John R. Seffrin, PhD National Chief Executive Officer American Cancer Society A Ticking Time Bomb: The Global Tobacco Pandemic Current and Future Scenarios Global Tobacco-Free Research Initiative Stanford, California May 15, 2008

John R. Seffrin, PhD National Chief Executive Officer American Cancer Society A Ticking Time Bomb: The Global Tobacco Pandemic Current and Future Scenarios Global Tobacco-Free Research Initiative Stanford, California May 15, 2008

Global Smoking Prevalence There are currently 1.3 billion smokers in the world. Asia; Central and Eastern Europe; and the former Soviet Union have the highest smoking rates in the world with overall country rates as high as 47%. One-third of the global population age 15 and older smokes.

Nearly 2/3 of the World’s Smokers Live in Just 10 Countries More than 40% live in just two countries.

Smoking and Secondhand Smoke Damage Every Part of the Body Smoking Secondhand Smoke

More than 600 million people alive today will die from smoking-related causes; half of them children. Cigarettes kill half of all lifetime users. Half of all deaths from smoking occur in middle age – between 35 and 69 years old, when individuals are most productive. Global Smoking Deaths

Economic Effects of Tobacco Use The WHO estimates the annual global cost of tobacco to be US$500 billion – a figure higher than the GDP of 174 of the 192 UN members.

Economic Effects of Tobacco Use (continued) For nearly 50% of the world’s population, a pack of Marlboros costs approximately half of a family’s daily income. Smoking-related costs can contribute up to 15% of total health care costs in high- income countries.

Global Tobacco Control is Underfunded Globally, tobacco tax revenues are 500 times higher than spending on tobacco control. In low- and middle-income countries, tax revenues are 5,000 times higher.

Only 5% of World Covered by Effective Tobacco Control Policies 5% or less benefit from effective interventions to reduce use

Sub- Saharan Africa China Japan Southeast Asia Latin America North Africa Eastern Europe Southern Europe Western Europe, UK USA Canada Australia Countries in each stage Adapted from: Lopez AD, Collishaw NE, Piha T. A descriptive model of the cigarette epidemic in developed countries. Tobacco Control, 1994, 3: STAGE 1 STAGE 2 STAGE 3 STAGE 4 Four Stages of the Tobacco Pandemic

Tobacco Deaths in the Industrialized and Developing World, 2000 and 2030 Industrialized countries Developing countries While tobacco- related deaths will only increase slightly in the industrialized world during the next 30 years, they will more than triple in the developing world. WHO World Health Report 1999.

World Tobacco Deaths - if Current Smoking Patterns Continue ~ 150M ~ 300M > 500M TOTAL for the 21 st century 1 billion

“Reversing this entirely preventable epidemic must now rank as a top priority for public health and for potential leaders in every country of the world.” Dr. Margaret Chan, WHO Director-General

We know what to do NOW: Educate the public about the dangers of tobacco use. Reduce the number of physicians who smoke. Tobacco Control: A Global Remedy

Make health care facilities smoke- free. Protect all nonsmokers from secondhand smoke. Regulate tobacco and other dangerous products. Raise cigarette excise taxes. Implement and enforce the Framework Convention on Tobacco Control. Tobacco Control: A Global Remedy (continued)

Successes: Tobacco taxes Smoke-free laws Lower adult smoking rates California: An Anti-Tobacco Pioneer – With Work to be Done Needed improvements: Tobacco taxes Youth smoking rates

Successes: Tobacco taxes Smoke-free laws Lower adult smoking rates California: An Anti-Tobacco Pioneer – With Work to be Done Needed improvements: Tobacco taxes Youth smoking rates

WHO Recommendations for Global Tobacco Control: M onitor tobacco use and prevention policies P rotect people from tobacco smoke O ffer help to quit tobacco use W arn about the damages of tobacco use E nforce advertising/promotion/sponsorship bans R aise taxes on tobacco Source: MPOWER, WHO 2008

Good News What will the effects of turning the tide be?  Hundreds of millions of lives could be saved.  Lung cancer could virtually disappear as a public health menace.  Global heart disease risks could be reduced by as much as 25 percent.  Trillions of dollars will be saved from health care expenditures and redirected to research and public health.

Thank you.