362 Million Adults Use Smokeless Tobacco-WHO Report

By Michael Gwarisa

Latest data on the prevalence of smokeless tobacco use and several users aged 15 years and older from 89 countries between 2012 and 2022 shows a 6.3 percent – 9.0 percent prevalence among males and 3.5% among females.

Smokeless tobacco is a tobacco product that is used by means other than smoking. Their use involves chewing, sniffing, or placing the product between gum and the cheek or lip.

According to the World Health Organisation (WHO) global report on trends in the prevalence of tobacco use 2000–2030, the highest use rates are in the South-East Asia Region, where 24.9 percent of males and 11.8 percent of females, on average, use smokeless tobacco.

The lowest average rates are seen in the Region of the Americas, where 1.2 percent of adults are current users of smokeless tobacco – 2.2 percent of males and 0.3 percent of females. Smokeless tobacco use is moderately high among men in the Eastern Mediterranean Region, where an estimated 5.4% of adults are current users,” reads the report.

These prevalence estimates translate to at least 362 million adult users of smokeless tobacco globally – 259 million men and 103 million women. Over 280 million smokeless tobacco users, or 77 percent of the global total, live in the South-East Asia Region. The region with the second highest burden of smokeless tobacco use is the Eastern Mediterranean Region where at least 27 million adult smokeless tobacco users live; at least 21 million users live in the Western Pacific Region. Each WHO region is estimated to have at least 10 million adult smokeless tobacco users.

“Of the World Bank country income groups, the heaviest burden of smokeless tobacco use is carried by the lower middle-income group of countries where prevalence is around 13%, totalling 310 million current users (86 percent of total users globally). The second highest average prevalence is among low- income countries where an estimated 3.6 percent of adults are currently using smokeless tobacco products.”

While prevalence is unknown in countries who are not monitoring smokeless tobacco use among adolescents aged 13–15 years, for this analysis it was assumed that use rates are negligible in countries with no data.

On average globally, around 3.1 percent of adolescents aged 13–15 years report current use of smokeless tobacco products: 3.7 percent of boys and 2.5 percent of girls. Use rates are highest in the Eastern Mediterranean and South-East Asia regions where respectively 4.2 percent and 3.6 percent of adolescents aged 13–15 years use smokeless tobacco.

These two regions, along with the Western Pacific Region, are also those with the best survey coverage – with at least 77 percent of the population aged 13–15 years in all three regions asked about their use of smokeless tobacco products. The lowest data coverage rate was in the African Region (35 percent of the population aged 13–15), followed by the European Region (51 percent).

“At least 7 million boys and 5 million girls globally are current smokeless tobacco users, totalling12 million adolescents aged 13–15 years who use smokeless tobacco products. These numbers are underestimate as there are 71 countries with no data on this indicator.”

Use of smokeless tobacco among adolescents aged 13–15 years is highest on average in low-income countries, at 4.4 percent. This group has the lowest coverage of surveys that ask specifically about smokeless tobacco use – only 31 percent of the group’s population has been surveyed in the period –therefore this income group’s estimate is the least reliable of all income groups.

Meanwhile, the report did not have any conclusive data on the use of electronic nicotine devices including e-cigarettes.

According to the report, monitoring the use of Electronic Nicotine Delivery Systems (ENDS) among both adults and adolescents is necessary to understand the level of use in the population and changes in this level of use over time. Countries began collecting data on current use of ENDS among adults in 2013. By 2022, 70 countries had nationally representative data available, and 69 percent of the global adult population has now been surveyed at least once.

Among adolescents, national data are available from 102 countries since 2013, but these surveys cover only 38 percent of the global population aged 13-17.

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