Global Epidemic

The Toll of Tobacco

Tobacco use is the world’s leading cause of preventable death, according to the World Health Organization.

Increasingly, the burden of tobacco use is greatest in low- and middle-income countries that have been targeted by the tobacco industry with its deadly products and deceptive marketing practices. The result: A global tobacco epidemic of preventable death, disease and economic harm to countries and families.

Tobacco Consumption

There are more than one billion smokers in the world.1

  • Globally, 21% of adults are current smokers (men 36%; women 7%).1
  • More than 80% of the world’s smokers live in low- and middle-income countries.1
    • 32% of men in high-income countries, 38% in middle-income countries, and 30% of men in low-income countries are smokers.
    • 17% of women in high-income countries, 4% in middle-income, and 3% of women in low- income countries smoke.
  • According to the Global Youth Tobacco Survey which was conducted in 61 countries around the world between 2012 and 2015, the median rate of current smoking among students aged 13–15 years was 10.7%, with the highest rate found in Timor-Leste (35%).2
    • By sex, the median rate of current smoking was 14.6% for boys and 7.5% for girls, with the highest rate for boys found in Timor-Leste (61.4%) and the highest rate for girls found in Bulgaria (29%).
  • Cigarette smoking and use of other tobacco products is increasing in many low- and middle-income countries due to population growth and tobacco industry marketing.

Tobacco Health Consequences

100 million people died from tobacco use in the 20th century. If current trends continue one billion people will die from tobacco use in the 21st century.3

  • Tobacco use kills up to half of all lifetime users.4 On average, smokers lose 15 years of life.5
  • Tobacco kills more than 7 million people each year.6 By 2030, the number of tobacco-related deaths will increase to 8 million each year.4
  • Tobacco-related illnesses account for 1 in 10 adult deaths worldwide. By 2030, 80% of those deaths will be in low- and middle-income countries.4

Tobacco Costs to Society

  • Smoking is estimated to cause about 1.4 trillion USD in economic damage each year.7
  • Health care costs associated with tobacco-related illnesses are extremely high. Economic costs associated with smoking represent 1.8% of global GDP, and smoking-attributable health expenditure represents 5.7% of total health spending.7
    • In the United States, annual tobacco-related health care costs amount to 170 billion USD8; in China, 28.9 billion9; in Vietnam, 0.6 billion USD10; in Brazil, 5.8 billion USD.11
  • Tobacco-related illnesses and premature mortality impose high productivity costs to the economy because of sick workers and those who die prematurely during their working years. Lost economic opportunities in highly-populated low- and middle-income countries will be particularly severe as tobacco use is high and growing in those areas.5
    • Global indirect costs of smoking are estimated to be about 1 trillion USD, nearly two thirds of which are due to premature mortality.7
    • In Ukraine, the productivity loss due to premature smoking-related mortality is at least 3 billion USD annually.12
  • Tobacco production damages the environment:
    • Tobacco plants are especially vulnerable to many pests and diseases, prompting farmers to apply large quantities of chemicals and pesticides that harm human health and the environment.3
    • Clearing of land for cultivation and large amounts of wood needed for curing tobacco cause massive deforestation at a rate of about 200,000 hectares per year.3


1 WHO Report on the Global Tobacco Epidemic, 2015: The MPOWER package. Geneva: World Health Organization; 2015.
2 Arrazola RA et al. Current tobacco smoking and desire to quit smoking among students aged 13-15 years—Global Youth Tobacco Survey, 61 countries, 2012-2015. MMWR Morb Mortal Wkly Rep 2017;66:533-537.3 Eriksen M et al. The Tobacco Atlas. Fifth Ed. Atlanta, GA: American Cancer Society; 2015.
4 WHO Report on the Global Tobacco Epidemic, 2011: The MPOWER package. Geneva: World Health Organization; 2011.
5 WHO Report on the Global Tobacco Epidemic, 2008: The MPOWER package. Geneva: World Health Organization; 2008.
6 Global Burden of Disease (GBD) 2015. Seattle, WA: Institute for Health Metrics and Evaluation (IHME), University of Washington;2017. Available from
7 U.S. NCI and WHO. The Economics of Tobacco and Tobacco Control. NCI Tobacco Control Monograph 21. NIH Publication No. 16-CA-8029A. Bethesda: U.S. DHSS, NIH, NCI, and Geneva: WHO; 2016.
8 Campaign for Tobacco-free Kids. Toll of Tobacco in the United States of America.
9 Yang L et al. Economic costs attributable to smoking in China: update and an 8-year comparison, 2000-2008. Tobacco Control; 2011; 20(4): 266-272.
10 Anh PTH et al. Direct and indirect costs of smoking in Vietnam. Tobacco Control. 2014 December 15;0:1-5.
11 Pinto MT, Pichon-Riviere A, Bardach A. The burden of smoking-related diseases in Brazil: mortality, morbidity and costs. Cadernos de Saúde Pública. 2015 June; 31(6):1-14. Available from arttext&tlng=en
12 Ross H. Economic and public health impact of 2007-2010 tobacco tax increases in Ukraine. Tobacco Control. 2012 June;21:429-435.

Last Updated: Aug. 2017