21.7% 27.9% 16.0% 45.5% 754 15% Mexico
Micronesia, Federated States of 123 - – – - - - - – – Micronesia, Federated States of
Moldova, Republic of 4,295 32.0% 46.0% 18.0% - - - - 2,640 – Moldova, Republic of
Monaco 33 – – – - - - - – – Monaco
Mongolia 2,533 46.7% 67.8% 25.5% - - - - – – Mongolia
Morocco 29,878 18.1% 34.5% 1.6% - - - - 800 – Morocco
Mozambique 18,292 – – – - - - - 432 – Mozambique
Myanmar 47,749 32.9% 43.5% 22.3% - - - - – – Myanmar
Namibia 1,757 50.0% 65.0% 35.0% - - - - – – Namibia
Nauru 12 54.0% 61.0% 47.0% - - - - – – Nauru
Nepal 23,043 38.5% 48.0% 29.0% 7.8% 12.0% 6.0% - 619 – Nepal
Netherlands 15,864 33.0% 37.0% 29.0% - - - - 2,323 – Netherlands
New Zealand 3,778 25.0% 25.0% 25.0% - - - - 1,213 – New Zealand
Nicaragua 5,071 – – – - - - - 793 – Nicaragua
Niger 10,832 - – – - - - - – – Niger
Nigeria 113,862 8.6% 15.4% 1.7% 18.1% 22.0% 16.0% 34.3% 189 – Nigeria
Niue 2 37.5% 58.0% 17.0% - - - - – – Niue
Norway 4,469 31.5% 31.0% 32.0% - - - - 725 – Norway
Oman 2,538 8.5% 15.5% 1.5% - - - - – – Oman
Pakistan 141,256 22.5% 36.0% 9.0% - - - - 564 – Pakistan
Palau 19 15.1% 22.3% 7.9% 58.5% 55.0% 62.0% 46.0% – – Palau
Panama 2,856 38.0% 56.0% 20.0% - - - - 244 – Panama
Papua New Guinea 4,809 37.0% 46.0% 28.0% - - - - – – Papua New Guinea
Paraguay 5,496 14.8% 24.1% 5.5% - - - - 1,748 – Paraguay
Peru 25,662 28.6% 41.5% 15.7% 19.5% 22.0% 15.0% 29.0% 195 12% Peru
Philippines 75653 32.4% 53.8% 11.0% 23.3% 31.2% 17.2% 58.2% 1,849 – Philippines
Poland 38,605 34.5% 44.0% 25.0% 24.4% 29.0% 20.0% 67.0% 2,061 – Poland
Portugal 10,016 18.7% 30.2% 7.1% - - - - 2,079 – Portugal
Qatar 565 18.8% 37.0% 0.5% - - - - – – Qatar
Romania 22,438 43.5% 62.0% 25.0% - - - - 1,676 – Romania
Russian Federation 145,491 36.5% 63.2% 9.7% 35.1% 40.9% 29.5% 55.3% 1,702 1% Russian Federation
Rwanda 7,609 5.5% 7.0% 4.0% - - - - 135 – Rwanda
98 Sources: see page 124 1 For some countries, data are based on youth surveys in major cities or provinces, 2 For some countries, data are based on youth surveys in major cities or provinces, 99
and are not necessarily representative of the entire country. and are not necessarily representative of the entire country.
Ta bl e A T h e D e m o g r ap h i c s o f To b a c c o
1 2 3 4 5 6
Countries Population Adult smoking Youth smoking 1 Youth exposed to Cigarette Quitting Countries
passive smoking at home 2 consumption percentages of people
thousands percentages percentages who quit smoking
total male female total male female percentages annual per person by 2002

Saint Kitts and Nevis 38 – – – - - - - – – Saint Kitts and Nevis

Saint Lucia 148 – – – - - - 26.9% – – Saint Lucia
Saint Vincent and Grenadines 113 15% 26.4% 3.5% - - - - – – Saint Vincent and Grenadines
Samoa 159 23.3% 33.9% 12.7% - - - - 1,509 – Samoa
San Marino 27 22.5% 28.0% 17.0% - - - - – – San Marino
Sao Tome and Principe 138 44.1% – – - - - - – – Sao Tome and Principe
Saudi Arabia 20,346 11.5% 22.0% 1.0% - - - - 810 9% Saudi Arabia-
Senegal 9,421 4.6% – – - - - - 340 – Senegal
Seychelles 80 22.0% 37.0% 6.9% - - - - – – Seychelles-
Sierra Leone 4,405 18.5% – – - - - - 465 – Sierra Leone
Singapore 4,018 15.0% 26.9% 3.1% 9.1% 10.5% 7.5% 35.1% 1,230 – Singapore
Slovakia 5,399 42.6% 55.1% 30.0% - - - - 2,282 – Slovakia
Slovenia 1,988 25.2% 30.0% 20.3% - - - 2,917 – Slovenia
Solomon Islands 447 – – 23.0% - - - - 678 – Solomon Islands
Somalia 8,778 – – – - - - - – – Somalia
South Africa 43,309 26.5% 42.0% 11.0% 24.3% 29.0% 20.8% 43.6% 1,516 35% South Africa
Spain 39,910 33.4% 42.1% 24.7% - - - - 2,779 – Spain
Sri Lanka 18,924 13.7% 25.7% 1.7% 9.9% 13.7% 5.8% - 374 – Sri Lanka
Sudan 31,095 12.9% 24.4% 1.4% - - - - 77 1% Sudan
Suriname 417 – – – 14.3% 18.5% 10.1% 56.6% 1,930 – Suriname
Swaziland 925 13.4% 24.7% 2.1% - - - - – – Swaziland
Sweden 8,842 19.0% 19.0% 19.0% - - - - 1,202 33% Sweden
Switzerland 7,170 33.5% 39.0% 28.0% - - - 2,720 – Switzerland
Syrian Arab Republic 16,189 30.3% 50.6% 9.92% - - - - 1,283 – Syrian Arab Republic
Tajikistan 6,087 – – – - - - - – – Tajikistan
Tanzania, United Republic of 35,119 31.0% 49.5% 12.4% - - - - 177 – Tanzania, United Republic of
Thailand 62,806 23.4% 44.1% 2.6% - - - - 1,067 1% Thailand
Togo 4,527 – – – - - - - 306 – Togo
Tonga 99 38.3% 62.4% 14.2% - - - - – 5% Tonga
Trinidad and Tobago 1,294 25.1% 42.1% 8.0% 14.2% 17.9% 10.2% 37.2% 2,180 13% Trinidad and Tobago
Tunisia 9,459 34.8% 61.9% 7.7% - - - - 1,341 – Tunisia
Turkey 66,668 44.0% 60–65% 20–24% - - - - 2,394 10% Turkey
Turkmenistan 4,737 14.0% 27.0% 1.0% - - - - 2,307 – Turkmenistan
Tuvalu 10 41.0% 51.0% 31.0% - - - - – 5% Tuvalu
Uganda 23,300 34.5% 52.0% 17.0% - - - - 180 – Uganda
Ukraine 49,568 35.3% 51.1% 19.4% 34.6% 37.7% 30.8% 49.0% 1,456 – Ukraine
United Arab Emirates 2,606 9.0% 18.3% <1.0% - - - - – – United Arab Emirates
United Kingdom 59,415 26.5% 27.0% 26.0% - - - - 1,748 – United Kingdom
United States of America 283,230 23.6% 25.7% 21.5% 25.8% 27.5% 24.2% 42.1% 2,255 42% United States of America
Uruguay 3,337 23.0% 31.7% 14.3% 23.9% 22.0% 24.0% - 1,396 16% Uruguay
Uzbekistan 24,881 29.0% 49.0% 9.0% - - - - 1,104 – Uzbekistan
Vanuatu 197 27.0% 49.0% 5.0% - - - - – – Vanuatu
Venezuela 24,170 40.5% 41.8% 39.2% 14.8% 15.3% 13.9% 43.5% 1,079 7% Venezuela
Viet Nam 78,137 27.1% 50.7% 3.5% - - - - 1,025 – Viet Nam
Yemen 18,349 44.5% 60.0% 29.0% - - - - – – Yemen
Yugoslavia 10,552 47.0% 52.0% 42.0% - - - - 1,548 – Yugoslavia
Zambia 10,421 22.5% 35.0% 10.0% - - - - 408 72% Zambia
Zimbabwe 12,627 17.8% 34.4% 1.2% 18.3% 19.0% 17.0% 35.6% 399 – Zimbabwe
100 Sources: see page 124 1 For some countries, data are based on youth surveys in major cities or provinces, 2 For some countries, data are based on youth surveys in major cities or provinces, 101
and are not necessarily representative of the entire country. and are not necessarily representative of the entire country.
Ta bl e B T h e B u s i n e s s o f To b a c c o
1 2 3 4 5 6
Growing Tobacco Tobacco Trade Manufacturing Costs Tax
Countries Tobacco Countries
Land Agricultural Tobacco Malboro or Local Labour needed to Tax as a Tobacco industry
devoted to land devoted produced equivalent brand buy a pack of proportion excise tax
international Marlboro or of cigarette revenue as a documents
growing to tobacco Tobacco Tobacco on the
tobacco farming Cigarettes Cigarettes leaf leaf Number Cigarettes brand equivalent price proportion
of manufactured international of total tax Legacy
percentage exports imports exports imports brand revenue website
millions workers
hectares of total metric tons millions metric tons metric tons millions $US per pack city minutes percentages percentages

Afghanistan – – – – 1,500 - – 0 – – – – – – – 7 Afghanistan

Albania 7,300 0.88% 8,000 4,000 – 1,500 34 1,946 – – – – – 70% – 10 Albania
Algeria 5,700 0.03% 7,153 – – – 18,000 6,096 – – – – – – – 52 Algeria
Andorra – – – – – – – – – – – – – – – 133 Andorra
Angola 3,100 0.11% 3,000 – 400 – 180 478 – – – – – – – 15 Angola
Antigua and Barbuda – – – – – – – – – – – – – – – 9 Antigua and Barbuda
Argentina 57,300 0.18% 114,156 2,400 2,400 72,580 6,803 4,650 39,800 1.70 1.50 Buenos Aires 20.5 70% 4.34% 1,931 Argentina
Armenia 2,528 0.04% 4,577 – 2,200 319 2,537 0 – – – – – 50% – 6 Armenia
Australia 3,185 0.01% 7,762 4,000 1,600 1,803 14,355 1,569 32,000 3.46 3.20 Sydney 28.4 65% 3.38% 10,472 Australia
Austria 111 0.01% 230 11,803 1,681 931 10,404 1,756 – 3.31 3.04 Vienna 21.8 73% 0.16% 2,907 Austria
Azerbaijan 7,789 0.51% 17,258 500 3,400 11,870 – 1,751 – 0.88 0.33 – – – – 1 Azerbaijan
Bahamas – – – – – – 55 0 – – – – – – – 153 Bahamas
Bahrain – – – – – – 40 0 – 1.32 – Manama 17.6 – – 212 Bahrain
Bangladesh 31,161 0.44% 35,000 – 400 892 2,839 32,829 – 1.26 0.83 – – 30% – 101 Bangladesh
Barbados – – – 55 20 – 4 75 – – – – – – – 45 Barbados
Belarus 800 0.01% 1,400 – 4,000 – 10,347 – – – – – – – – 1 Belarus
Belgium *380 0.05% *1,300 *14,000 *8,200 *16,666 *41,014 4,400 *20,750 2.93 2.93 Brussels 22 75% - 2,502 Belgium
Belize – – – 20 155 – 84 116 – – – – – – – 5 Belize
Benin 917 0.03% 702 – 500 – 50 – – – – – – – – 13 Benin
Bhutan 110 0.07% 160 – – – 4 0 – – – – – – – 1 Bhutan
Bolivia 1,060 0.05% 975 – – – 530 197 – – – – – 61% – 140 Bolivia
Bosnia and Herzegovina 2,000 0.25% 3,600 – 1,000 550 890 849 – – – – – – – 2 Bosnia and Herzegovina
Botswana – – – – 900 56 618 0 – – – – – – – 32 Botswana
Brazil 309,989 0.45% 578,451 700 – 343,029 2,647 18,807 175,000 0.85 0.80 Rio de Janeiro 21.8 75% 7.37% 2,492 Brazil
Sao Paulo 17.2
Brunei Darussalam – – – – 800 – – – – 1.70 – – – – – 48 Brunei Darussalam
Bulgaria 42,000 0.32% 70,000 8,728 1,000 21,000 7,400 15,800 55,400 1.13 – – – 42% 3.63% 305 Bulgaria
Burkina Faso 800 0.03% 400 – – – 590 195 – – – – – – – 11 Burkina Faso
Burundi 360 0.04% 350 – – 1 1,084 180 – – – – – – – 5 Burundi
Cambodia 9,669 0.35% 7,665 – – 1,051 890 2,126 – 0.90 – – – 20% – 8 Cambodia
Cameroon 3,400 0.03% 4,700 100 5 220 2,400 436 – 1.42 0.99 – – – – 53 Cameroon
Canada 25,000 0.06% 71,000 1,600 396 23,075 3,297 4,600 58,000 3.40 2.88 Montreal 19.4 51% 11,851 Canada
Toronto 20.7
Cape Verde – – – – – – 40 47 – – – – – – – 1 Cape Verde
Central African Rep. 600 0.04% 500 – – 140 350 – – – – – – – – 1 Central African Rep.
Chad 145 <0.1% 210 – 55 – 100 – - – – – – – – 38 Chad
Chile 3,508 0.16% 10,521 230 135 915 1,837 535 – 1.69 1.43 Santiago de C. 38.4 70% 4.10% 980 Chile
China 1,441,147 1.1% 2,563,510 41,566 47,740 131,980 27,018 297,472 1,748,500 1.57 1.40 Shanghai 61.8 38%-40% 2.79% 9,047 China
Colombia 18,250 0.3% 33,216 5,500 13,260 10,217 3,331 1,243 – 1.03 0.64 Bogota 24.9 45% 0.91% 647 Colombia
Comoros – – – – – – – – – – – – – – – 3 Comoros
Congo 280 0.19% 100 3 30 – 270 194 – – – – – – – 21 Congo
Congo, Dem. Rep. 7,700 0.09% 3,600 – – – 680 1,243 – – – – – – – – Congo, Dem. Rep.
Cook Islands – – – – – – – – – – – – – – – 1 Cook Islands
Costa Rica 108 0.20% 200 – – 960 890 576 – 0.75 0.75 – – 75% 1.58% 573 Costa Rica
Côte d’Ivoire 20,000 0.28% 10,000 400 500 70 2,300 555 – 0.92 0.71 – – – – 10 Côte d’Ivoire
Croatia 6,100 0.55% 8,600 5,545 15 5,899 3,032 2,050 – 2.06 1.33 – – 0.82% 62 Croatia
Cuba 45,785 0.85% 30,562 100 – 6,400 4,000 44,970 16,000 – – – – – – 142 Cuba
Cyprus 76 0.05% 374 3,550 – 147 420 272 – – – – – – – 429 Cyprus
Czech Republic – 0.06% – 16,500 4,000 761 20,242 2,000 0 1.42 1.13 – – 58% – 355 Czech Republic
Denmark – – – 6,000 2,000 1,550 16,050 1,415 – 4.00 4.00 Copenhagen 23 84% 2.03% 1,681 Denmark
102 Sources: see page 124 * data for Belgium and Luxembourg 103
Ta bl e B T h e B u s i n e s s o f To b a c c o
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Growing Tobacco Tobacco Trade Manufacturing Costs Tax
Tobacco
Land Agricultural Tobacco Malboro or Local Labour needed to Tax as a Tobacco industry
devoted to land devoted produced equivalent brand buy a pack of proportion excise tax
international Marlboro or of cigarette revenue as a documents
growing to tobacco Tobacco Tobacco on the
tobacco farming Cigarettes Cigarettes leaf leaf Number Cigarettes brand equivalent price proportion
of manufactured international of total tax Legacy
percentage exports imports exports imports brand revenue website
millions workers
hectares of total metric tons millions metric tons metric tons millions $US per pack city minutes percentages percentages

Djibouti – – – – – – 80 – – – – – – – – 29 Djibouti
Dominica – – – – – – 30 – – – – – – – – 35 Dominica
Dominican Republic 13,250 1.28% 17,229 40 – 14,640 – 1,480 – – – – – – – 239 Dominican Republic
East Timor – – – – – – – – – – – – – – – – East Timor
Ecuador 1,725 0.02% 3,461 100 – 883 246 361 – 1.90 1.30 – – – – 617 Ecuador
Egypt – – – 1,400 500 – 55,040 17,469 40,000 1.16 1.16 – – 57% 1.34% 629 Egypt
El Salvador 600 0.10% 1,100 – – 84 448 0 – – – – – 42% – 310 El Salvador
Equatorial Guinea – – – – – – – – – – – – – – – 0 Equatorial Guinea
Eritrea – – – – – – – – – – – – – – – 1 Eritrea
Estonia – – – – 600 – 4 – – – – – – 70% 1.29% 20 Estonia
Ethiopia 4,500 0.05% 3,000 – 200 - 200 898 – – – – – – – 9 Ethiopia
Fiji 180 0.07% 150 12 14 – 130 98 – – – – – – – 58 Fiji
Finland – – – 193 1,700 1,307 3,904 700 – 3.73 3.35 Helsinki 28.7 73% 2.03% 4,856 Finland
France 9,254 0.05% 25,534 23,300 67,571 46,023 70,528 4,400 48,000 3.13 2.75 Paris 20.5 75% 0.37% 5,298 France
Gabon – – – – – – 100 50 – 1.32 1.22 – – – – 16 Gabon
Gambia – – – – – 116 793 0 – – – – – – – 18 Gambia
Georgia 1,801 0.11% 1,855 – 1,500 – 2,000 – – 1.00 – – – – – 1,732 Georgia
Berlin 18.4
Germany 3,000 0.03% 8,500 90,637 33,604 41,430 189,669 15,455 205,500 2.81 2.75 Frankfurt 17.3 72% 1.38% 9,489 Germany
Ghana 4,200 0.06% 2,500 – 35 255 56 1,121 – 1.40 – – – – – 40 Ghana
Greece 62,917 1.65% 136,593 17,000 11,000 100,889 19,554 9,943 28,200 2.05 1.64 Athens 24 73% 8.69% 1,228 Greece
Grenada – – – – – – 30 19 – – – – – – – 18 Grenada
Guatemala 8,374 0.43% 18,630 1,900 600 9,043 643 556 – 1.29 0.97 – – – – 628 Guatemala
Guinea 2,000 0.13% 1,800 – 20 – 70 – – – – – – – – 2,025 Guinea
Guinea-Bissau – – - – – – – – – – – – – – – 3 Guinea-Bissau
Guyana 100 0.02% 90 – – – – 193 – – – – – – – 22 Guyana
Haiti 400 0.05% 550 – 20 – 660 350 – – – – – – – 87 Haiti
Honduras 11,214 0.47% 4,318 236 – 2,547 3,205 – – – – – – – – 163 Honduras
Hungary 5,764 0.14% 10,485 3,500 500 759 17,539 2,750 30,000 1.09 0.77 Budapest 71.4 42% 0.02% 480 Hungary
Iceland – – – – 600 – – – – 4.43 4.53 – – – – 235 Iceland
India 463,200 0.23% 701,700 1,500 200 119,643 1,500 537,692 90,000 1.24 0.91 Mumbai 102.5 75% 2.43% 1,447 India
Indonesia 223,000 0.72% 145,000 17,500 140 37,097 40,913 237,401 190,000 0.62 0.62 Jakarta 61.7 30% 3.38% 834 Indonesia
Iran, Isl. Rep. 20,000 0.07% 21,000 – 8,000 1,516 842 7,197 – 0.96 0.46 – – – – 289 Iran, Isl. Rep.
Iraq 2,400 0.04% 2,250 – – – 2,400 1,000 – – – – – – – 129 Iraq
Ireland – – – 2,000 450 83 5,650 1,279 – 4.47 4.47 Dublin 30.6 75% – 6,605 Ireland
Israel – 0.05% – 200 2,400 10 4,700 600 – 3.22 1.91 Tel Aviv 29.3 – – 3,277 Israel
Italy 46,900 0.46% 132,200 193 56,475 93,862 38,830 13,330 55,300 2.70 1.93 Milan 26 73% – 2,165 Italy
Jamaica 1,175 0.44% 1,800 40 1,780 130 450 750 – – – – – 42% – 227 Jamaica
Japan 23,991 0.6% 60,803 13,961 83,478 31 98,919 14,200 265,000 2.34 2.09 Tokyo 8.9 60% 0.02% 17,611 Japan
Jordan 3,099 1.06% 2,667 300 200 483 1,400 1,051 – 2.04 0.98 – – – – 5,954 Jordan
Kazakhstan 4,500 0.01% 9,000 12,600 3,000 7,521 6,129 – – – – – – – – 33 Kazakhstan
Kenya 4,500 0.19% 7,000 550 50 4,423 50 1,701 – 1.55 0.90 Nairobi 157.6 – 0.09% 169 Kenya
Kiribati – – – – – – – – – – – – – – – 0 Kiribati
Korea, Republic of 24,300 1.62% 68,198 6,712 9,378 5,618 12,781 3,600 84,600 1.50 1.26 Seoul 26.6 60% 3.46% ***1,717 Korea, Republic of
Korea, Dem. People’s Rep. of 44,000 2.10% 63,000 – – 5,000 576 – – – – – – – – ***1,717 Korea, Dem. People’s Rep. of
Kuwait – – – – 1,000 – – 0 – 1.10 – – – – – 571 Kuwait
Kyrgyzstan 14,465 0.64% 34,613 – 1,000 35,000 6 1,294 – – – – – – – 1 Kyrgyzstan
Lao People’s Dem. Rep. 6,700 0.87% 33,400 – – – 260 500 – – – – – – – 30 Lao People’s Dem. Rep.
Latvia – – – – 1,000 – 1,544 286 – – – – – – – 13 Latvia
104 Sources: see page 124 ***combined total for Democratic People’s Republic of Korea and Republic of Korea 105
Ta bl e B T h e B u s i n e s s o f To b a c c o
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Growing Tobacco Tobacco Trade Manufacturing Costs Tax
Countries Tobacco Countries
Land Agricultural Tobacco Malboro or Local Labour needed to Tax as a Tobacco industry
devoted to land devoted produced equivalent brand buy a pack of proportion excise tax
international Marlboro or of cigarette revenue as a documents
growing to tobacco Tobacco Tobacco on the
tobacco farming Cigarettes Cigarettes leaf leaf Number Cigarettes brand equivalent price proportion
of manufactured international of total tax Legacy
percentage exports imports exports imports brand revenue website
millions workers
hectares of total metric tons millions metric tons metric tons millions $US per pack city minutes percentages percentages

Lebanon 9,700 2.02% 13,500 – 1,400 3,100 270 3,800 – – – – – – – 610 Lebanon
Lesotho – – – – – – – – – – – – – – – 6 Lesotho
Liberia – – – – 200 - – 91 – – – – – – – 105 Liberia
Libyan Arab Jamahiriya 650 0.03% 1,500 – 2,200 - 3,100 1,251 – 4.55 1.82 – – – – 24 Libyan Arab Jamahiriya
Lithuania – – – – 1,500 - 2,915 418 – – – – – – 0.16% 44 Lithuania
Luxembourg *380 – *1,300 *14,000 *8,200 *16,666 *41,014 – *20,750 2.24 1.90 Luxembourg 12 – – 495 Luxembourg
Macedonia, Former Yugos. Rep. of 25,000 1.66% 32,000 – 500 9,900 2,200 5,604 – – – – – – – 24 Macedonia, Former Yugos. Rep. of
Madagascar 2,110 0.11% 2,000 – 1 40 362 814 – – – – – – – 14 Madagascar
Malawi 113,823 6.18% 120,000 30 80 93,000 800 74 – – – – – – – 421 Malawi
Malaysia 12,500 0.14% 7,260 10,609 1,037 274 19,974 9,873 – 1.13 1.08 Kuala Lumpur 20.7 33% – 1,429 Malaysia
Maldives – – – – – – 70 – – – – – – – – 3 Maldives
Mali 230 0.02% 180 – – – 60 – – – – – – – – 31 Mali
Malta – – – 250 50 1 7 158 – – – – – – – 140 Malta
Marshall Islands – – – – – – – – – – – – – – – – Marshall Islands
Mauritania – – – – – – 800 – – – – – – – – – Mauritania
Mauritius 440 0.63% 700 – – – 89 207 – – – – – – – 60 Mauritius
Mexico 22,674 0.06% 45,205 20 5 10,509 8,623 5,122 46,500 1.55 1.24 Mexico City 49.4 60% 1.41% 2,121 Mexico
Micronesia, Federated States of – – – – – – – – – – – – – – – 2 Micronesia, Federated States of
Moldova, Republic of 18,608 0.92% 22,407 5,300 400 21,811 2.652 – – 1 – – – – – 2 Moldova, Republic of
Monaco – – – – – – – – – – – – – – – 767 Monaco
Mongolia – – – – – – – 0 – – – – – – – 8 Mongolia
Morocco 3,500 0.03% 3,500 – 3,100 – 8,021 2,301 – 2.63 1.36 – – – – 179 Morocco
Mozambique 7,000 0.08% 9,470 – 40 – 600 – – – – – – – – 32 Mozambique
Myanmar 30,000 0.31% 46,260 800 800 – 622 2,059 – – – – – – – 440 Myanmar
Namibia – – – – – – – 0 – – – – – – – 1 Namibia
Nauru – – – – – – – – – – – – – – – 1 Nauru
Nepal 4,283 0.20% 3,809 – – – 3,100 3,142 – – – – – 73% 6.37% 39 Nepal
Netherlands – – – 101,550 14,725 19,630 112,607 4,739 90,000 2.80 2.56 Amsterdam 18.5 72% 1.44% 1,956 Netherlands
New Zealand – – – 75 20 36 3,930 450 – 3.71 3.69 Auckland 35.3 68% – 2,353 New Zealand
Nicaragua 1,395 0.05% 2,000 – – 1,243 775 – – – – – – – – 82 Nicaragua
Niger 1,000 0.03% 850 – 800 413 100 – – – – – – – – 29 Niger
Nigeria 22,000 0.07% 9,200 – 8,500 180 1,500 0 – 0.86 0.86 – – – – 529 Nigeria
Niue – – – – – – – – – – – – – – – 1 Niue
Norway – – – 50 1,000 364 6,480 – – 6.48 6.48 Oslo 38.5 78% 1.76% 2,755 Norway
Oman 270 0.18% 1,300 – – 514 327 0 – – – – – – – 87 Oman
Pakistan 56,400 0.22% 107,700 400 4,000 2,446 180 5,701 36,644 0.83 0.53 – – 73% 0.11% 634 Pakistan
Palau – – – – – – – – – – – – – – – 5 Palau
Panama 1,100 0.17% 1,800 – 100 152 2 177 – 1.20 1.20 Panama 81.4 – – 1,220 Panama
Papua New Guinea – – – – 5 – 140 617 – 1.85 1.85 – – – – 60 Papua New Guinea
Paraguay 7,000 0.2% 11,000 2,500 2,500 4,625 5,500 250 – 1.10 0.93 – – – – 168 Paraguay
Peru 13,500 0.06% 17,231 – 10 144 628 470 – 1.42 1.34 – – – – 440 Peru
Philippines 40,869 0.59% 49,493 3,105 2,614 17,639 26.790 14,682 74,400 0.67 0.51 Manila 41.8 63% – 1,907 Philippines
Poland 14,057 0.13% 29,545 7,716 104 4,955 60,288 12,440 110,000 1.51 1.13 Warsaw 55.7 39% 3.26% 2,169 Poland
Portugal 2,132 0.07% 6,193 3,800 1,606 3,505 7,840 1,193 – 1.86 1.77 Lisbon 26.2 81% – 495 Portugal
Qatar – – – – – – 20 – – – – – – – – 101 Qatar
Romania 10,970 0.1% 14,800 – 5,500 838 25,257 7,500 21,000 1.01 0.88 – – – 0.20% 90 Romania
Russian Federation 1,700 <0.1% 1,600 900 15,000 420 263,129 17,600 **293,000 0.98 0.59 Moscow 71.3 – – 503 Russian Federation
Rwanda 2,800 0.24% 3,800 – 30 – 30 0 – – – – – – – 1 Rwanda
106 Sources: see page 124 * data for Belgium and Luxembourg ** data for Former Soviet Union 107
Ta bl e B T h e B u s i n e s s o f To b a c c o
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Growing Tobacco Tobacco Trade Manufacturing Costs Tax
Countries Tobacco Countries
Land Agricultural Tobacco Malboro or Local Labour needed to Tax as a Tobacco industry
devoted to land devoted produced equivalent brand buy a pack of proportion excise tax
international Marlboro or of cigarette revenue as a documents
growing to tobacco Tobacco Tobacco on the
tobacco farming Cigarettes Cigarettes leaf leaf Number Cigarettes brand equivalent price proportion
of manufactured international of total tax Legacy
percentage exports imports exports imports brand revenue website
millions workers
hectares of total metric tons millions metric tons metric tons millions $US per pack city minutes percentages percentages

Saint Kitts and Nevis - – – – – – – – – – – – – – – 14 Saint Kitts and Nevis

Saint Lucia – – – – – – 20 0 – – – – – – – 10 Saint Lucia
Saint Vincent and Grenadines 70 0.55% 85 – – – 30 20 – – – – – – – 362 Saint Vincent and Grenadines
Samoa 40 0.03% 135 3,250 25 – – 0 – – – – – – – 7 Samoa
San Marino – – – – – – – – – – – – – – 3.35% 5 San Marino
Sao Tome and Principe – – – – – – - – – – – – – – – 27 Sao Tome and Principe
Saudi Arabia – – – 150 20,000 2 622 – – 1.30 0.93 – – – – 1,806 Saudi Arabia
Senegal – – – 3 500 366 1,647 400 – 0.71 0.28 – – – – 89 Senegal
Seychelles – – – – 15 – 40 – – – – – – 44% 3.71% 14 Seychelles
Sierra Leone 40 0.11% 20 200 13 100 500 194 – – – – – – – 27 Sierra Leone
Singapore – 0.30% – 58,745 49,350 2,266 12,158 0 – 3.92 3.52 Singapore 42.6 – – 1,969 Singapore
Slovakia 1,134 0.47% 1,870 50 900 1,775 5,674 0 – – – – – 34% – 17 Slovakia
Slovenia – – – – – 750 8,500 – – – – – – 63% – 36 Slovenia
Solomon Islands 100 0.16% 85 – 25 – 20 – – – – – – – – 7 Solomon Islands
Somalia 250 0.02% 100 – – – 130 526 – – – – – – – 65 Somalia
South Africa 14,100 0.09% 29,700 1,926 324 15,905 6,930 3,110 37,795 1.34 1.34 Johannesburg 19.5 33% 1.15% 624 South Africa
Spain 13,450 0.09% 42,250 5,133 25,175 25,615 53,895 9,277 79,000 2.16 1.15 Barcelona 21.1 72% 2.37% 3,183 Spain
Madrid 21.4
Sri Lanka 4,780 0.45% 6,000 400 50 2,374 3,825 23,114 – 1.78 1.66 – – 24% – 66 Sri Lanka
Sudan – – – – 700 – 70 497 – – – – – – – 87 Sudan
Suriname – – – – 20 – 420 80 – – – – – – – 17 Suriname
Swaziland 194 0.04% 71 – – 2 7 0 – – – – – – – 21 Swaziland
Sweden – – – 400 2,000 1,653 10,789 560 – 3.75 3.64 Stockholm 27.6 69% 1.63% 3,512 Sweden
Geneva 12.5
Switzerland 651 0.17% 1,182 23,400 200 7,372 31,486 – 39,515 2.80 2.80 Zurich 11.1 52% 1.69% 4,734 Switzerland
Syrian Arab Republic 16,726 0.25% 26,112 500 2,000 2,315 – – – 1.12 0.56 – – – – 71 Syrian Arab Republic
Tajikistan 5,200 0.54% 13,500 – 1,000 – 7,000 – – – – – – – – 1 Tajikistan
Tanzania, United Republic of 40,000 1.06% 26,670 12,265 – 21,350 250 4,551 – – – – – – – 53 Tanzania, United Republic of
Thailand 51,800 0.21% 74,200 1,500 8,000 25,025 10,177 24,033 47,000 1.08 0.69 Bangkok 35 62% – 1,240 Thailand
Togo 4,000 0.16% 2,000 – 1,000 – 3 – – – – – – – – 23 Togo
Tonga – – – – – – – 0 – – – – – – – 4 Tonga
Trinidad and Tobago – 0.04% – – 2 – 2,065 166 – – – – – – – 157 Trinidad and Tobago
Tunisia 3,100 0.08% 3,400 – 2,000 278 8,013 3,554 – 1.96 – – – – – 65 Tunisia
Turkey 290,000 0.77% 260,000 111,006 30 129,284 48,846 21,504 – 1.23 0.89 Istanbul 30 42% 0.21% 1,033 Turkey
Turkmenistan 800 0.07% 2,000 – 1,500 – 800 – – – – – – – – 0 Turkmenistan
Tuvalu – – – – – – – – – – – – – – – 0 Tuvalu
Uganda 7,500 0.11% 10,000 – – 4,714 144 719 – 1.89 – – – – – 33 Uganda
Ukraine 4,300 0.02% 3,000 – 20,000 1,579 70,000 7,000 – 0.80 – – – – – 29 Ukraine
United Arab Emirates 50 0.07% 608 – 8,000 60 236 0 – 1.77 0.29 Abu Dhabi 19.7 – – 144 United Arab Emirates
United Kingdom of Gr. Br. & N Ir. – – – 2 45,018 9,945 128,569 6,450 114,300 6.24 6.25 London 39.7 78% 3.23% 9,181 United Kingdom of Gr. Br. & N Ir.
United States of America 191,176 0.15% 477,630 148,261 15,064 190,538 241,062 27,300 716,500 3.71 3.60 Chicago 18 24% 0.44% 78,615 United States of America
Los Angeles 20
Uruguay 830 0.06% 2,800 22,950 40 74 8,954 396 – 3.14 1.42 – – 60% 2.64% 300 Uruguay
Uzbekistan 10,500 0.17% 19,000 15 7,500 – 5,450 – – – 1.11 – – – – 29 Uzbekistan
Vanuatu – – – – – – – – – – – – – – – 0 Vanuatu
Venezuela 6,000 0.23% 11,288 250 50 186 10,507 2,581 – 1.42 1.28 Caracas 28.5 50% 2.30% 1,145 Venezuela
Viet Nam 24,400 0.41% 27,200 – 2,000 96 16,000 – – 0.72 0.57 – – 36% – 329 Viet Nam
Yemen 5,209 0.26% 12,581 2,000 150 14 8,502 961 – – – – – – – 28 Yemen
Yugoslavia 9,858 0.26% 11,341 3,250 14,500 3,710 2,700 4,900 0 0.94 0.28 – – 522 Yugoslavia
Zambia 2,900 0.06% 3,200 – – 3,600 1,100 503 – 2.03 – – – 30% 0.04% 73 Zambia
Zimbabwe 90,769 2.56% 227,726 2,000 – 163,933 6,723 4,290 – 1.15 0.65 – – 80% 1.17% 864 Zimbabwe
108 Sources: see page 124 109