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.