New report highlights epidemic of tobacco and global health inequalities

  • Posted: March 21, 2012
NCI Press Office


A new set of 11 global health studies calls attention to the burden of tobacco-related inequalities in low- and middle-income countries and finds that socioeconomic inequalities are associated with increased tobacco use, second-hand smoke exposure and tobacco-related cancer and diseases among disadvantaged populations in Asia, Latin America and Africa. Funded by the National Cancer Institute (NCI), Research to Reduce Global Tobacco Inequalities suggests the need for more policy and intervention efforts to stem this rising epidemic that causes six million annual deaths worldwide.  The supplement was published March 2012 in Cancer Causes and Control (to view the supplement, go to

To cite several examples from the supplement:

  • Data from Southeast Asia show a five-fold mortality increase from oral cancers among tobacco chewers compared to never chewers. These cancers also showed a strong inverse correlation with educational level.
  • Several studies also highlight the role of industry practices, mass media and social influences on tobacco use. One study shows that transnational tobacco companies are exploiting new vulnerable markets in low- and middle-income countries by using the same economic, political, and marketing practices that were successfully used in high-income countries to promote smoking.  These industry marketing practices highlight the need for global countermarketing mass media campaigns.
  • In a study conducted in Mexico, participants reported higher levels of overall effectiveness for graphic pictorial health warnings that featured diseased organs or tobacco victims compared to those with symbolic representations or testimonials.  Furthermore, participants with lower levels of education reported even greater levels of effectiveness for graphic warning labels compared to their more educated counterparts.  Another study conducted in India showed that a national awareness campaign on the harmful effects of smokeless tobacco can increase knowledge about the dangers of smokeless tobacco use, anti-tobacco attitudes and cessation intentions and behaviors among smokeless tobacco users—including among groups that suffer the greater burden, such as women and rural tobacco users who predominantly fall in the lower socioeconomic categories.