Abstract
Background: Chewing tobacco and other types of smokeless tobacco use have had less attention from the global health community than smoked tobacco use. However, the practice is popular in many parts of the world and has been linked to several adverse health outcomes. Understanding trends in prevalence with age, over time, and by location and sex is important for policy setting and in relation to monitoring and assessing commitment to the WHO Framework Convention on Tobacco Control.
Methods: We estimated prevalence of chewing tobacco use as part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 using a modelling strategy that used information on multiple types of smokeless tobacco products. We generated a time series of prevalence of chewing tobacco use among individuals aged 15 years and older from 1990 to 2019 in 204 countries and territories, including age-sex specific estimates. We also compared these trends to those of smoked tobacco over the same time period.
Findings: In 2019, 273·9 million (95% uncertainty interval 258·5 to 290·9) people aged 15 years and older used chewing tobacco, and the global age-standardised prevalence of chewing tobacco use was 4·72% (4·46 to 5·01). 228·2 million (213·6 to 244·7; 83·29% [82·15 to 84·42]) chewing tobacco users lived in the south Asia region. Prevalence among young people aged 15–19 years was over 10% in seven locations in 2019. Although global age-standardised prevalence of smoking tobacco use decreased significantly between 1990 and 2019 (annualised rate of change: –1·21% [–1·26 to –1·16]), similar progress was not observed for chewing tobacco (0·46% [0·13 to 0·79]). Among the 12 highest prevalence countries (Bangladesh, Bhutan, Cambodia, India, Madagascar, Marshall Islands, Myanmar, Nepal, Pakistan, Palau, Sri Lanka, and Yemen), only Yemen had a significant decrease in the prevalence of chewing tobacco use, which was among males between 1990 and 2019 (−0·94% [–1·72 to –0·14]), compared with nine of 12 countries that had significant decreases in the prevalence of smoking tobacco. Among females, none of these 12 countries had significant decreases in prevalence of chewing tobacco use, whereas seven of 12 countries had a significant decrease in the prevalence of tobacco smoking use for the period.
Interpretation: Chewing tobacco remains a substantial public health problem in several regions of the world, and predominantly in south Asia. We found little change in the prevalence of chewing tobacco use between 1990 and 2019, and that control efforts have had much larger effects on the prevalence of smoking tobacco use than on chewing tobacco use in some countries. Mitigating the health effects of chewing tobacco requires stronger regulations and policies that specifically target use of chewing tobacco, especially in countries with high prevalence.
Funding: Bloomberg Philanthropies and the Bill & Melinda Gates Foundation.
Original language | English |
---|---|
Pages (from-to) | e482-e499 |
Number of pages | 18 |
Journal | The Lancet Public Health |
Volume | 6 |
Issue number | 7 |
DOIs | |
Publication status | Published - Jul 2021 |
Externally published | Yes |
Bibliographical note
Copyright © 2021 The Author(s). Published by Elsevier Ltd. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.Fingerprint
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In: The Lancet Public Health, Vol. 6, No. 7, 07.2021, p. e482-e499.
Research output: Contribution to journal › Article › peer-review
TY - JOUR
T1 - Spatial, temporal, and demographic patterns in prevalence of chewing tobacco use in 204 countries and territories, 1990-2019
T2 - a systematic analysis from the Global Burden of Disease Study 2019
AU - GBD 2019 Chewing Tobacco Collaborators
AU - Kendrick, Parkes J.
AU - Reitsma, Marissa B.
AU - Abbasi-Kangevari, Mohsen
AU - Abdoli, Amir
AU - Abdollahi, Mohammad
AU - Abedi, Aidin
AU - Abhilash, E. S.
AU - Aboyans, Victor
AU - Adebayo, Oladimeji M.
AU - Advani, Shailesh M.
AU - Ahinkorah, Bright Opoku
AU - Ahmad, Sohail
AU - Ahmadi, Keivan
AU - Ahmed, Haroon
AU - Aji, Budi
AU - Akalu, Yonas
AU - Akunna, Chisom Joyqueenet
AU - Alahdab, Fares
AU - Al-Aly, Ziyad
AU - Alanezi, Fahad Mashhour
AU - Alanzi, Turki M.
AU - Alhabib, Khalid F.
AU - Ali, Tilahun
AU - Alif, Sheikh Mohammad
AU - Alipour, Vahid
AU - Aljunid, Syed Mohamed
AU - Alomari, Mahmoud A.
AU - Amin, Tarek Tawfik
AU - Amini, Saeed
AU - Amu, Hubert
AU - Ancuceanu, Robert
AU - Anderson, Jason A.
AU - Andrei, Catalina Liliana
AU - Andrei, Tudorel
AU - Ansari-Moghaddam, Alireza
AU - Antony, Benny
AU - Anvari, Davood
AU - Arabloo, Jalal
AU - Arian, Nicholas D.
AU - Arora, Monika
AU - Artanti, Kurnia Dwi
AU - Asmare, Wondwossen Niguse
AU - Atnafu, Desta Debalkie
AU - Ausloos, Marcel
AU - Awan, Asma Tahir
AU - Ayano, Getinet
AU - Aynalem, Getie Lake
AU - Azari, Samad
AU - Darshan, B. B.
AU - Badiye, Ashish D.
AU - Baig, Atif Amin
AU - Banach, Maciej
AU - Banerjee, Srikanta K.
AU - Barker-Collo, Suzanne Lyn
AU - Bärnighausen, Till Winfried
AU - Barqawi, Hiba Jawdat
AU - Basu, Sanjay
AU - Bayati, Mohsen
AU - Bazargan-Hejazi, Shahrzad
AU - Bekuma, Tariku Tesfaye
AU - Bennett, Derrick A.
AU - Bensenor, Isabela M.
AU - Benzian, Habib
AU - Benziger, Catherine P.
AU - Berman, Adam E.
AU - Bhagavathula, Akshaya Srikanth
AU - Bhala, Neeraj
AU - Bhardwaj, Nikha
AU - Bhardwaj, Pankaj
AU - Bhattacharyya, Krittika
AU - Bibi, Sadia
AU - Bijani, Ali
AU - Biondi, Antonio
AU - Braithwaite, Dejana
AU - Brenner, Hermann
AU - Brunoni, Andre R.
AU - Burkart, Katrin
AU - Nagaraja, Sharath Burugina
AU - Butt, Zahid A.
AU - Dos Santos, Florentino Luciano Caetano
AU - Car, Josip
AU - Carreras, Giulia
AU - Castaldelli-Maia, Joao Mauricio
AU - Cattaruzza, Maria Sofia Sofia
AU - Chang, Jung-Chen
AU - Chaturvedi, Pankaj
AU - Chen, Simiao
AU - Chido-Amajuoyi, Onyema Greg
AU - Chu, Dinh-Toi
AU - Chung, Sheng-Chia
AU - Ciobanu, Liliana G.
AU - Costa, Vera Marisa
AU - Couto, Rosa A. S.
AU - Dagnew, Baye
AU - Dai, Xiaochen
AU - Damasceno, Albertino Antonio Moura
AU - Damiani, Giovanni
AU - Dandona, Lalit
AU - Dandona, Rakhi
AU - Daneshpajouhnejad, Parnaz
AU - Gela, Jiregna Darega
AU - Molla, Meseret Derbew
AU - Desta, Abebaw Alemayehu
AU - Dharmaratne, Samath Dhamminda
AU - Dhimal, Meghnath
AU - Eagan, Arielle Wilder
AU - Kalan, Mohammad Ebrahimi
AU - Edvardsson, Kristina
AU - Effiong, Andem
AU - El Tantawi, Maha
AU - Elbarazi, Iffat
AU - Esmaeilnejad, Saman
AU - Fadhil, Ibtihal
AU - Faraon, Emerito Jose A.
AU - Farwati, Medhat
AU - Farzadfar, Farshad
AU - Fazlzadeh, Mehdi
AU - Feigin, Valery L.
AU - Feldman, Rachel
AU - Filip, Irina
AU - Filippidis, Filippos
AU - Fischer, Florian
AU - Flor, Luisa Sorio
AU - Foigt, Nataliya A.
AU - Folayan, Morenike Oluwatoyin
AU - Foroutan, Masoud
AU - Gad, Mohamed M.
AU - Gallus, Silvano
AU - Geberemariyam, Biniyam Sahiledengle
AU - Gebregiorgis, Birhan Gebresillassie
AU - Getacher, Lemma
AU - Obsa, Abera Getachew
AU - Ghafourifard, Mansour
AU - Gheshlagh, Reza Ghanei
AU - Ghashghaee, Ahmad
AU - Ghith, Nermin
AU - Gil, Gabriela Fernanda
AU - Gill, Paramjit Singh
AU - Ginawi, Ibrahim Abdelmageed
AU - Goharinezhad, Salime
AU - Golechha, Mahaveer
AU - Gopalani, Sameer Vali
AU - Gorini, Giuseppe
AU - Grivna, Michal
AU - Guha, Avirup
AU - Guimarães, Rafael Alves
AU - Guo, Yuming
AU - Gupta, Rajat Das
AU - Gupta, Rajeev
AU - Gupta, Tarun
AU - Gupta, Vin
AU - Hafezi-Nejad, Nima
AU - Haider, Mohammad Rifat
AU - Hamadeh, Randah R.
AU - Hankey, Graeme J.
AU - Hargono, Arief
AU - Hay, Simon I.
AU - Heidari, Golnaz
AU - Herteliu, Claudiu
AU - Hezam, Kamal
AU - Hird, Thomas R.
AU - Holla, Ramesh
AU - Hosseinzadeh, Mehdi
AU - Hostiuc, Mihaela
AU - Hostiuc, Sorin
AU - Househ, Mowafa
AU - Hsiao, Thomas
AU - Huang, Junjie
AU - Ibeneme, Charles Ugochukwu
AU - Ibitoye, Segun Emmanuel
AU - Ilic, Irena M.
AU - Ilic, Milena D.
AU - Inbaraj, Leeberk Raja
AU - Irvani, Seyed Sina Naghibi
AU - Islam, Jessica Y.
AU - Islam, Rakibul M.
AU - Islam, Sheikh Mohammed Shariful
AU - Islami, Farhad
AU - Iso, Hiroyasu
AU - Itumalla, Ramaiah
AU - Jaafari, Jalil
AU - Jain, Vardhmaan
AU - Jakovljevic, Mihajlo
AU - Jang, Sung-In
AU - Jayaram, Shubha
AU - Jeemon, Panniyammakal
AU - Jha, Ravi Prakas
AU - Jonas, Jost B.
AU - Jürisson, Mikk
AU - Kabir, Ali
AU - Kabir, Zubair
AU - Kalankesh, Leila R.
AU - Kanchan, Tanuj
AU - Kandel, Himal
AU - Kapoor, Neeti
AU - Karch, André
AU - Karimi, Salah Eddin
AU - Kebede, Kindie Mitiku
AU - Kelkay, Bayew
AU - Kennedy, Ryan David
AU - Khader, Yousef Saleh
AU - Khan, Ejaz Ahmad
AU - Khayamzadeh, Maryam
AU - Kim, Gyu Ri
AU - Kimokoti, Ruth W.
AU - Kivimäki, Mika
AU - Kosen, Soewarta
AU - Laxminarayana, Sindhura Lakshmi Koulmane
AU - Koyanagi, Ai
AU - Krishan, Kewal
AU - Kugbey, Nuworza
AU - Kumar, G. Anil
AU - Kumar, Nithin
AU - Kurmi, Om P.
AU - Kusuma, Dian
AU - Lacey, Ben
AU - Landires, Iván
AU - Lasrado, Savita
AU - Lauriola, Paolo
AU - Lee, Doo Woong
AU - Lee, Yo Han
AU - Leung, Janni
AU - Li, Shanshan
AU - Lin, Hualiang
AU - Liu, Wei
AU - Lugo, Alessandra
AU - Kunjathur, Shilpashree Madhava
AU - Majeed, Azeem
AU - Maleki, Afshin
AU - Malekzadeh, Reza
AU - Malta, Deborah Carvalho
AU - Mamun, Abdullah A.
AU - Manjunatha, Narayana
AU - Mansouri, Borhan
AU - Mansournia, Mohammad Ali
AU - Martini, Santi
AU - Mathur, Manu Raj
AU - Mathur, Prashant
AU - Mazidi, Mohsen
AU - McKee, Martin
AU - Medina-Solís, Carlo Eduardo
AU - Mehata, Suresh
AU - Mendoza, Walter
AU - Menezes, Ritesh G.
AU - Miazgowski, Bartosz
AU - Michalek, Irmina Maria
AU - Miller, Ted R.
AU - Mini, G. K.
AU - Mirica, Andreea
AU - Mirrakhimov, Erkin M.
AU - Mirzaei, Hamed
AU - Misra, Sanjeev
AU - Mohammad, Yousef
AU - Mohammadian-Hafshejani, Abdollah
AU - Mohammed, Shafiu
AU - Mokdad, Ali H.
AU - Molokhia, Mariam
AU - Monasta, Lorenzo
AU - Moni, Mohammad Ali
AU - Moradzadeh, Rahmatollah
AU - Morrison, Shane Douglas
AU - Mossie, Tilahun Belete
AU - Mubarik, Sumaira
AU - Mullany, Erin C.
AU - Murray, Christopher J. L.
AU - Nagaraju, Shankar Prasad
AU - Naghavi, Mohsen
AU - Naik, Nitish
AU - Nalini, Mahdi
AU - Nangia, Vinay
AU - Naqvi, Atta Abbas
AU - Swamy, Sreenivas Narasimha
AU - Naveed, Muhammad
AU - Nazari, Javad
AU - Nduaguba, Sabina O.
AU - Negoi, Ruxandra Irina
AU - Neupane Kandel, Sandhya
AU - Nguyen, Huong Lan Thi
AU - Nigatu, Yeshambel T.
AU - Nixon, Molly R.
AU - Nnaji, Chukwudi A.
AU - Noubiap, Jean Jacques
AU - Nowak, Christoph
AU - Nuñez-Samudio, Virginia
AU - Ogbo, Felix Akpojene
AU - Oguntade, Ayodipupo Sikiru
AU - Oh, In-Hwan
AU - Olagunju, Andrew T.
AU - Owolabi, Mayowa O.
AU - P. A., Mahesh
AU - Pakshir, Keyvan
AU - Pana, Adrian
AU - Panagiotakos, Demosthenes
AU - Panda-Jonas, Songhomitra
AU - Pandey, Ashok
AU - Parekh, Utsav
AU - Park, Eun-Cheol
AU - Park, Eun-Kee
AU - Pashazadeh Kan, Fatemeh
AU - Pathak, Mona
AU - Pawar, Shrikant
AU - Pestell, Richard G.
AU - Pham, Hai Quang
AU - Pinheiro, Marina
AU - Pokhrel, Khem Narayan
AU - Pourshams, Akram
AU - Prashant, Akila
AU - Radfar, Amir
AU - Rahimi-Movaghar, Vafa
AU - Rahman, Mohammad Hifz Ur
AU - Rahman, Muhammad Aziz
AU - Rahmani, Amir Masoud
AU - Ram, Pradhum
AU - Rana, Juwel
AU - Ranabhat, Chhabi Lal
AU - Rathi, Priya
AU - Rawaf, David Laith
AU - Rawaf, Salman
AU - Rawassizadeh, Reza
AU - Renzaho, Andre M. N.
AU - Rezapour, Aziz
AU - Riaz, Mavra A.
AU - Roever, Leonardo
AU - Ronfani, Luca
AU - Roshandel, Gholamreza
AU - Roy, Ambuj
AU - Roy, Bedanta
AU - Saddik, Basema
AU - Sahebkar, Amirhossein
AU - Salehi, Sana
AU - Salimzadeh, Hamideh
AU - Samy, Abdallah M.
AU - Sanabria, Juan
AU - Santric-Milicevic, Milena M.
AU - Sao Jose, Bruno Piassi
AU - Sathian, Brijesh
AU - Sawhney, Monika
AU - Saya, Ganesh Kumar
AU - Schwendicke, Falk
AU - Seidu, Abdul-Aziz
AU - Senthil Kumar, Nachimuthu
AU - Sepanlou, Sadaf G.
AU - Shafaat, Omid
AU - Shah, Syed Mahboob
AU - Shaikh, Masood Ali
AU - Shannawaz, Mohammed
AU - Sharafi, Kiomars
AU - Sheikh, Aziz
AU - Sheikhbahaei, Sara
AU - Shigematsu, Mika
AU - Shiri, Rahman
AU - Shishani, Kawkab
AU - Shivakumar, K. M.
AU - Shivalli, Siddharudha
AU - Shrestha, Roman
AU - Siabani, Soraya
AU - Sidemo, Negussie Boti
AU - Sigfusdottir, Inga Dora
AU - Sigurvinsdottir, Rannveig
AU - Silva, João Pedro
AU - Singh, Ambrish
AU - Singh, Jasvinder A.
AU - Singh, Virendra
AU - Sinha, Dhirendra Narain
AU - Skryabin, Valentin Yurievich
AU - Skryabina, Anna Aleksandrovna
AU - Soroush, Ali
AU - Soyiri, Ireneous N.
AU - Sreeramareddy, Chandrashekhar T.
AU - Stein, Dan J.
AU - Steiropoulos, Paschalis
AU - Stortecky, Stefan
AU - Straif, Kurt
AU - Abdulkader, Rizwan Suliankatchi
AU - Sulo, Gerhard
AU - Sundström, Johan
AU - Tabuchi, Takahiro
AU - Tadesse, Eyayou Girma
AU - Tamiru, Animut Tagele
AU - Tareke, Minale
AU - Tareque, Md Ismail
AU - Tarigan, Ingan Ukur
AU - Thakur, Bhaskar
AU - Thankappan, Kavumpurathu Raman
AU - Thapar, Rekha
AU - Tolani, Musliu Adetola
AU - Tovani-Palone, Marcos Roberto
AU - Tran, Bach Xuan
AU - Tripathy, Jaya Prasad
AU - Tsegaye, Gebiyaw Wudie
AU - Tymeson, Hayley D.
AU - Ullah, Saif
AU - Unim, Brigid
AU - Updike, Rachel L.
AU - Uthman, Olalekan A.
AU - Vacante, Marco
AU - Vardavas, Constantine
AU - Venketasubramanian, Narayanaswamy
AU - Verma, Madhur
AU - Vidale, Simone
AU - Vo, Bay
AU - Vu, Giang Thu
AU - Waheed, Yasir
AU - Wang, Yanzhong
AU - Welding, Kevin
AU - Werdecker, Andrea
AU - Whisnant, Joanna L.
AU - Wickramasinghe, Nuwan Darshana
AU - Wubishet, Befikadu Legesse
N1 - Copyright © 2021 The Author(s). Published by Elsevier Ltd. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.
PY - 2021/7
Y1 - 2021/7
N2 - Background: Chewing tobacco and other types of smokeless tobacco use have had less attention from the global health community than smoked tobacco use. However, the practice is popular in many parts of the world and has been linked to several adverse health outcomes. Understanding trends in prevalence with age, over time, and by location and sex is important for policy setting and in relation to monitoring and assessing commitment to the WHO Framework Convention on Tobacco Control.Methods: We estimated prevalence of chewing tobacco use as part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 using a modelling strategy that used information on multiple types of smokeless tobacco products. We generated a time series of prevalence of chewing tobacco use among individuals aged 15 years and older from 1990 to 2019 in 204 countries and territories, including age-sex specific estimates. We also compared these trends to those of smoked tobacco over the same time period. Findings: In 2019, 273·9 million (95% uncertainty interval 258·5 to 290·9) people aged 15 years and older used chewing tobacco, and the global age-standardised prevalence of chewing tobacco use was 4·72% (4·46 to 5·01). 228·2 million (213·6 to 244·7; 83·29% [82·15 to 84·42]) chewing tobacco users lived in the south Asia region. Prevalence among young people aged 15–19 years was over 10% in seven locations in 2019. Although global age-standardised prevalence of smoking tobacco use decreased significantly between 1990 and 2019 (annualised rate of change: –1·21% [–1·26 to –1·16]), similar progress was not observed for chewing tobacco (0·46% [0·13 to 0·79]). Among the 12 highest prevalence countries (Bangladesh, Bhutan, Cambodia, India, Madagascar, Marshall Islands, Myanmar, Nepal, Pakistan, Palau, Sri Lanka, and Yemen), only Yemen had a significant decrease in the prevalence of chewing tobacco use, which was among males between 1990 and 2019 (−0·94% [–1·72 to –0·14]), compared with nine of 12 countries that had significant decreases in the prevalence of smoking tobacco. Among females, none of these 12 countries had significant decreases in prevalence of chewing tobacco use, whereas seven of 12 countries had a significant decrease in the prevalence of tobacco smoking use for the period.Interpretation: Chewing tobacco remains a substantial public health problem in several regions of the world, and predominantly in south Asia. We found little change in the prevalence of chewing tobacco use between 1990 and 2019, and that control efforts have had much larger effects on the prevalence of smoking tobacco use than on chewing tobacco use in some countries. Mitigating the health effects of chewing tobacco requires stronger regulations and policies that specifically target use of chewing tobacco, especially in countries with high prevalence.Funding: Bloomberg Philanthropies and the Bill & Melinda Gates Foundation.
AB - Background: Chewing tobacco and other types of smokeless tobacco use have had less attention from the global health community than smoked tobacco use. However, the practice is popular in many parts of the world and has been linked to several adverse health outcomes. Understanding trends in prevalence with age, over time, and by location and sex is important for policy setting and in relation to monitoring and assessing commitment to the WHO Framework Convention on Tobacco Control.Methods: We estimated prevalence of chewing tobacco use as part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 using a modelling strategy that used information on multiple types of smokeless tobacco products. We generated a time series of prevalence of chewing tobacco use among individuals aged 15 years and older from 1990 to 2019 in 204 countries and territories, including age-sex specific estimates. We also compared these trends to those of smoked tobacco over the same time period. Findings: In 2019, 273·9 million (95% uncertainty interval 258·5 to 290·9) people aged 15 years and older used chewing tobacco, and the global age-standardised prevalence of chewing tobacco use was 4·72% (4·46 to 5·01). 228·2 million (213·6 to 244·7; 83·29% [82·15 to 84·42]) chewing tobacco users lived in the south Asia region. Prevalence among young people aged 15–19 years was over 10% in seven locations in 2019. Although global age-standardised prevalence of smoking tobacco use decreased significantly between 1990 and 2019 (annualised rate of change: –1·21% [–1·26 to –1·16]), similar progress was not observed for chewing tobacco (0·46% [0·13 to 0·79]). Among the 12 highest prevalence countries (Bangladesh, Bhutan, Cambodia, India, Madagascar, Marshall Islands, Myanmar, Nepal, Pakistan, Palau, Sri Lanka, and Yemen), only Yemen had a significant decrease in the prevalence of chewing tobacco use, which was among males between 1990 and 2019 (−0·94% [–1·72 to –0·14]), compared with nine of 12 countries that had significant decreases in the prevalence of smoking tobacco. Among females, none of these 12 countries had significant decreases in prevalence of chewing tobacco use, whereas seven of 12 countries had a significant decrease in the prevalence of tobacco smoking use for the period.Interpretation: Chewing tobacco remains a substantial public health problem in several regions of the world, and predominantly in south Asia. We found little change in the prevalence of chewing tobacco use between 1990 and 2019, and that control efforts have had much larger effects on the prevalence of smoking tobacco use than on chewing tobacco use in some countries. Mitigating the health effects of chewing tobacco requires stronger regulations and policies that specifically target use of chewing tobacco, especially in countries with high prevalence.Funding: Bloomberg Philanthropies and the Bill & Melinda Gates Foundation.
UR - http://www.scopus.com/inward/record.url?scp=85111785026&partnerID=8YFLogxK
U2 - 10.1016/S2468-2667(21)00065-7
DO - 10.1016/S2468-2667(21)00065-7
M3 - Article
C2 - 34051920
AN - SCOPUS:85111785026
SN - 2468-2667
VL - 6
SP - e482-e499
JO - The Lancet Public Health
JF - The Lancet Public Health
IS - 7
ER -