Tobacco

Fact sheet
Updated June 2016

Key facts
 Tobacco kills up to half of its users.
 Tobacco kills around 6 million people each year. More than 5 million of those deaths are the result of direct
tobacco use while more than 600 000 are the result of non-smokers being exposed to second-hand smoke.
 Nearly 80% of the world's 1 billion smokers live in low- and middle-income countries.

Leading cause of death, illness and impoverishment

The tobacco epidemic is one of the biggest public health threats the world has ever faced, killing around 6
million people a year. More than 5 million of those deaths are the result of direct tobacco use while more than
600 000 are the result of non-smokers being exposed to second-hand smoke.
Nearly 80% of the more than 1 billion smokers worldwide live in low- and middle-income countries, where
the burden of tobacco-related illness and death is heaviest.
Tobacco users who die prematurely deprive their families of income, raise the cost of health care and hinder
economic development.
In some countries, children from poor households are frequently employed in tobacco farming to provide
family income. These children are especially vulnerable to "green tobacco sickness", which is caused by the
nicotine that is absorbed through the skin from the handling of wet tobacco leaves.
Surveillance is key
Good monitoring tracks the extent and character of the tobacco epidemic and indicates how best to tailor
policies. Only 1 in 3 countries, representing one third of the world's population, monitors tobacco use by
repeating nationally representative youth and adult surveys at least once every 5 years.
Second-hand smoke kills
Second-hand smoke is the smoke that fills restaurants, offices or other enclosed spaces when people burn
tobacco products such as cigarettes, bidis and water-pipes. There are more than 4000 chemicals in tobacco
smoke, of which at least 250 are known to be harmful and more than 50 are known to cause cancer.
There is no safe level of exposure to second-hand tobacco smoke.
 In adults, second-hand smoke causes serious cardiovascular and respiratory diseases, including coronary heart
disease and lung cancer. In infants, it causes sudden death. In pregnant women, it causes low birth weight.
 Almost half of children regularly breathe air polluted by tobacco smoke in public places.
 Second-hand smoke causes more than 600 000 premature deaths per year.
 In 2004, children accounted for 28% of the deaths attributable to second-hand smoke.
Every person should be able to breathe tobacco-smoke-free air. Smoke-free laws protect the health of non-
smokers, are popular, do not harm business and encourage smokers to quit.
Over 1.3 billion people, or 18% of the world's population, are protected by comprehensive national smoke-
free laws.
Tobacco users need help to quit
Studies show that few people understand the specific health risks of tobacco use. For example, a 2009 survey
in China revealed that only 38% of smokers knew that smoking causes coronary heart disease and only 27%
knew that it causes stroke.
Among smokers who are aware of the dangers of tobacco, most want to quit. Counselling and medication can
more than double the chance that a smoker who tries to quit will succeed.
 National comprehensive cessation services with full or partial cost-coverage are available to assist tobacco
users to quit in only 24 countries, representing 15% of the world's population.
There is no cessation assistance of any kind in one quarter of low-income countries.
Picture warnings work
Hard-hitting anti-tobacco advertisements and graphic pack warnings – especially those that include pictures –
reduce the number of children who begin smoking and increase the number of smokers who quit.
Graphic warnings can persuade smokers to protect the health of non-smokers by smoking less inside the home
and avoiding smoking near children. Studies carried out after the implementation of pictorial package
warnings in Brazil, Canada, Singapore and Thailand consistently show that pictorial warnings significantly
increase people's awareness of the harms of tobacco use.
Only 42 countries, representing 19% of the world's population, meet the best practice for pictorial warnings,
which includes the warnings in the local language and cover an average of at least half of the front and back
of cigarette packs. Most of these countries are low- or middle-income countries.
Mass media campaigns can also reduce tobacco consumption by influencing people to protect non-smokers
and convincing youths to stop using tobacco.
Over half of the world's population live in the 39 countries that have aired at least 1 strong anti-tobacco mass
media campaign within the last 2 years.
Ad bans lower consumption
Bans on tobacco advertising, promotion and sponsorship can reduce tobacco consumption.
 A comprehensive ban on all tobacco advertising, promotion and sponsorship could decrease tobacco
consumption by an average of about 7%, with some countries experiencing a decline in consumption of up to
16%.
 Only 29 countries, representing 12% of the world’s population, have completely banned all forms of tobacco
advertising, promotion and sponsorship.
 Around 1 country in 3 has minimal or no restrictions at all on tobacco advertising, promotion and sponsorship.
Taxes discourage tobacco use
Tobacco taxes are the most cost-effective way to reduce tobacco use, especially among young and poor people.
A tax increase that increases tobacco prices by 10% decreases tobacco consumption by about 4% in high-
income countries and about 5% in low- and middle-income countries.
Even so, high tobacco taxes is a measure that is rarely implemented. Only 33 countries, with 10% of the
world's population, have introduced taxes on tobacco products so that more than 75% of the retail price is tax.
Tobacco tax revenues are on average 269 times higher than spending on tobacco control, based on available
data.
Illicit trade of tobacco products must be stopped
The illicit trade in tobacco products poses major health, economic and security concerns around the world. It
is estimated that 1 in every 10 cigarettes and tobacco products consumed globally is illicit. The illicit market
is supported by various players, ranging from petty peddlers to organized criminal networks involved in arms
and human trafficking.
Eliminating illicit trade in tobacco will reduce the harmful consumption of tobacco by restricting availability
of cheap, unregulated alternatives and increasing overall tobacco prices. Critically, this will reduce premature
deaths from tobacco use and raise tax revenue for governments. Stopping illicit trade in tobacco products is a
health priority, and is achievable. But to do so requires improvement of national and sub-national tax
administration systems and international collaboration, such as ratification and implementation of the Protocol
to Eliminate the Illicit Trade in Tobacco Products, an international treaty in its own right, negotiated by parties
to the WHO Framework Convention on Tobacco Control (WHO FCTC).
While publicly stating its support for action against the illicit trade, the tobacco industry’s behind-the-scenes
behaviour has been very different. Internal industry documents released as a result of court cases demonstrate
that the tobacco industry has actively fostered the illicit trade globally. It also works to block implementation
of tobacco control measures, such as tax increases and pictorial health warnings, by misleadingly arguing they
will fuel the illicit trade.
 WHO response
WHO is committed to fighting the global tobacco epidemic. The WHO Framework Convention on Tobacco
Control entered into force in February 2005. Since then, it has become one of the most widely embraced
treaties in the history of the United Nations with 180 Parties covering 90% of the world's population.
The WHO Framework Convention is WHO's most important tobacco control tool and a milestone in the
promotion of public health. It is an evidence-based treaty that reaffirms the right of people to the highest
standard of health, provides legal dimensions for international health cooperation and sets high standards for
compliance.
In 2008, WHO introduced a practical, cost-effective way to scale up implementation of provisions of the WHO
Framework Convention on the ground: MPOWER. Each MPOWER measure corresponds to at least 1
provision of the WHO Framework Convention on Tobacco Control.
The 6 MPOWER measures are:
 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
 Raise taxes on tobacco.
For more details on progress made for tobacco control at global, regional and country level, please refer to the
series of WHO reports on the global tobacco epidemic.
The WHO FCTC Protocol to Eliminate the Illicit Trade in Tobacco Products requires a wide range of measures
relating to the tobacco supply chain, including the licensing of imports, exports and manufacture of tobacco
products; the establishment of tracking and tracing systems and the imposition of penal sanctions on those
responsible for illicit trade. It would also criminalize illicit production and cross-border smuggling.
For more information contact:
WHO Media centre
Telephone: +41 22 791 2222
E-mail: mediainquiries@who.int
 Epidemi Tembakau : Si Pembunuh Nomor Satu di Dunia
Disusun oleh : Andika Ponco Wibowo
NIM : 22010116130185
Program Studi : Pendidikan Dokter
Menurut sebuah artikel yang diterbitkan di halaman WHO yang berjudul “Tobacco” pada Juni
2016, WHO menyatakan bahwa epidemi tembakau atau yang secara harfiah dapat diartikan
sebagai penyakit yang disebabkan akibat tindakan mengonsumsi, mengemas, atau menghirup
produk berbahan dasar tembakau merupakan pembunuh nomor satu di dunia. Hal tersebut
didukung oleh fakta bahwa sedikitnya 5 juta orang meninggal akibat mengonsumsi rokok dan
sedikitnya 600.000 orang meninggal akibat terpapar asap rokok setiap tahunnya. Dan rata-rata
80% dari sedikitnya 1 milyar konsumen di seluruh dunia berasal dari negara-negara
berpendapatan perkapita menengah kebawah, termasuk Indonesia.
Sebuah riset terpadu yang dilakukan oleh sekelompok ahli kesehatan yang diterbitkan melalui
Jurnal Kesehatan Universitas Indonesia, yang bertujuan untuk mengukur konsentrasi asap
rokok pada tempat-tempat umum di Indonesia tepat sebelum diberlakukannya kebijakan
regulasi larangan merokok pada tempat-tempat umum diberlakukan, memberikan hasil yang
cukup mengejutkan. Pasalnya, meskipun areal merokok dan tidak merokok telah diterapkan,
konsentrasi asap rokok yang lebih tinggi terdapat pada areal tidak merokok. Hal ini
membuktikan bahwa pembagian areal merokok bukanlah solusi yang tepat guna
menghilangkan asap rokok yang kian mengancam kesehatan masyarakat dari berbagai
kalangan usia.
Mengingat amat berbahayanya merokok, Pemerintah Indonesia kini telah mengambil langkah
maju dengan memberlakukan regulasi larangan merokok di tempat-tempat umum. Berbagai
sosialisasi maupun riset terbaru telah dilakukan guna mengantisipasi ataupun mengobati
penderita, salah satunya dengan menekan produksi senyawa malondialdehyde (MDA).
Riset terbaru yang dilakukan mahasiswa Universitas Brawijaya melalui Jurnal Kesehatan yang
diterbitkan pada tahun 2016 menjelaskan bahwa produksi senyawa malondialdehyde (MDA)
dapat ditekan dengan pemberian ekstrak kulit buah naga berdaging super merah (Hylocereus
Costaricencis). Menurut mereka, malondialdehyde (MDA) yang merupakan senyawa produk
akhir dari tingkat peroksidasi lipid yang terjadi di membran sel, bersifat toksik terhadap sel.
Peroksidasi lipid sendiri merupakan mekanisme sel atau jaringan akibat serangan dari radikal
bebas yang terdapat didalam asap rokok. Dengan pemberian ekstrak kulit buah naga tersebut,
kadar MDA yang dihasilkan ternyata cukup rendah, meskipun objek telah dipapar asap rokok
setiap hari selama 28 hari.
Riset yang hampir serupa juga dilakukan mahasiswa Universitas Indonesia melalui Jurnal
Kesehatan yang diterbitkan pada Tahun 2011. Hanya saja mereka menjelaskan bahwa yang
dapat menekan angka produksi malondialdehyde (MDA) adalah bubuk buah delima (Punica
Granatum L).
Kedua riset tersebut sama-sama menghasilkan sebuah inovasi baru bagi masa depan
pengobatan penyakit epidemi tembakau. Namun sayangnya, untuk saat ini kedua riset masih
terbatas pada tikus sebagai objek penelitiannya.