Cigarette consumption high in low-and-middle-income countries

Cigarette consumption has increased in low-and-middle-income countries, say recent studies, which have been published in the 'British Medical Journal' (BMJ).

These studies question the widely held belief that the WHO Framework Convention on Tobacco Control (FCTC) has been the most successful health treaty ever created.

The research also puts the spotlight on the urgent need not only for investment in tobacco control practices but also an evaluation of the effectiveness of this international law and reporting practices.

"The policies promoted by this treaty -- plain packaging, smoke-free areas, tobacco taxes -- have been monolithically proven to be effective," said Steven Hoffman, the lead author of the study.

"What this study shows is that it's probably not enough at the global level to recognise these policies as important or to formally adopt them. We need countries to implement them to make sure they're affecting people's lives around the world," Hoffman added.

In the first study, Hoffman and co-author Mathieu Poirier, analysed data collected from 71 countries, representing 95 per cent of the world's tobacco consumption and over 80 per cent of the world's population between the years of 1970 and 2015.

Researchers found that cigarette consumption fell in most countries, however, consumption trends varied from country to country, especially in lower-income countries.

The open-access dataset looked at sales, production, imports, and exports.

Researchers found a general decline in per capita cigarette consumption beginning around 1985 in five of the top ten cigarette-consuming countries -- United States, Japan, Poland, Brazil, and Germany.

The United States, Canada, and Australia -- all demonstrated similar continuous declines in consumption since the early 1980s, while Latin American and Caribbean countries experienced more modest declines.

In contrast, the per capita consumption rose steadily in China and Indonesia. China was found to be the world's leading consumer of cigarettes, with over 2.5 million metric tonnes consumed in 2013 - more than the next 40 highest consuming countries combined.

In the second study, Hoffman and his team used the data from the first study and looked at it in the context of the Framework Convention on Tobacco Control which has been ratified by 181 countries since its adoption in 2003.

The data showed no significant change in the rate at which global cigarette consumption had been decreasing after the adoption of the treaty.

"This study sets a new gold standard for how to evaluate international laws," said co-author Poirier.

"The FCTC was widely celebrated at the time it was launched and no one has actually evaluated that treaty on a global level until now."

The research showed that after 2003, high income and European countries experienced a decrease in annual consumption by more than 1,000 cigarettes per adult, while low- and middle-income and Asian countries showed an increase of more than 500 cigarettes annually per adult.