A study that compiled data on three billion tobacco users worldwide, including thousands of face to face interviews, shows that global tobacco use is greatly influenced by the pro-tobacco lobby. The study focused on tobacco use in 14 low and middle-income countries and made comparisons with two developed countries - the United States and the United Kingdom.

Dr. Gary Giovino at the University at Buffalo School of Public Health in New York State was the lead author.

“Tobacco contributes an enormous burden to the health care system in developed countries, and that scenario will play out in the not-too-distant future in low and middle income countries. It already has in many countries, in India for example," Giovino said.

Giovino’s data shows that China leads with some 300 million tobacco users, followed by India with almost 275 million. The researchers came across powerful pro-tobacco forces active even at the elementary school level.

“The China National Tobacco Company has supported elementary schools in China, dozens and dozens of them. And they use their support to promote propaganda about tobacco use, and they are basically telling students that genius comes from hard work and tobacco helps them to be successful. That to me is mind boggling, that a government would tell its children to use tobacco to be successful when tobacco will addict them and shorten their lives,” Giovino said.

The data shows that governments and social norms in many countries are receptive to influence from strong pro-tobacco forces.

So the Australian court decision is viewed as important in encouraging those fighting to control tobacco use. Jonathan Liberman directs the McCabe Centre for Law and Cancer in Australia.

"It shows to everybody that the only way to deal with the tobacco industry's claims, sabre rattling, legal threats, is to stare them down in court. It's a fantastic decision for public health in Australia and globally," Liberman said.

The Buffalo survey concludes that, unless urgent action is taken, about a billion people will die prematurely in this century, losing 15 years of life on average. Dr. Giovino hopes the extensive data spurs many countries to implement policies that will save lives.

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