The World Health Organization and the U.S. National Cancer Institute recently published a 700-page report on the economic consequences of smoking, tobacco use, or both (here). The dozens of tobacco experts who contributed failed to distinguish between tobacco and smoke. This is especially disappointing, since one of the two editors, University of Illinois at Chicago professor Frank Chaloupka, previously acknowledged the difference (here).
The report’s summary conclusions, which are mainly about smoking and not tobacco, follow, with smoke highlighted in red and tobacco highlighted in green.
1. There are about 1.1 billion smokers in the world, and about 4 in 5 smokers live in low- and middle-income countries. Nearly two-thirds of the world’s smokers live in 13 countries.
2. Substantial progress has been made in reducing tobacco smoking in most regions, especially in high-income countries. Overall smoking prevalence is decreasing at the global level, but the total number of smokers worldwide is still not declining, largely due to population growth. Unless stronger action is taken, it is unlikely the world will reach the WHO Member States’ 30% global reduction target by 2025.
3. Globally, more than 80% of the world’s smokers are men. Differences in prevalence between male and female smokers are particularly high in the South-East Asia and Western Pacific Regions and in low- and middle-income countries.
4. Globalization and population migration are contributing to a changing tobacco landscape, and non-traditional products are beginning to emerge within regions and populations where their use had not previously been a concern.
5. An estimated 25 million youth currently smoke cigarettes. Although cigarette smoking rates are higher among boys than girls, the difference in smoking rates between boys and girls is narrower than that between men and women. Smoking rates among girls approach or even surpass rates among women in all world regions.
6. Worldwide, an estimated 13 million youth and 346 million adults use smokeless tobacco products. The large majority of smokeless tobacco users live in the WHO South-East Asia Region. Smokeless tobacco use may be undercounted globally due to scarcity of data.
7. Secondhand smoke exposure remains a major problem. In most countries, an estimated 15%–50% of the population is exposed to secondhand smoke; in some countries secondhand smoke exposure affects as much as 70% of the population.
8. Annually, around 6 million people die from diseases caused by tobacco use, including about 600,000 from secondhand smoke exposure. The burden of disease from tobacco is increasingly concentrated in low- and middle-income countries.
In the last item, the substitution of tobacco for smoke is obvious. In fact, most of the report is distorted by this bogus substitution.
The sham synonym tactic reflects the anti-tobacco posture of the report’s sponsors, NCI and WHO. Officials at those organizations supplied two prefaces, totaling 2,700 words. “Tobacco” appears 128 times, while “smoke” is used only 14 times.
Decades of scientific studies document that tobacco is not synonymous with smoke (here and here). The deliberate conflation of terms by anti-tobacco forces would not be tolerated in any other serious scientific or medical debate.