/ 9 November 2007

Global tobacco burden ‘to get much worse’

The global burden of tobacco is going to get much worse before it gets better, an expert from the World Lung Foundation said in Cape Town on Friday.

Developing countries will bear the brunt of this burden and its ”huge” economic implications, Dr Judith Mackay, coordinator of tobacco control at the foundation, told a media briefing on the fringe of a major international conference on lung health.

She said tobacco, responsible for five million deaths a year, is as significant a worldwide killer as tuberculosis (TB). Without effective action, by 2030 the number of annual deaths will have risen to about 10-million.

”The tobacco burden will get a lot worse before it gets better,” she said.

The number of smokers is projected to rise from the current worldwide total of 1,3-billion to 1,64-billion by 2030.

Mackay said the 10-million deaths will be made up of people who are currently smoking.

”So it represents an increase that has gone on over the last 30 years. These are all smokers who will come up and die,” she said. ”The number of smokers reflects what will happen with children who are being born, or under-10s, 10- to 20-year-olds now.

”And that’s why we need a sort of pincer approach, to try and help smokers quit, and try and stop children start smoking. I’m very confident that things are being put in place that will eventually bring this epidemic down; robustly confident.

”But I’m still realistic, and I think it’s going to be a major struggle. There’s not going to be a single tobacco farmer out of work in my lifetime, that’s for sure.

”That on the one hand is rather daunting and depressing … but I don’t think that the enormity of the problem should paralyse us into inactivity.”

She said that up to now, the smoking epidemic has been restricted mainly to men.

Though there has been a significant rise in smoking rates in developing countries, the prediction by tobacco-control experts that rates among women would increase has not materialised.

This could be because of the influence of Islam, or Confucianism in China, where one in every worldwide three cigarettes is smoked, or because anti-smoking health messages have been effective.

Among other causes for hope is the passage of the Framework Convention of Tobacco Control, which reads like a ”good national law”, and the fact that many individual countries have already taken tough action on smoking.

Mongolia’s tobacco control laws are a lot better than in many Western countries, while Bhutan has banned all smoking.

The head of operations at the International Union against TB and Lung Disease, Karen Slama, said there is compelling scientific evidence that smoking and exposure to smoking increase TB rates.

The World Health Organisation has estimated that probably more than 30% of the global TB burden can be attributable to smoking.

Effective tobacco control can reduce the pool of people who have TB, and among those who have TB, it could reduce the number who move from TB to death. ”You can save millions of dollars in TB treatment costs,” she said. — Sapa