ABSTRACT
Epidemiology There are nearly 1.1 billion users of nicotine and tobacco products worldwide. Tobacco use through cigarette smoking is the leading preventable cause of death in the world and kills nearly four million people annually. By 2020, this number is expected to more than double. It causes harm not only to users but also to second-hand smokers. Smoking prevalence varies significantly by age, gender, ethnicity, socioeconomic status, and education level. In Europe, approximately 30% of the adult population are regular smokers. The prevalence among young people is around 27-30%, and individuals aged 65 or older have the lowest prevalence of smoking among adults. Nearly 38% of men smoke, whereas the rates among women are around 23%. With the decline of tobacco use in many industrialized countries, the smoking epidemic is shifting from the developed to the developing world. To a large extent, this is due to the adoption of a very aggressive marketing strategy by the tobacco industry in these countries. The increase is particularly dramatic in China, where more than 60% of adult men are estimated to smoke, representing almost one-third of the total number of smokers worldwide. Current smoking prevalence is higher among adults living below the poverty level (29.1%) compared with those at or above the poverty level (20.6%). Education is inversely related to smoking status; college graduates are less likely to be current smokers and more likely to be never smokers compared with other adults.
