Trends in Smoking. 98/2

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The use of tobacco has been established amongst men since the middle of the last century, when most tobacco was sold for pipes, chewing, cigars, and snuff. Manufactured cigarettes started to become popular in the late 1890s, and their use increased steadily through the first half of this century. Amongst men, cigarette smoking became well established during the First World War, but did not become popular amongst women until the Second World War.

Annual Consumption

Figure 1:Annual consumption of manufactured cigarettes per person

This shows the estimated annual consumption of manufactured cigarettes per person since 1905. The time lag between men and women is clearly visible, as are the peaks associated with the First and Second World Wars. In men, consumption rose steadily until the mid-1940s, before decreasing and remaining steady for thirty years. Since the mid-1970s, cigarette smoking in men has seen a sharp decline. In women, the peak consumption occurred in the mid-1970s. Until the 1960s, the number of cigarettes smoked was a good estimator of the weight of tobacco smoked, but greater use of filter cigarettes has led to a decrease in total weight of tobacco smoked despite the number of cigarettes smoked remaining relatively stable.

Prevalence of smoking

Figure 2:Prevalence of smoking in Great Britain

Surveys carried out by the Tobacco Advisory Council (TAC) estimate that in 1948 65% of men smoked manufactured cigarettes, and this had fallen to 34% by 1987. The General Household Survey (GHS) reported that by 1996, 29% of men smoked cigarettes. In women, equivalent figures were 41% in 1948, 34% in 1987 and 28% by 1996. This decrease has been seen in all age groups except men aged 20-24, where there has been a small but steady increase since 1988.

Smoking in children

Figure 3:Prevalence of smoking in children

National surveys of smoking habits in secondary school children have been carried out since the early 1980s. In 1984, 13% of children in England, 11% in Wales and 16% in Scotland were regular smokers. A further 7-9% were occasional smokers. The most recent data suggests similar levels in England and Wales and a slightly lower prevalence in Scotland. The proportion of children who have never tried smoking has increased in England and Scotland, and decreased slightly in Wales.

Health of the Nation targets

Figure 4:Prevalence of cigarette smoking in relation to Health of the Nation targets

In July 1992, the Government published a White Paper detailing its Health of the Nation targets for England. Following the 1998 Green Paper, "Our Healthier Nation", it is likely that the smoking targets will be updated. Figure 4 shows the 1992 targets in relation to recent trends. Although smoking prevalence has fallen among adults, a sharper rate of decline would have been needed to achieve the target of 20% prevalence by 2000. Recent studies have also shown an increase in prevalence in young men. In children, the 1994 target prevalence of 6% was not met, although it is now accepted that the1988 baseline figure of 8% that was chosen was unusually low. Similar targets were also set up for Wales and Scotland. In Wales, a steeper rate of decline may be needed to meet the target of 20% prevalence in adults by 2002. In Scotland, the target reduction of 20% in the number of smokers aged 25-64 was achieved by 1994, but again, the prevalence amongst children and young adults does not seem to be falling.

International variations

Figure 5:Estimated smoking prevalence by WHO region

Worldwide, it is estimated that there are about 1100 million smokers, about 1/3 of the global population aged over 15. There are 800 million smokers in developing countries, 700 million of which are men. It is thought that about 47% of men and 12% of women are smokers. Amongst men, the prevalence is similar in developed and developing countries - 42% and 48% respectively, whereas in women the figures are 24% and 7% respectively. This shows the variation in smoking prevalence by WHO region. Prevalence amongst males varies from 30% in the African Region to 60% in the Western Pacific Region. This latter is mostly accounted for by a prevalence of 61% in China. In women, smoking is most common in the European and Americas Regions. Prevalence is very low in women in the other Regions.

Summary

• Cigarette smoking has been well-established in men since the First World War. In women, cigarette smoking became popular during the Second World War.

• The prevalence of smoking in men has fallen since the late 1940s, although in young men, prevalence is rising; in women, the prevalence of smoking started falling in the 1970s.

• In children, the prevalence of regular and occasional smoking in 1994 was similar to 1984 levels.

• Smoking is equally common amongst men in developed and developing countries; in women, smoking is more common in developed countries.

Footnote

Data sources
Information on smoking habits in adults in Great Britain is available from two sources. Annual surveys commissioned by the Tobacco Advisory Council (TAC) give prevalence estimates from the late 1940s to 1987. The General Household Survey (GHS) carried out by the Office for National Statistics provides information on smoking habits every two years from 1972 onwards. Information on smoking habits in children is available from surveys carried out by the Office for National Statistics since 1982.