Tobacco use is the second leading risk factor for early death and disability worldwide, claiming more than 5 million lives every year since 1990. The negative effects of smoking spread out beyond individual and population health affecting the economy as well. Worldwide in 2015, the age-standardised prevalence of daily smoking was 25% for men and 5.4% for women, representing 28.4% and 34.4% reductions, respectively, since 1990. It is estimated that in 2015 there were between 5.7 to 7 million deaths due to smoking, equivalent to 11.5% of all global deaths (Reitsma et al., 2017[23]). Currently, 1.1 billion people are estimated to be active smokers, 84% of which were males and 80% of which live in low- and middle-income countries. Moreover, second-hand smoke causes more than 1.2 million premature deaths per year, of which 65 000 are children (WHO, 2019[24]). The UN SDGs call for strengthening the implementation of the World Health Organization Framework Convention on Tobacco Control in all countries, as appropriate.
The proportion of daily tobacco smokers varies greatly across countries but close to one in four men aged 15 and above in the LAC18 smokes daily, a very similar rate to the OECD (Figure 4.20). Rates are particularly high in Cuba, where over half of all men smoke, followed by Surinam where 43% men smoke. The lowest rates among men are observed in Costa Rica, Panama and Mexico, all below 10%. Rates are lower among women with 7% smoking daily, lower than the OECD average. Chile is at the top with over one women of every five smoking, followed closely by Cuba and Argentina. Cuban women smoke three times less than men do. The lowest rates for women are found in Barbados and Ecuador with 2% or less, followed by El Salvador, Costa Rica, Haiti and Panama, all below 2%.
Among adolescents aged between 13 and 15 years old in 29 LAC countries, tobacco use prevalence for men was 15% and almost 12% for women. Chile shows the highest tobacco use among women (26%) followed by Argentina (25%) and Mexico (18%), while the lowest rates are found in Dominican Republic (6%) and Honduras (6%). Among men, Saint Vincent and the Grenadines has the highest tobacco use (24%) followed by Argentina (23%) and Mexico (22%). Paraguay has the lowest rate among men of 7% (Figure 4.21).
Increasing tobacco prices through higher taxes is one of the most effective interventions to reduce tobacco use, by discouraging youth from beginning cigarette smoking and encouraging smokers to quit. A recent review of studies conducted in LAC countries found that tax increases effectively reduce cigarette use and can also be expected to increase cigarette tax revenue (Guindon, Paraje and Chaloupka, 2018[25]), which can be used in complementary interventions. The average taxation in LAC is 48% for a pack of 20 cigarettes (Figure 4.22). The countries with the highest taxation on tobacco are Chile and Argentina with over 80%, but these are not the countries with the highest prices. The most expensive tobacco can be found in Jamaica with a price of USD 14.3, while the cheapest one is observed in Paraguay, Colombia, Cuba, Dominica and Guyana, all below USD 3 dollars.
LAC countries can strengthen its regulations to reduce tobacco use by fully implementing the WHO Framework Convention on Tobacco Control. For this, WHO’s strategy MPOWER can be followed to Monitor tobacco use and prevention policies; Protect people from tobacco use; Offer help to quit tobacco use; Warn about the dangers of tobacco; Enforce bans on tobacco advertising, promotion and sponsorship; and Raise taxes on tobacco (WHO, 2019[24]).
