Tobacco Use Epidemic Places Heavy Burden on Low- and Middle-Income Countries

By Brandon Talley

Talley is associate vice president for programs, Tobacco Control at the CDC Foundation

Infectious and chronic diseases take a tremendous toll on the world’s population, but none takes a greater one than tobacco use, which represents the leading cause of death and disease. More than 100 million people lost their lives to tobacco use in the 20th century, and if current smoking patterns continue, tobacco-related deaths will reach around 1 billion in the 21st century, according to The Tobacco Atlas. But the devastating global effects of tobacco use are highly preventable by implementing scientifically proven interventions.

Some intervention options include the implementation of smoke-free environments; providing help and support to quit smoking; graphic warning labels on tobacco products; enforcing bans on advertising, promotion and sponsorship of tobacco; and raising taxes on tobacco products. But to implement and measure effective interventions, countries need robust tobacco use data. With this information, countries can measure the extent of the tobacco epidemic as well as the actual impact of any intervention.

A Field Interviewer contracted to carry out the Global Adult Tobacco Survey (GATS) in Malaysia shows off one of the 75 hand held electronic data recorders provided to the survey team by the World Health Organization. Five of the units are held in reserve as back ups in case of any problems during the eight week survey, which is also supported by the CDC Foundation.

To help curb the tobacco epidemic and systematically monitor global tobacco use prevalence and track tobacco control indicators, the CDC Foundation has partnered for eight years with the U.S. Centers for Disease Control and Prevention (CDC), World Health Organization (WHO), and other national and international partners to support implementation of the Global Adult Tobacco Survey (GATS). GATS, which is supported in part by the Bloomberg Initiative to Reduce Tobacco Use and the Bill & Melinda Gates Foundation, is a nationally representative household survey of adults 15 years of age or older.

The survey has been completed in 28 countries, with two countries having conducted repeat surveys. The data collected through GATS covers over 3.6 billion adults—more than 68 percent of the world’s adult smokers. Plans are underway to repeat GATS in 11 countries over the next two years. The data generated will be used to evaluate tobacco control interventions and measure tobacco control progress in low- and middle-income countries where the health-related and economic burden of tobacco use is particularly heavy.

Respondents take part in a survey conducted by the Info Survey Group, contracted as part of the Global Adult Tobacco Survey (GATS) with support from the CDC Foundation. Launched in Malaysia in 2010, the survey is helping the Institute for Public Health compile data on adult tobacco use habits that can ultimately be used by the Ministry of Health to combat tobacco usage.

Additionally, over the next three years, GATS will be implemented in three additional countries in sub-Saharan Africa. Compared to many other regions, tobacco use in sub-Saharan Africa remains relatively low, but according to WHO, consumption in the region is rising as tobacco companies are globally targeting underdeveloped markets. The implementation of GATS in sub-Saharan Africa provides a unique opportunity to curb tobacco use in the region by enhancing tobacco control and surveillance capacity there.

Monitoring the tobacco epidemic through the implementation of GATS represents a critical component of a comprehensive tobacco control program. Data collected through GATS provides stakeholders with scientific information to overcome challenges in developing, implementing and evaluating effective national tobacco control policies and programs. At the CDC Foundation, we are pleased to have a role in helping to facilitate this vital work.

Ahidah Binti Mohammed Din (right), a Field Supervisor for the Global Adult Tobacco Survey (GATS) in Malaysia, speaks with other GATS survey team members while conducting interviews in the community of Behrang in the Perak state of Malaysia. The GATS teams members often work long and irregular hours to carry out the comprehensive tobacco survey.

Talley is associate vice president for programs, Tobacco Control at the CDC Foundation

 Photos © David Snyder/CDC Foundation