Are we in the endgame for smoking?

Clive Bates

Counterfactual

www.clivebates.com

Global cigarette consumption - still rising

Data source: Ng M, Freeman MK, Fleming TD, et al. Smoking prevalence and cigarette consumption in 187 countries, 1980-2012. JAMA 2014; 311: 183–92.

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1,000

2,000

3,000

4,000

5,000

6,000

7,000

1980 1985 1990 1995 2000 2005 2010

Bill

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Global cigarette consumption 1980-2012

Developing countries

Developed countries

Number of smokers - still rising

Data source: Ng M, Freeman MK, Fleming TD, et al. Smoking prevalence and cigarette consumption in 187 countries, 1980-2012. JAMA 2014; 311: 183–92.

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200

400

600

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1,000

1,200

1980 1985 1990 1995 2000 2005 2010

Mill

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Global adult daily smokers - 1980-2012

Males

Females

Global cigarette consumption – linear trend

Data source: Ng M, Freeman MK, Fleming TD, et al. Smoking prevalence and cigarette consumption in 187 countries, 1980-2012. JAMA 2014; 311: 183–92.

y = 53.203x + 2741.8R² = 0.9669

y = -16.501x + 2437.1R² = 0.949

y = 36.702x + 5179R² = 0.8909

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1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000

1980 1985 1990 1995 2000 2005 2010 2015 2020 2025 2030

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Global cigarette consumption and trends - linear

A 2030 ‘endgame’ requires implausible declines

Data source: Ng M, Freeman MK, Fleming TD, et al. Smoking prevalence and cigarette consumption in 187 countries, 1980-2012. JAMA 2014; 311: 183–92.

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1,000

2,000

3,000

4,000

5,000

6,000

7,000

1980 1985 1990 1995 2000 2005 2010 2015 2020 2025 2030

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Global cigarette consumption - phase out by 2030

Global

Developed countries

Developing countries

Consumption rising since 2005 but slower

Data source: Ng M, Freeman MK, Fleming TD, et al. Smoking prevalence and cigarette consumption in 187 countries, 1980-2012. JAMA 2014; 311: 183–92.

y = 44.274x + 4035.9

y = -23.881x + 2022.7

y = 20.393x + 6058.6

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1,000

2,000

3,000

4,000

5,000

6,000

7,000

2005 2010 2015 2020 2025 2030

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Global cigarette consumption and trends since 2005 - linear

Global

Developed countries

Developing countries

Recent increase in growth of cigarette consumption

Data source: Ng M, Freeman MK, Fleming TD, et al. Smoking prevalence and cigarette consumption in 187 countries, 1980-2012. JAMA 2014; 311: 183–92.

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-40

-20

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20

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1980 1985 1990 1995 2000 2005 2010

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Annual change in global cigarette consumption

Global

Developed countries

Developing countries

Global cigarette consumption – trend to 2030

Data source: Ng M, Freeman MK, Fleming TD, et al. Smoking prevalence and cigarette consumption in 187 countries, 1980-2012. JAMA 2014; 311: 183–92.

y = -1.0886x2 + 90.215x + 2525.9R² = 0.9962

y = -0.3737x2 - 3.7956x + 2363R² = 0.9843

y = -1.4623x2 + 86.419x + 4888.9R² = 0.9932

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1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000

1980 1985 1990 1995 2000 2005 2010 2015 2020 2025 2030

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Global cigarette consumption and trends – parabolic trend

Global

Developed countries

Developing countries

Global cigarette consumption – trend to 2050

Data source: Ng M, Freeman MK, Fleming TD, et al. Smoking prevalence and cigarette consumption in 187 countries, 1980-2012. JAMA 2014; 311: 183–92.

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1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000

1980 1990 2000 2010 2020 2030 2040 2050

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Global cigarette consumption and trends – parabolic trend

Global

Developed countries

Developing countries

Cigarette global consumption trend projection to 2030

Consumption 2010-2030 on parabolic trend projection from 1908-2012 data from Ng M, Freeman MK, Fleming TD, et al. Smoking prevalence and cigarette consumption in 187 countries, 1980-2012. JAMA 2014; 311: 183–92.

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1,000

2,000

3,000

4,000

5,000

6,000

7,000

2010 2015 2020 2025 2030

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Global cigarette consumption 2010-2030 - on trend

Global cigarette consumption

Hypothetical introduction of new nicotine products

Consumption 2010-2030 on parabolic trend projection from 1908-2012 data from Ng M, Freeman MK, Fleming TD, et al. Smoking prevalence and cigarette consumption in 187 countries, 1980-2012. JAMA 2014; 311: 183–92.

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1,000

2,000

3,000

4,000

5,000

6,000

7,000

2010 2015 2020 2025 2030

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New non-combustible nicotine with high initial but declining growth

Low risk nicotineconsumption

Global cigarette consumption

Hypothetical introduction of new nicotine products

Consumption 2010-2030 on parabolic trend projection from 1908-2012 data from Ng M, Freeman MK, Fleming TD, et al. Smoking prevalence and cigarette consumption in 187 countries, 1980-2012. JAMA 2014; 311: 183–92.

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1,000

2,000

3,000

4,000

5,000

6,000

7,000

2010 2015 2020 2025 2030

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New non-combustible nicotine with high initial but declining growth

This boundary is harder to move. It means reducing both smoking and nicotine use, and may require coercive measures

This boundary is easier to move. It does not require limiting or prohibiting nicotine use and works through user choice.