title: Global trends and projections for tobacco use, 1990-2025: an analysis of smoking indicators from the WHO Comprehensive Information Systems for Tobacco Control.
abstract: BACKGROUND
  Countries have agreed on reduction targets for tobacco smoking stipulated in the WHO global monitoring framework, for achievement by 2025. In an analysis of data for tobacco smoking prevalence from nationally representative survey data, we aimed to provide comprehensive estimates of recent trends in tobacco smoking, projections for future tobacco smoking, and country-level estimates of probabilities of achieving tobacco smoking targets.
  
  
  METHODS
  We used a Bayesian hierarchical meta-regression modelling approach using data from the WHO Comprehensive Information Systems for Tobacco Control to assess trends from 1990 to 2010 and made projections up to 2025 for current tobacco smoking, daily tobacco smoking, current cigarette smoking, and daily cigarette smoking for 173 countries for men and 178 countries for women. Modelling was implemented in Python with DisMod-MR and PyMC. We estimated trends in country-specific prevalence of tobacco use, projections for future tobacco use, and probabilities for decreased tobacco use, increased tobacco use, and achievement of targets for tobacco control from posterior distributions.
  
  
  RESULTS
  During the most recent decade (2000-10), the prevalence of tobacco smoking in men fell in 125 (72%) countries, and in women fell in 156 (88%) countries. If these trends continue, only 37 (21%) countries are on track to achieve their targets for men and 88 (49%) are on track for women, and there would be an estimated 1·1 billion current tobacco smokers (95% credible interval 700 million to 1·6 billion) in 2025. Rapid increases are predicted in Africa for men and in the eastern Mediterranean for both men and women, suggesting the need for enhanced measures for tobacco control in these regions.
  
  
  CONCLUSIONS
  Our findings show that striking between-country disparities in tobacco use would persist in 2025, with many countries not on track to achieve tobacco control targets and several low-income and middle-income countries at risk of worsening tobacco epidemics if these trends remain unchanged. Immediate, effective, and sustained action is necessary to attain and maintain desirable trajectories for tobacco control and achieve global convergence towards elimination of tobacco use.
  
  
  BACKGROUND
  Ministry of Health, Labour and Welfare, Japan; Ministry of Education, Culture, Sports and Technology, Japan; Department of Health, Australia; Bloomberg Philanthropies.
authors.affiliation: Department of Global Health Policy, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
authors.forename: Ver
authors.initials: V
authors.lastname: Bilano
authors.affiliation: Department of Global Health Policy, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
authors.forename: Stuart
authors.initials: S
authors.lastname: Gilmour
authors.affiliation: School of Mathematical and Physical Sciences, University of Newcastle, Newcastle, NSW, Australia.
authors.forename: Trevor
authors.initials: T
authors.lastname: Moffiet
authors.affiliation: Comprehensive Information Systems for Tobacco Control, Tobacco Free Initiative, World Health Organization, Geneva, Switzerland.
authors.forename: Edouard Tursan
authors.initials: ET
authors.lastname: d'Espaignet
authors.affiliation: Department of Health Statistics and Information Systems, World Health Organization, Geneva, Switzerland.
authors.forename: Gretchen A
authors.initials: GA
authors.lastname: Stevens
authors.affiliation: Comprehensive Information Systems for Tobacco Control, Tobacco Free Initiative, World Health Organization, Geneva, Switzerland.
authors.forename: Alison
authors.initials: A
authors.lastname: Commar
authors.affiliation: School of Mathematical and Physical Sciences, University of Newcastle, Newcastle, NSW, Australia.
authors.forename: Frank
authors.initials: F
authors.lastname: Tuyl
authors.affiliation: School of Mathematical and Physical Sciences, University of Newcastle, Newcastle, NSW, Australia.
authors.forename: Irene
authors.initials: I
authors.lastname: Hudson
authors.affiliation: Department of Global Health Policy, Graduate School of Medicine, University of Tokyo, Tokyo, Japan. Electronic address: shibuyak@m.u-tokyo.ac.jp.
authors.forename: Kenji
authors.initials: K
authors.lastname: Shibuya
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004812:Epidemiologic Methods; D005260:Female; D005544:Forecasting; D014943:Global Health; D006801:Humans; D008297:Male; D008875:Middle Aged; D017678:Sex Distribution; D012907:Smoking / Q000453:epidemiology / Q000639:trends*; D055815:Young Adult