The potential impact of smoking control policies on future global smoking trends.

BACKGROUND: The authors develop projections for global smoking prevalence for the years 2020 and 2030 with and without the implementation, starting in 2010, of the WHO's recommended multipronged approach to tobacco control known as the MPOWER policy package. METHODS: Using data from the WHO's Global InfoBase Database and the WHO's Global Adult Tobacco Survey, the authors construct adult cigarette smoking prevalence time series for 60 countries that account for 90% of the world's smokers and 85% of the world's population. The authors then use a stock/flow model to project those countries' smoking prevalence for the years 2020 and 2030, with and without the implementation of MPOWER. The authors aggregate the results and report regional and global figures. RESULTS: The authors estimate global adult cigarette smoking prevalence in 2010 to be 23.7%. If no additional policies are set in place and the initiation and cessation rates existing in 2010 persist, the authors estimate that global prevalence will be 22.7% by 2020 and 22.0% by 2030 (872 million smokers). If MPOWER had been implemented globally starting in 2010 with a 100% price increase for cigarettes, the authors estimate that global cigarette smoking prevalence would be 15.4% in 2020 and 13.2% in 2030 (523 million smokers). CONCLUSIONS: The estimates indicate the magnitude and trajectory of the global tobacco pandemic and of the impact the authors could expect if evidence-based tobacco control policies were applied immediately and universally throughout the world. As half of lifetime smokers die of tobacco-related diseases, if MPOWER were applied globally, within a few decades, many millions of premature tobacco-related deaths would be avoided.

The impact of declining smoking on radon-related lung cancer in the United States.

OBJECTIVES: We examined the effect of current patterns of smoking rates on future radon-related lung cancer. METHODS: We combined the model developed by the National Academy of Science's Committee on Health Risks of Exposure to Radon (the BEIR VI committee) for radon risk assessment with a forecasting model of US adult smoking prevalence to estimate proportional decline in radon-related deaths during the present century with and without mitigation of high-radon houses. RESULTS: By 2025, the reduction in radon mortality from smoking reduction (15 percentage points) will surpass the maximum expected reduction from remediation (12 percentage points). CONCLUSIONS: Although still a genuine source of public health concern, radon-induced lung cancer is likely to decline substantially, driven by reductions in smoking rates. Smoking decline will reduce radon deaths more that remediation of high-radon houses, a fact that policymakers should consider as they contemplate the future of cancer control.

Tobacco control success versus demographic destiny: examining the causes of the low smoking prevalence in California.

We examined the effect of demographics on California's low smoking prevalence. We estimated that if the United States had the same demographics as California, then the US adult smoking prevalence in 2005 would have been 19.3%, 1.6 percentage points lower than the reported 20.9% for the United States, but 4.1 percentage points higher than California's prevalence of 15.2% in 2005. Tobacco control appears to be a much more important factor than demographics in determining California's low smoking rates.