Smoking in developing countries: What are the triggers?
By Nana Amankwah and Fiorenzo Conte
While tobacco consumption has been falling in many developed countries, the opposite is true for many developing countries (to find out how these two trends are connected stay tuned to the blog). This post wants to shed some lights on the following question: What ‘tips’ people to develop the habit of smoking in developing countries? What are the factors which explain tobacco consumption in LDCs?
Let’s first take a look at the impact of income and education status.
Findings from the analysis of high income countries show that smoking prevalence is low among individuals with high income and high education levels. This social gradient factor explains the reduction in tobacco consumption as education rises, which is often (not always) associated with high level of income in some contexts. However, studies on smoking in developing countries show more varied results. While some find smoking to be popular among the wealthy in low income countries, others show that tobacco use is more common among the poor in countries such as India, China and Costa Rica. This varied pattern is also applicable to education groups in middle and low income countries.
A recent study published in the WHO bulletin does not seem to share the same mixed results. In fact it posits that as economic and political empowerment increases there is bound to be an increase in tobacco consumption. What it is striking is that China, where tobacco consumption is more common among poor people, is held as example of such dynamic.
An analysis in 74 countries found that men are five times more likely to smoke than women in countries with lower rates of female empowerment, such as China, Indonesia, Pakistan, Saudi Arabia and Uganda.
In countries with relatively high female empowerment, such as Australia, Canada, Norway, Sweden and the United States, this gap is small and women smoke almost as much as men do.
Hence, the WHO article would seem to assume that the more income-more smoking connection will show that millions of women in developing countries risk disease and early death in the coming decades as their rising economic and political status leads them to smoke more. However, such warning rests on an assumption (more income and more power = more smoking) which is not as clear as the report claims it is.