Rationale

Tobacco use is a major contributor to illness and death from non-communicable diseases (NCDs). There is no proven safe level of tobacco use or of second-hand smoke exposure. All daily and non-daily users of tobacco are at risk of a variety of poor health outcomes across the life-course, including NCDs. Reducing the prevalence of current tobacco use will make a large contribution to reducing premature mortality from NCDs. Routine and regular monitoring of this indicator is necessary to enable accurate monitoring and evaluation of the impact of implementation of the WHO Framework Convention on Tobacco Control (WHO FCTC), or tobacco control policies in the countries that are not yet Parties to the WHO FCTC, over time.

Definition

The percentage of the population aged 15 years and over who currently use any tobacco product (smoked and/or smokeless tobacco) on a daily or non-daily basis. Tobacco products include cigarettes, pipes, cigars, cigarillos, waterpipes (hookah, shisha), bidis, kretek, heated tobacco products, and all forms of smokeless (oral and nasal) tobacco. Tobacco products exclude e-cigarettes (which do not contain tobacco), “e-cigars”, “e-hookahs”, JUUL and “e-pipes”.

Method of estimation

A statistical model based on a Bayesian negative binomial meta-regression is used to model prevalence of current tobacco use for each country, separately for men and women. A full description of the method is available as a peer-reviewed article in The Lancet, volume 385, No. 9972, p966–976 (2015). Once the age-and-sex-specific prevalence rates from national surveys were compiled into a dataset, the model was fit to calculate trend estimates from the year 2000 to 2025. The model has two main components: (a) adjusting for missing indicators and age groups, and (b) generating an estimate of trends over time as well as the 95% credible interval around the estimate. Depending on the completeness/comprehensiveness of survey data from a particular country, the model at times makes use of data from other countries to fill information gaps. When a country has fewer than two nationally representative population-based surveys in different years, no attempt is made to fill data gaps and no estimates are calculated. To fill data gaps, information is “borrowed” from countries in the same UN subregion. The resulting trend lines are used to derive estimates for single years, so that a number can be reported even if the country did not run a survey in that year. In order to make the results comparable between countries, the prevalence rates are age-standardized to the WHO Standard Population. Estimates for countries with irregular surveys or many data gaps will have large uncertainty ranges, and such results should be interpreted with caution.