Changes in cigarette smoking among adults in 35 populations in the mid-1980s

Objective-To examine changes in the prevalence of cigarette smoking in 35 s tudy populations of the World Health Organisation's MONICA Project. Design-Data from two independent, community-based surveys conducted, on ave rage, five years apart. Setting-Geographically defined populations in 21 countries mainly in easter n and western Europe. Subjects-Randomly selected men and women aged 25-64 years. Numbers of parti cipants in each study population ranged from 586 to 2817 in each survey. Main outcome measures-Changes in proportions of current smokers, ex-smokers , and never-smokers by age and sex using data collected by standardised met hods. Results-Among men, smoking prevalence decreased in most populations, by thr ee to four percentage points over five years. In Beijing, however, it incre ased in all age groups-overall by 11 percentage points. Among women there w ere increases in smoking in about half the populations. The increases were mainly in the age group 35-54 years and often in those populations where sm oking prevalence among women has been relatively low. Conclusions-Smoking initiation by middle-aged women in parts of southern an d eastern Europe and among men of all ages in Beijing is a matter of concer n. The various public health measures that have helped to reduce smoking am ong men in developed countries should be vigorously extended to these other groups now at growing risk of smoking-related disease.