title: Smoking prevalence and cigarette consumption in 187 countries, 1980-2012.
abstract: OBJECTIVE
  Tobacco is a leading global disease risk factor. Understanding national trends in prevalence and consumption is critical for prioritizing action and evaluating tobacco control progress.
  
  
  OBJECTIVE
  To estimate the prevalence of daily smoking by age and sex and the number of cigarettes per smoker per day for 187 countries from 1980 to 2012.
  
  
  METHODS
  Nationally representative sources that measured tobacco use (n = 2102 country-years of data) were systematically identified. Survey data that did not report daily tobacco smoking were adjusted using the average relationship between different definitions. Age-sex-country-year observations (n = 38,315) were synthesized using spatial-temporal gaussian process regression to model prevalence estimates by age, sex, country, and year. Data on consumption of cigarettes were used to generate estimates of cigarettes per smoker per day.
  
  
  METHODS
  Modeled age-standardized prevalence of daily tobacco smoking by age, sex, country, and year; cigarettes per smoker per day by country and year.
  
  
  RESULTS
  Global modeled age-standardized prevalence of daily tobacco smoking in the population older than 15 years decreased from 41.2% (95% uncertainty interval [UI], 40.0%-42.6%) in 1980 to 31.1% (95% UI, 30.2%-32.0%; P < .001) in 2012 for men and from 10.6% (95% UI, 10.2%-11.1%) to 6.2% (95% UI, 6.0%-6.4%; P < .001) for women. Global modeled prevalence declined at a faster rate from 1996 to 2006 (mean annualized rate of decline, 1.7%; 95% UI, 1.5%-1.9%) compared with the subsequent period (mean annualized rate of decline, 0.9%; 95% UI, 0.5%-1.3%; P = .003). Despite the decline in modeled prevalence, the number of daily smokers increased from 721 million (95% UI, 700 million-742 million) in 1980 to 967 million (95% UI, 944 million-989 million; P < .001) in 2012. Modeled prevalence rates exhibited substantial variation across age, sex, and countries, with rates below 5% for women in some African countries to more than 55% for men in Timor-Leste and Indonesia. The number of cigarettes per smoker per day also varied widely across countries and was not correlated with modeled prevalence.
  
  
  CONCLUSIONS
  Since 1980, large reductions in the estimated prevalence of daily smoking were observed at the global level for both men and women, but because of population growth, the number of smokers increased significantly. As tobacco remains a threat to the health of the world's population, intensified efforts to control its use are needed.
authors.affiliation: Institute for Health Metrics and Evaluation, University of Washington, Seattle.
authors.forename: Marie
authors.initials: M
authors.lastname: Ng
authors.affiliation: Institute for Health Metrics and Evaluation, University of Washington, Seattle.
authors.forename: Michael K
authors.initials: MK
authors.lastname: Freeman
authors.affiliation: Institute for Health Metrics and Evaluation, University of Washington, Seattle.
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Fleming
authors.affiliation: Institute for Health Metrics and Evaluation, University of Washington, Seattle.
authors.forename: Margaret
authors.initials: M
authors.lastname: Robinson
authors.affiliation: Institute for Health Metrics and Evaluation, University of Washington, Seattle.
authors.forename: Laura
authors.initials: L
authors.lastname: Dwyer-Lindgren
authors.affiliation: Institute for Health Metrics and Evaluation, University of Washington, Seattle.
authors.forename: Blake
authors.initials: B
authors.lastname: Thomson
authors.affiliation: Institute for Health Metrics and Evaluation, University of Washington, Seattle.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Wollum
authors.affiliation: Institute for Health Metrics and Evaluation, University of Washington, Seattle.
authors.forename: Ella
authors.initials: E
authors.lastname: Sanman
authors.affiliation: Institute for Health Metrics and Evaluation, University of Washington, Seattle.
authors.forename: Sarah
authors.initials: S
authors.lastname: Wulf
authors.affiliation: School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Alan D
authors.initials: AD
authors.lastname: Lopez
authors.affiliation: Institute for Health Metrics and Evaluation, University of Washington, Seattle.
authors.forename: Christopher J L
authors.initials: CJ
authors.lastname: Murray
authors.affiliation: Institute for Health Metrics and Evaluation, University of Washington, Seattle.
authors.forename: Emmanuela
authors.initials: E
authors.lastname: Gakidou
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D014943:Global Health / Q000706:statistics & numerical data*; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012044:Regression Analysis; D012907:Smoking / Q000453:epidemiology*; D062789:Tobacco Products / Q000706:statistics & numerical data*; D055815:Young Adult