The truth is that four million people die yearly from tobacco-related diseases, one death every eight seconds. If current trends continue, WHO estimates that the toll will rise to ten million by 2030, one death every three seconds. Tobacco is fast becoming a greater cause of death and disability than any single disease.

It doesn't have to be that way. WHO has decided to focus attention and resources on tobacco use, to try to prevent at least some of these predicted deaths, and to prevent hundreds of millions to more in the decades to come after 2030.

How many deaths?

Tobacco is a silent killer. Peaks in tobacco mortality reflect peaks in tobacco consumption three to four decades earlier. Current smoking mortality is the result of past lifetimes of tobacco consumption.

From 1950 to 2000, tobacco will have killed more than 60 million people in developed countries alone, more than died in World War II.

If current trends continue, tobacco will kill more than 100 million people in the first two decades of the 21st century.

If current trends continue, 500 million people alive today will be killed by tobacco.

Of the 300 million Chinese men now aged 0-29, at least 100 million will eventually be killed by tobacco. Half the deaths will be among those aged 35-69.

In the Former Socialist Economies (FSE), around 14% of all deaths were traced to tobacco use in 1990. By 2020, this figure is slated to rise to 22%. And smoking is the major risk factor responsible for a predicted 56% increase in male deaths from chronic diseases in FSE countries from 1990 to 2020.

How much illness?

Tobacco is a known or probable cause of some 25 different diseases. For some, like lung cancer, bronchitis and emphysema, it is the major cause.

Other people's tobacco smoke contains essentially all of the same carcinogens and toxic agents that are inhaled by the smoker. Other people's tobacco smoke is harmful to non-smokers because it causes lung cancer and other diseases, and aggravates allergies and asthma.

Tobacco consumption has been explicitly linked to high incidence and gravity of cardiac disease.

Maternal smoking is associated with a higher risk of miscarriage, lower birthweight of babies and inhibited child development. Parental smoking is also a factor in sudden infant death syndrome and is associated with higher rates of respiratory illnesses, including bronchitis, colds and pneumonia in children.

How many smokers?

WHO estimated that there were 1.1 billion smokers in the world at the beginning of the 1990s, 300 million in developed countries and 800 million in developing countries. About one-third of the world's adults were smokers at the beginning of this decade, and there is little sign that this proportion has changed substantially since.

At the beginning of the 1990s, 47% of men and 12% of women were smokers. In developing countries, it was estimated that 48% of men and 7% of women were smokers, while in developed countries, 42% of men and 24% of women were smokers.

Tobacco use among adolescents remains stubbornly persistent. Smoking prevalence among adolescents rose in the 1990s in several developed countries . While new markets are being opened by tobacco industry actions, old markets have not been closed tobacco is a global threat.

Tobacco and smoke concern us all, smokers and non-smokers alike. Tobacco is everybody's problem. It is a major public health issue that demands urgent action now.

Fact Sheet No 221
April 1999