Between 1990 and 2009, cigarette consumption in regions of the world like Western Europe dropped by more than 25%. But according to the American Cancer Society's newly released Tobacco Atlas, these numbers tell just a fraction of a much larger story.
According to the extensive report, which you can access in its entirety on tobaccoatlas.org [click here for the 99MB pdf], cigarette consumption in poorer countries has increased more than enough to offset the decreases seen in wealthier nations like France, Germany, the U.S. and Canada. In the past twenty years, for example, cigarette use in the Middle East and Africa has increased by just shy of 60%. "Among the 14 countries where 50% or more of men smoke," the report reads, "all but one country (Greece) are classified as low- or middle-income." [The figure up top is taken from page 29 of the ACS report. Click here for hi-res, or click here to download]
Historically speaking, cigarette consumption has been highest in high-income countries; but as people in wealthier parts of the world have come to better understand the dangers of smoking, "targeted marketing, increased social acceptability, economic development and population increases" have led to unprecedented spikes in cigarette use among the world's poor.
This shift in consumption is disturbing for a number of reasons, but one of the most unsettling is the stunting effect that smoking could wind up having on nations that, by all appearances, should be maturing. That might sound counterintuitive, at first; after all, as mentioned above, cigarette consumption in many low- or middle-income nations is being driven by economic development. But economic development is not always synonymous with progress. In fact, as statistician Hans Rosling and others have pointed out, most countries appear to advance much faster if they are healthy first than if they are wealthy first.
"As consumption rates continue to increase in low- and middle-income countries," the ACS report reads, "these countries will experience a disproportionate amount of tobacco-related illness and death." China, for example, which has experienced incredible economic growth as a middle-income country in recent years, consumed close to 40% of the world's cigarettes in 2009 (interestingly, these cigarettes were also consumed almost entirely by men); that's more than the other top four tobacco-consuming countries combined. "If the smoking prevalence among Chinese women increases," reasons the ACS report, "global consumption of cigarettes will skyrocket, and the country's economy and health-care systems will be overwhelmed."