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This encouraging development is due to the tobacco control efforts of governments, civil society, and the international community, including through the WHO Framework Convention on Tobacco Control (FCTC). This change means more lives saved, and healthier and more productive societies. Overall global tobacco consumption has also continued its modest decrease since our last Atlas, but there remain some dark clouds: there are still more than 1.1 billion smokers in the world and youth smoking is increasing in dozens of countries. Change is happening, but not quickly enough.

This seventh edition of the Tobacco Atlas once again brings a compelling and comprehensive guide to today’s key tobacco control issues by combining two concomitant narratives: the harshness of the wreckage that tobacco causes and the tools that countries are successfully using to address these challenges.

The first half of the narrative tackles key aspects of the disastrous consequences of tobacco use. It starts with Growing because the deforestation to clear land and the intense use of chemicals to cultivate tobacco leaf mean that the damage starts before a tobacco sprout even pokes through the soil. In the meantime, tobacco companies are aggressively Marketing their products, mainly to youth and children. This all contributes to Product Sales of varying types in the hundreds of billions of dollars annually (and tens of billions in profits).  The Atlas begins to count the human consequences in the Prevalence (Adult) and Prevalence (Youth) chapters. Because smoking is not the only deadly tobacco product, the next two chapters address non-cigarette tobacco products that are causing myriad public health challenges globally: Smokeless tobacco and E-cigarettes. The next two chapters examine the physical consequences: Health Effects and Death.

The second half focuses on the evidence-driven tools and strategies that we are using to tackle the tobacco epidemic. We begin with Global Strategy, which of course begins its focus on the FCTC, but also examines closely related efforts such as the UN Sustainable Development Goals. Next, we examine tobacco Taxes, typically viewed as the most effective but least implemented tobacco control measure. Next, the Atlas’ corollary to the Marketing chapter is Counter-marketing – how governments use tools such as warning labels and plain packaging to replace the tobacco companies’ increasingly loud messages with truthful, science-based narratives. The Atlas also tackles Media Campaigns, a wildly successful population-level intervention in many countries. The next topic focuses more on the individual level and explores smoking Cessation. Finally, it would not be the early 2020s if we did not take time to consider tobacco control in the time of COVID-19.

For the first time, the Tobacco Atlas includes “special topics” that we believe merit more in-depth examination and, often, call upon experts outside of our author team to help. To kick things off, Tobacco Atlas has proudly partnered with our colleagues at the African American Tobacco Control Leadership Council in the US to write the new Race, Ethnicity and Equity chapter. Equity is at the cornerstone of successful tobacco control and this discussion begins to tackle many of the key complexities.

Finally, we offer a Path Forward as we consider where we go next so that we can report in the eighth edition that we have finally brought the number of smokers in the world below 1 billion (and then to keep going down from there…).

For the ambitious we suggest making your way systematically through the topics, reading it as a whole— a comprehensive narrative of the complete “cycle of tobacco.” Alternatively, authors wrote each chapter to stand on its own and to serve as a one-stop resource if you need to understand the central debates of a major issue and/or to download useful, current data.

We hope the Tobacco Atlas will inspire you to action to improve tobacco control in your country and will provide helpful guidance on the many tools to achieve these goals.

Editors

Jeff Drope Tobacconomics

Jeff Drope

Lead editor and author

Jeffrey Drope, PhD, is a Research Professor at Johns Hopkins University. He currently leads multinational research projects on accelerating tobacco taxation in low- and middle-income countries (LMICs); the economics of tobacco farming; alcohol taxation in LMICs; and fiscal policies and food systems. He has led the publication of the last three editions of the Tobacco Atlas. He was previously the Scientific Vice President of Economic & Health Policy Research at the American Cancer Society.

Steve Hamill

Steve Hamill

Stephen Hamill is Vital Strategies’ Vice President for Policy Advocacy and Communication. In this role Stephen oversees external affairs and heads a global team working to improve health in 60 countries. He has 25 years of experience in civil society and government with a focus on strategic communications, advocacy, design, and digital communications. He is bringing this expertise to bear on global health issues including tobacco control, overdose prevention, environmental health, healthy food policy and other leading health areas.

Authors

Frank Chaloupka

Frank Chaloupka

Frank J. Chaloupka, PhD, is a Distinguished Professor Emeritus at the University of Illinois Chicago after nearly 33 years on the faculty and almost two decades as Director of the UIC Health Policy Center. He is a Research Associate in the National Bureau of Economic Research’s Health Economics Program and Children’s Program. Dr. Chaloupka’s research focuses on the economics of health behaviors, including cigarette smoking and other tobacco use, alcohol use and abuse, illicit drug use, diet, and physical activity, as well as on various outcomes related to substance use and abuse. In addition to hundreds of articles, Dr. Chaloupka co-authored or edited seminal works including, Curbing the Epidemic: Governments and the Economics of Tobacco Control, Tobacco Control in Developing Countries and the NCI and WHO monograph on The Economics of Tobacco and Tobacco Control.

Carlos Guerrero

Carlos Guerrero

Carlos Guerrero is an Economist on the Tobacconomics team at Johns Hopkins University. He received his master’s degree in Health Economics from the National Institute of Public Health in Mexico. He also completed the Global Tobacco Control Leadership Program at Johns Hopkins Bloomberg School of Public Health. His research interests focus on tobacco control, alcohol abuse, population nutrition, environmental health, impact evaluation of health interventions and fiscal policy, and health outcomes differentiated by gender.

Hye Myung Lee

Hye Myung Lee

Formerly a pre-doctoral researcher on the Tobacconomics team, Hye Myung Lee is currently a post-doctoral fellow at the Mailman School of Public Health at Columbia University. She earned her PhD from the University of Illinois Chicago.

Maryam Mirza

Maryam Mirza

Maryam Mirza, PhD, is an Economist on the Tobacconomics team at Johns Hopkins University. Previously, her research focus was studying the unintended consequences of policies designed to increase education and health outcomes. At present, she focuses on fiscal policies for health, primarily in low- and middle-income countries.

Alyssa Mouton

Alyssa Mouton

Alyssa Mouton, MPH, MPP, is a Senior Manager, Tobacco Control Advocacy with Vital Strategies where she provides technical support and policy advocacy guidance to teams across ten countries. Previously, she worked with the North Carolina Department of Health and Human Services as a Tobacco-free Policy and Health Equity Strategist to support the development of comprehensive tobacco policies across the state. She is also a Health Equity Leadership Awakened Fellow (Human Impact Partners, 2018-2019) who is committed to applying a health equity lens to the design and implementation of policies and programs.

Nandita Murukutla

Nandita Murukutla

Nandita Murukutla, PhD, is a social scientist with a background in behavioral economics. At Vital Strategies, Dr. Murukutla provides scientific leadership by ensuring that its health communication programs and policy advocacy efforts reflect the latest evidence from the social behavioral sciences. She collaborates with experts and supervises a team in primary research, monitoring and evaluation, cost-effectiveness, and policy analysis. This analysis has supported decisions by governments and other stakeholders in up to 60 countries across Africa, the Americas, Asia, and Eastern Europe in the areas of food policy, road safety and injury prevention, tobacco control, maternal and reproductive health, and more recently in the public health response to COVID-19.

Anh Ngo

Anh Ngo

Anh Ngo, PhD, recently completed a postdoctoral research fellowship with the Tobacconomics team at the University of Illinois Chicago (UIC). Dr. Ngo’s research focuses on the effects of tobacco control policies on tobacco use (i.e., smoking prevalence and cigarette consumption) in a global context, e-cigarette use among youth and young adults, and alcohol excise taxes. She is currently a Research Associate at West Virginia University, Office of Health Affairs.

Rebecca Perl

Rebecca Perl

Rebecca Perl is Vice President of Partnerships and Initiatives at the international public health organization, Vital Strategies. There she oversees the organization’s tobacco control programs and global work on noncommunicable disease prevention. Rebecca has an MS in Journalism from Columbia University. Before coming to Vital, she was an investigative health and science reporter for the Washington Post and NPR. She lives in New York.

Germán Rodriguez-Iglesias

Germán Rodriguez-Iglesias

Germán Rodriguez-Iglesias is an Economist on the Tobacconomics team at Johns Hopkins University. He is the regional team leader for Latin America on the project entitled Accelerating Progress on Tobacco Taxes in Low- and Middle-Income Countries. He conducts and coordinates research in Latin America, and mentors think tanks that specialize in economic and fiscal policies on tobacco taxation, including research design, analysis, and dissemination. He also co-leads work in other regions and on related conceptual research.

Neil Schluger

Neil Schluger

Neil Schluger M.D. is the Barbara and William Rosenthal Professor and Chairman of the Department of Medicine at New York Medical College, and a Senior Advisor for Science at Vital Strategies. He has had a long career as a leading physician-scientist working in areas of global lung health as an investigator, educator and advocate, particularly I areas such as tuberculosis, tobacco control and air pollution. He was a co-editor of the sixth edition of the Tobacco Atlas, and is a founder of the East African Training Initiative in Pulmonary Medicine.

Erika Siu

Erika Siu

Formerly a member of the Tobacconomics team, Erika Siu currently serves as the Director of Research and Academic Centers at the University of Chicago Law School. She also serves as a member of the Subcommittee on health taxes in the United Nationals Committee of Experts on International Cooperation in Tax Matters. She is former Director of the International Commission on the Reform of International Corporate Taxation and a researcher for the International Centre for Tax and Development and the United Nations Development Programme. A lawyer by training, her research interests on the Tobacconomics team focus on fiscal policy and sustainable development.

Violeta Vulovic

Violeta Vulovic

Formerly a member of the Tobacconomics team, Violeta Vulovic currently serves as a Senior Economist (Tax) at the World Bank in Washington, D.C. Previously, Violeta worked as an economist with the World Bank Group, where she led and supported technical assistance on a variety of tax policy and administration issues, focusing on East and South Asia regions. Violeta has published journal articles on optimal tax structures, the macro-economic and distributional impacts of tax and expenditure policies, and tax effort.

Saw Min Thu Oo

Saw Min Thu Oo is a graduate research assistant on the Tobacconomics team at Johns Hopkins University. He is currently a MS Biostatistics (Health Analytics) candidate at the University of Illinois Chicago. Before his study, he worked as Monitoring and Evaluation Manager for healthcare programs at Access to Health Fund, UNOPS in Yangon, Myanmar. He completed his Bachelor degree in Medicine at University of Medicine 2, Yangon and his MPH at Umeå University, Sweden.

Special Contributors

Phillip S. Gardiner

Phillip S. Gardiner

Dr. Gardiner is a Public Health activist, administrator, evaluator and researcher. For the past 20 years, Dr. Gardiner has lectured around the country on African American health disparities generally and menthol smoking in the Black community, particularly. Dr. Gardiner recently retired as the Senior Program Officer for the Tobacco Related Disease Research Program (TRDRP), University of California Office of the President, a position he had been in since 1997. Dr. Gardiner is currently the Co-Chair of the African American Tobacco Control Leadership Council (AATCLC), a group of Black professionals dedicated to fighting the scourge of tobacco impacting African American communities both in California and Nationally.

Carol McGruder

Carol McGruder

Carol McGruder is a seasoned leader of California’s tobacco control initiatives and has served as an advisor in many capacities, including as a founding member and co-chair of the African American Tobacco Control Leadership Council (AATCLC). McGruder recognized the importance of the global fight against tobacco early on in her career. In the 1990’s, Carol work on the Framework Convention for Tobacco Control, San Francisco’s Global Summit on Tobacco Control, and San Francisco’s “Intercambios”-north-south partnering of local community based organizations oriented her worldview and approach on transnational tobacco control issues.

Valerie B. Yerger

Valerie B. Yerger

Valerie B. Yerger, ND is Professor in Health Policy at the University of California, San Francisco. She is also a licensed naturopathic doctor and a former Health Disparities Scholar of the National Institutes of Health. For over twenty years, Dr. Yerger’s research and advocacy work have focused on framing the disproportionate burden of tobacco among marginalized communities as a social injustice and informing public health policies to effectively reach and engage these communities. Dr. Yerger is a founding member of the African American Tobacco Control Leadership Council, which spearheaded the national movement to ban the sale of menthol cigarettes and other flavored tobacco products.

Communications

Ally Davis

Ally Davis

Ally Davis is the Deputy Director of Public Relations and Marketing at Vital Strategies. Previously, she oversaw The ALS Association Greater New York Chapter’s communication and national advocacy efforts. Ally received her master’s in public health at Boston University School of Public Health.

Margaret Dorokina

Margaret Dorokina

Margaret Dorokhina is the Director of Communications and Content Management on the Tobacconomics team at Johns Hopkins University. She recently received her master’s in public health from the University of Illinois Chicago. Previously, she interned at the American Heart Association and several other non-profit organizations in Washington, DC.

Mareda Smith

Mareda Smith

Mareda Smith recently completed her graduate research assistant position on the Tobacconomics team working on tobacco control and taxation research dissemination. Previously, Mareda worked as a paralegal for Covington & Burling, LLP and on issues of economic justice with Jubilee USA Network. She holds a Bachelor’s in political science and is currently a Master’s of Public Health student studying Health Policy and Administration.

Creative

Shantal Henry

Shantal Henry

Shantal Henry is a Senior Designer at Vital Strategies where she provides critical storytelling solutions to support Vital Strategies’ core programs and partner organizations. With a background in spatial exhibition design for museums and cultural institutions she has established an essential expertise in creating captivating experiences for varied audiences.

Johnny Hsu

Johnny Hsu

Johnny Hsu is Vital Strategies’ Creative Director where he leads the in-house design team elevating through design leadership throughout the organization. He has background building brands in consumer and non-profit spaces.

David Shin

David Shin

David Shin is a Digital Designer at Vital Strategies where he supports the STOP (Stopping Tobacco Organizations and Products) team and partner organizations. Before joining Vital Strategies, he worked with a variety of non-profits and global in-house design teams with work spanning across websites, applications, and physical installations.

Daniel Stolle

Daniel Stolle

Daniel Stolle is a German-Finnish illustrator. His work has appeared in The New York Times, The New Yorker, The Guardian, New Scientist and many more. Daniel has previously been contributing drawings to the sixth edition of the Tobacco Atlas. See more of his work: danielstolle.com

DXDY

DXDY

Development Partner

Amalan Premkumar, Tech lead; Mohammad Anees, UI/UX Lead; Anuththiga Thurairasasingam, Backend Developer; Hafsa Ghouse, QA Engineer; Sanjeevan Jeevaratnam, UI/UX Developer; Kanishka Jayawardene, Project Manager; dxdydigital.com

Acknowledgments

The editors and authors of the Tobacco Atlas owe a debt of gratitude to a number of colleagues for their assistance and collaboration developing this new 7th edition. First, we wish to thank sincerely our earlier co-authors Michael Eriksen and Judith Mackay who were instrumental in the Atlas’ earliest days and then through the years. We also thank our close colleagues on the previous edition of the Atlas from which we borrowed several major concepts: Zach Cahn, Jacqui Drope, Farhad Islami, Alex Liber, Nigar Nargis and Michal Stoklosa. We are very grateful for the support and collaboration on data sharing from the Institute for Health Metrics and Evaluation and their Global Burden disease work, and the teams at the World Health Organization who work on the Global Tobacco Control Reports and their tobacco use surveillance and forecasting. The teams at these organizations have gone above and beyond to help us bring the Atlas to fruition. Finally, we are hugely grateful to the Bloomberg Philanthropies for supporting this edition. Of course, the views expressed in the Atlas do not necessarily represent any of these individuals or organizations, and all errors remain ours.

Suggested Citation:

Drope J, Hamill S, Chaloupka F, Guerrero C, Lee HM, Mirza M, Mouton A, Murukutla N, Ngo A, Perl R, Rodriguez-Iglesias G, Schluger N, Siu E, Vulovic V. The Tobacco Atlas. 2022. New York: Vital Strategies and Tobacconomics.

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