Tobacco use is massively entrenched in developing countries, where one of the biggest worries is the rise of smoking among women, according to a study published on Friday in The Lancet.
A survey of 16 countries that are home to three billion people found that 48.6 percent of all men and 11.3 percent of women are tobacco users, especially in poorer economies, where more girls are starting to smoke early and often at the same age as boys.
The data trawl covered a survey of tobacco habits among people aged over 15 in Bangladesh, Brazil, China, Egypt, India, Mexico, the Philippines, Thailand, Turkey, Ukraine, Uruguay and Vietnam, as well as Britain, Poland, Russia and the United States, from 2008 to 2010.
The surveys covered smoking as well as chewing tobacco — an oral carcinogenic that is especially popular in India, with 205 million users — and snuff.
Topping the table was Russia, where 39.1 percent of all over-15s used tobacco, followed by Turkey (31.2 percent), Poland (30.3 percent), the Philippines (28.2 percent) and China, with 28.1 percent.
By comparison, prevalence in Britain was 21.7 percent and 19.9 percent in the United States.
Policies to discourage or restrict tobacco use are few and flawed in many countries, according to the study, headed by Gary Giovino from the University at Buffalo in New York state.
In low-income countries, for every $9,100 received in tobacco taxes, only $1 was spent on tobacco control.
At present, the proportion of deaths from tobacco is greatest in rich countries, where 18 percent of deaths are attributable to tobacco use, compared to 11 percent in middle-income countries and four percent in low-income countries.
But smoking rates have been rising steadily in poorer countries and falling in rich ones, so these positions are likely to change, the study said.
On current trends, as many as a billion people could die prematurely from tobacco use during this century, the study said, citing estimates by World Health Organization (WHO) experts.