title: Epidemiology and public health policy of tobacco use and cardiovascular disorders in low- and middle-income countries.
abstract: All forms of tobacco lead to an increased risk of cardiovascular disorders. During the past few decades, the number of people who consume tobacco has increased worldwide because of an overall increase in the global population. It is estimated that close to 80% of the >1.3 billion people who smoke tobacco in the world are in low- and middle-income countries. Smokeless forms of tobacco are also widely consumed in low- and middle-income countries, including chewable and snuffed forms. Lack of targeted and effective strategies to control tobacco consumption contributes to a large burden of cardiovascular disorders in low- and middle-income countries, where cardiovascular disorders have become the leading cause of morbidity and mortality. In this review, we evaluate the epidemiology of tobacco use in low- and middle-income countries and assess the public health policies needed to control tobacco use in such regions for the prevention of cardiovascular disorders and other tobacco-related morbidities and mortality.
authors.affiliation: From the Department of Biostatistics and Epidemiology (D.S.) and Division of Translational Medicine and Human Genetics, Perelman School of Medicine (D.S., W.Z.), University of Pennsylvania, Philadelphia; and Center for Non-Communicable Diseases, Karachi, Pakistan (D.S., A.R.). saleheen@mail.med.upenn.edu.
authors.forename: Danish
authors.initials: D
authors.lastname: Saleheen
authors.affiliation: From the Department of Biostatistics and Epidemiology (D.S.) and Division of Translational Medicine and Human Genetics, Perelman School of Medicine (D.S., W.Z.), University of Pennsylvania, Philadelphia; and Center for Non-Communicable Diseases, Karachi, Pakistan (D.S., A.R.).
authors.forename: Wei
authors.initials: W
authors.lastname: Zhao
authors.affiliation: From the Department of Biostatistics and Epidemiology (D.S.) and Division of Translational Medicine and Human Genetics, Perelman School of Medicine (D.S., W.Z.), University of Pennsylvania, Philadelphia; and Center for Non-Communicable Diseases, Karachi, Pakistan (D.S., A.R.).
authors.forename: Asif
authors.initials: A
authors.lastname: Rasheed
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D002648:Child; D019049:Developed Countries / Q000191:economics; D003906:Developing Countries / Q000191:economics; D005260:Female; D017408:Guidelines as Topic; D006291:Health Policy; D006293:Health Promotion / Q000331:legislation & jurisprudence / Q000458:organization & administration; D006801:Humans; D007182:Income; D008297:Male; D009538:Nicotine / Q000032:analysis; D015995:Prevalence; D011634:Public Health; D017678:Sex Distribution; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology / Q000331:legislation & jurisprudence; D000074606:Smoking Prevention; D013660:Taxes; D019460:Tobacco Industry / Q000191:economics / Q000331:legislation & jurisprudence; D014028:Tobacco Smoke Pollution / Q000009:adverse effects / Q000331:legislation & jurisprudence / Q000517:prevention & control / Q000706:statistics & numerical data; D064424:Tobacco Use / Q000009:adverse effects* / Q000453:epidemiology / Q000331:legislation & jurisprudence; D014030:Tobacco, Smokeless / Q000009:adverse effects / Q000706:statistics & numerical data; D014944:World Health Organization
chemical_list: D014028:Tobacco Smoke Pollution; D009538:Nicotine
keywords: coronary disease; low- and middle-income countries; smoking; stroke; tobacco