Building the evidence base for global tobacco control

The tobacco control movement needs a global information system permitting r outine monitoring of the tobacco trade, tobacco farming, the tobacco indust ry, the prevalence of tobacco use, associated mortality, and national resou rces for combating tobacco. The Tobacco Control Country Profiles database, a data collection initiative led by the American Cancer Society in collabor ation with WHO and the Centers for Disease Control and Prevention, represen ts the first step in the development of such a system. Baseline data on sev eral indicators of tobacco use were obtained from 191 Member States of WH, two Associate Members, Hong Kong Special Administrative Region of China (Ho ng Kong SAR), China (Province of Taiwan) and the West Bank and Gaza Strip. The methods used to compile the data are described in the present paper. Se lected indicators from the database were analysed in order to demonstrate t he potential utility and value of data derived from an information system d evoted to tobacco control. The analyses covered gender-specific smoking pre valence by WHO Region, per capita cigarette consumption by Human Developmen t Index (HDI) category, and average real annual percentage changes in cigar ette prices between 1990 and 1999 for selected countries in each category. In 1998, men were almost four times more likely than women to be smokers. T he prevalence of smoking among men was highest in the Western Pacific Regio n. The differential in gender-specific smoking prevalence was narrowest in the Region of the Americas and the European Region. It was wider in the Sou th-East Asia Region and the Western Pacific Region. The lowest and highest per capita consumption of manufactured cigarettes occurred in the lowest an d highest HDI categories respectively. In the medium HDI category, China's growing cigarette consumption after 1975 had a major bearing on the rise in per capita consumption. Cigarette price trends suggest that there is consi derable scope for increasing taxes on tobacco products, particularly in low or medium HDI countries. The implications of the findings for future tobac co control efforts are discussed, as are issues surrounding the quality of available data, priorities for future data collection and the need to maint ain and improve the information system in order to support such efforts.