2000-2025年第三版全球烟草使用流行趋势全球报告.pdf

WHO global report on trends in prevalence of tobacco use 2000 -2025 third edition WHO global report on trends in prevalence of tobacco use 2000 -2025, third edition ISBN 978-92-4-000003 -2 World Health Organization 2019 Some rights reserved. This work is available under the Creative Commons Attribution - NonCommercial -ShareAlike 3.0 IGO licence (CC BY -NC-SA 3.0 IGO; creativecommons/licenses/by -nc -sa/3.0/igo ). Under the terms of this licence, you may copy, redistribute and adapt the work for non - commercial purposes, provided the work is appropriately cited, as indicated below. In an y use of this work, there should be no suggestion that WHO endorses any specific organization, products or services. The use of the WHO logo is not permitted. If you adapt the work, then you must license your work under the same or equivalent Creative Comm ons licence. 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C ontents List of Contributors Foreword 1. Introduction 2. Method s 3. Results 3.1 Trends in prevalence of tobacco use : 3.1.1 at global level 3.1.2 by age 3.1.3 by WHO region 3.1.4 by World Bank income group 3.1.5 numbers of tobacco user s 3.2 Progress towards meeting tobacco use reduction targets 3.3 Trends in prevalence of tobacco smoking 3.3.1 at global level 3.3.2 numbers of smokers 3.4 Levels of tobacco use, smoking and cigarette use among adults in 2018 3.5 Smokeless tobacco use among people aged 15 years and older 3.6 Smokeless tobacco use among adolescents aged 13 15 years 3.7 Tobacco use among adolescents aged 13 15 years 3.8 Cigarette s moking among adolescents aged 13 15 years 3.9 Electronic nicotine devices including e -cigarettes 4. Discussion 5. Conclusion References ANNEX 1. Tables of estimates by country , 2018 and 2000 - 2025 ANNEX 2. Country p rofiles ANNEX 3: Statistical annex iv C ontributors Lead authors (analysis and writ ing ): Alison Commar (WHO Geneva), Vinayak Prasad (WHO Geneva), Edouard Tursan dEspaignet (University of Newcastle , Australia). Analysis assistance provided by Luzian Ong. Reviewe rs : WHO Geneva : Douglas Bettcher, Rdiger Krech, Hebe Gouda, Kerstin Schotte, Benn McGrady , Ranti Fayokun , Marine Perraudin, Simone St Claire. WHO r egional offices: Fatimah el -Awa (Eastern Mediterranean); Angela Ciobanu, Liza Lebedeva , Kristina Mauer -Stender (Europe); Jagdish Kaur (South -East Asia ); and Mina Kashiwabara , Melanie Aldeon, Kate Lannan (Western Pacific) . Secretariat to the WHO F ramework Convention on Tobacco Control: Tibor Szilagyi Support to countries in data collection or reporting for tobacco -specific surveys or multi -risk factor surveys that include tobacco: WHO Geneva : Lubna Bhatti , Melanie Cowan, Stefan Savin, Patricia Rarau, Leanne Riley WHO r egional offices: Nivo Ramanandraibe (Africa); Adriana Bacelar and Rosa Sandoval (Americas); Heba Fouad (Eastern Mediterranean); Angela Ciobanu and Liza Lebedeva (Europe); Jagdish Kaur (South -East Asia); Mina Kashiwabara and Melanie Aldeon (Western Pacific) Secretariat to the WHO F ramework Convention on Tobacco Control: Tibor Szilagyi Copy -editing: Rebekka Yates Photo credits : Cover, Ridha Maasir Page 10, Cengiz Yar/UNMAS Afghanistan Page 26, World Bank/Sarah Farhat, reproduced without modifications, see Creative Commons licence at creativecommons/licenses/by -nc-nd/2.0/legalcode Funding source: The production of comparable estimates of tobacco use for adults was made possible by funding from Bloomberg Philanthropies. Production of this report was jointly funded by WHO and the University of Newcastle, Australia. v Foreword Dr Naoko Yamamoto Assistant Director -General, Universal Health Coverage/Healthier Populations World Health Organization I have great pleasure in releasing th e WHO global report on trends in prevalence of tobacco use 2000 -2025, third edition . This report offers a reflection on the phenomenal progress made by countries who are working to reduce the demand for tobacco, a celebration of the successes achieve d to date, and a preview of what can be achieved in the coming years. In this report we are able to see for the first tim e that the number of people using tobacco in the world is declining, despite population growth. The number of male tobacco users, which previously was increas ing every year , finally turned the corner in 2018 and is projected to decline each year from 2019 forward . For this projection to become reality, tobacco control efforts need to be reinforced, and in some countries accelerated , to prevent additional people falling victim to tobacco -related illnesses and death. Although admirable progress is being made, the tobacco epidemic is far from over. Progress towards reducing tobacco use everywhere in the world is uneven and some groups are getting left behind. We are falling short of achieving a global 30% relative red uction in current tobacco use by 2025 , a target of the WHO Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013 2020. This report contributes to the global monitoring of Sustainable Development Goal 3.a, which calls for stren gthening implementation of the WHO F ramework Convention on Tobacco Control (WHO FCTC) in all countries, as appropriate . I acknowledge the dedicated work of the Secretariat to the WHO -FCTC both as co-custodian of the Sustainable Development Goal indicator 3 .a.1, and in helping Parties to the WHO - FCTC achieve their goals of protecting their populations from the harms of tobacco. I congratulate all countries who are taking multisectoral actions to put in place effective policy measures and to continually monitor and enforc e these measures . Together, we will reverse the global tobacco epidemic and save millions of lives. vi Foreword Professor Kevin Hall S enior Deputy Vice Chancellor ( Research and Innovation ) University of Newcastle, Australia On behalf of the University of Newcastle, Australia, I congratulate the World Health Organization (WHO) on the publ ication of the third edition of the WHO global report on trends in prev alence of tobacco use 2000 -2025 . I also wish to thank my colleagues fr om the University of Newcastle Priority Research Centre for Health Behaviour (PRCHB) for their contribution and their continuing close collaboration with WHO scientists in helping to produce the report. The University of Newcastle has a proud record of eng aging with United Nations bodies to help improve the health and well-being of people everywhere. The y ear 2019 marks 35 years since the University of Newcastle became one of the WHO sites for the Multinational M onitoring of Trends and Determinants in Cardiovascular Disease (MONICA ) project. We are also particularly proud that the PRCHB has, this year, been designated as a WHO Collaborating Centre for Evidence -Based Non- Communicable Disease Program Implementation. This year also saw the r enegotiation of the cooperation agreement between the University of Newcastle and the United Nations Institute for Training and Research (UNITAR) CIFAL training centre. CIFAL Newcastle is the first CIFAL centre to be established within a university from it s inception, and the first to be established in Australia and the Asia -Pacific region. A s a WHO Collaborating Centre, our objective in being closely involved with the production of this report is to serv e countries needs . This latest edition contains encouraging numbers indicating that prevalence of tobacco use ha s peaked and is now declining globally. There is evidence that the hard work of WHO, countries and a variety of non-government al organizations in implementing the WHO F CTC is starting to achieve the desired results . The University of Newcastle remains committed to providing its technical know -how and energy to help the WHO, UNITAR and all countries improve the lives of people everywhere. vii Abbreviations BAU Business As Usual ENDS Electronic Nicotine Delivery Systerms GSHS Global School -based Student Health Survey GYTS Global Youth Tobacco Survey NYTS National Youth Tobacco Survey HBSC Health Behaviour in School -aged Children NCD Noncommunicable Disease SDG Sustainable Development Goal WHO FCTC WHO Framework Convention on Tobacco Control 1 1. I ntroduction Tobacco in any form kills and sickens millions of people every year . 1Around 8 million people died from a tobacco -related disease in 2017. 2The number of annual deaths can be expected to keep growing even after rates of tobacco use start to decline , because tobacco -related diseases take time to become apparent . 3A global commitment to revers ing the tobacco epidemic was made in 2003 when Member States of the World Health Organization adopted the WHO Framework Convention on Tobacco Control (WHO -FCTC ) 4 , which lays out specific, evidence -based actions that all Parties to the Convention should take to effectively reduce demand for tobacco. The United Nations Sustainable Development Goals include among their targets Target 3.a Strengthen the implementation of the WHO FCTC in all countries, as appropriate . The indicator that acc ompan ies this target is 3.a.1 Age -standardized prevalence of current tobacco use among persons aged 15 years and older . WHO monitors global progress of this indicator and reports results to the United Nations via this report. The WHO Global Action Plan for the Prevention and Control of Noncommunicable D iseases 2013 2020 includes a target for reducing the global prevalence of tobacco use (smoked and smokeless tobacco) by 30% by the year 2025 relative to 2010. 5Although the target for reducing tobacco use was set as a global target, each country is at liberty to set its own target . This report indicates whether tobacco use in each country is likely to achieve a 30% reduction by 2025 , or, if not, whether the trend is upwards, flat or downwards. Recent improvement s in the quantity and quality of national data allows calculation of internationally comparable estimate s of prevalence levels and trends in most countries . Combined, these estimates help us understand regional and global average prevalence rates , and whether or not we are collectively tracking towards meet ing tobacco use reduction targets . Each year, more countries are calculating their own trends and projections of tobacco use. Country - produced estimates are no less valid than WHO estimates. The value of WHO estimates is mainly to extract a global picture from comparable estimates by using one method for all countries. WHO estimates undergo a country consultation prior to publica tion, and country feedback is taken into account when producing final results. WHO published the first edition of this report in 2015 , and the second edition in 2018 . This is the third edition in the series. Previous editions focused on tobacco smoking rat es rather than all tobacco use rates , because the volume of data about smoking was high enough to allow global analyses. In contrast, data on smokeless tobacco use and dual use of smoked and smokeless products was insufficient to allow global analyses of t otal tobacco use. Prevalence of any tobacco use is defined as the proportion of the population of interest who exclusively use smoked tobacco products , or exclusively use smokeless tobacco products, or who use both smoking and smokeless tobacco products. Therefore, i n order to report the “any tobacco use” indicator from a survey, questions must be asked about both tobacco smoking and smokeless tobacco use. Rates of smokeless tobacco use cannot be derived by subtract ing smoking rates from any tobacco use rates. Similarly, any tobacco use cannot be derived by adding rates of tobacco 2 smoking to rates of smokeless tobacco use , because respondents who use both forms would be double -counted. Due to collaborations in recent years between countries , WHO and partners to introduce Global Tobacco Surveillance System 6surveys and Tobacco Questions for Surveys 7into more and more national surveys , the