The battle against tobacco is not yet won

The battle against tobacco is not yet won

Illustration: Daniel Stolle

Smoking kills. Maybe that’s not the most original thought you’ve read today, but it’s worth repeating. In 2019, around 14% of all deaths were caused by tobacco smoking — and were therefore entirely preventable. What a colossal waste.

The world is generally moving in the right direction. In countries deemed to have the highest level of economic and social development, there are now about as many former smokers as there are current smokers. That is encouraging, as is the decline in the global prevalence of tobacco smoking from 28% in 1990 to 20% in 2019. But we should not confuse progress with victory. As a result of population growth, there are actually more smokers now than there were in 1990.

Nicotine in cigarettes is highly addictive, which makes quitting smoking a miserable experience for many people. A new approach to help people kick the habit involves magnetically stimulating regions of the brain that are involved in addiction. The technique has already been approved for use in the United States, and it could improve considerably as researchers get a better handle on what goes on in a nicotine-addicted brain.

Policies that encourage quitting and discourage new smokers will continue to be crucial to ridding the world of smoking. In general, high-income countries are ahead of their lower-income neighbours in this regard — the US Food and Drug Administration is even considering limiting nicotine levels in cigarettes, to make quitting easier. In low-income countries in Africa, however, even common anti-smoking measures such as raising taxes on cigarettes have proved difficult to implement, in part owing to the interference of tobacco companies.

The negative health effects of smoked tobacco are unquestionable, but the role of nicotine itself in perpetrating these harms is not clear. The rising popularity of alternative nicotine delivery methods, such as e-cigarettes or vapes, is giving researchers more impetus — and more opportunity — to find out.

We are pleased to acknowledge the financial support of Haleon in producing this Outlook. As always, Nature retains sole responsibility for all editorial content.

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