Today, the World Health Organization released its "WHO global report on trends in prevalence of tobacco use 2000-2025, fourth edition." The key finding? The number of worldwide tobacco users declined by 20 million between 2015 and 2021, a drop from 1.32 billion to 1.3 billion.

According to the report, "Over 8 million people died from a tobacco-related disease in 2019. The number of annual deaths can be expected to keep growing even once rates of tobacco use are in decline, because tobacco kills its users and people exposed to its emissions slowly."

The report defines tobacco use as "any tobacco use" of any type, whether smoked or smokeless but excludes e-cigarettes.

The unanswered question is, since the 1.3 billion total does not include e-cig users, and the average annual increase in e-cig users since 2011 is estimated at roughly 4.8 million, are we seeing an uptick in the number of nicotine dependent humans?

The WHO Global Action Plan set a target for reducing the global prevalence of tobacco use (smoked and smokeless tobacco) by 30% by the year 2025 relative to 2010.

While the report notes that "150 countries are currently achieving measurable declines in tobacco use, and 60 of them are already at or beyond a 30% reduction," the goal "is not likely to be achieved in most countries. Instead of being on track towards a 30% reduction target by 2025, projections in this report show that a reduction of only 24% globally is likely to be achieved under current levels of tobacco control."

But why?

"Although the fall in prevalence rates among women is projected to exceed the 30% reduction target, rates among men are presently tracking towards only a 19% relative reduction over the period 2010–2025. Tobacco use reductions among men are proving particularly difficult to achieve."

The report also notes "mounting evidence that the tobacco and related industries are actively trying to derail tobacco control efforts using new products, with scant evidence of their potential risks and benefits, to confuse and confound regulators and legislators."

Most importantly, the report states that "No country has fully implemented the commitments made under the WHO FCTC [Framework Convention on Tobacco Control].

The core FCTC commitments include price, tax and other measures to reduce tobacco use, protection from exposure to tobacco smoke, regulation of the contents of tobacco products, requiring product disclosures, use of graphic packaging and use warnings, public harm awareness campaigns, regulation of tobacco advertising, promotion and sponsorship; and demands for increasing cessation and decreasing tobacco dependence.

Not mentioned is what Australia's Professor Simon Chapman calls, "The Global Research Neglect of Unassisted Smoking Cessation."

"Today's largest tobacco markets are nations with massive populations on low incomes for whom pharmacotherapy is prohibitively expensive," notes Chapman." "The persistent messaging that nicotine addiction is refractory and stopping unaided will be futile deflects attention away from what is by far the most common story of cessation: people doing it without professional or therapeutic help."

"The persistence of unassisted cessation as the most common way that most smokers have succeeded in quitting is an unequivocally positive message that, far from being suppressed or ignored, should be openly embraced by primary health care workers and public-health authorities as the front-line, primary “how” message in all clinical encounters and public communication about cessation."

---

---