A cross-national analysis of demographic variation in daily smoking across 22 countries

Cigarette use, a leading cause of preventable disease and millions of deaths worldwide each year, is not often studied separately from other tobacco use, and global data and previous studies on cigarette smoking are based mostly on its prevalence rather than quantity. To address these oversights, we analyze the first wave of data from Global Flourishing Study, a study of over 200,000 adults nationally representative of 22 countries. We measured cigarette smoking by daily consumption per capita (mean) and per individual who smoked (intensity) as well as prevalence. The mean of daily smoking was positively correlated with the prevalence, whereas the intensity was not significantly related to the prevalence. Similarly, we found that random effects meta-analysis results of country-specific means of daily smoking in each category of demographic variables (age, gender, marital status, employment, religious service attendance, education, and immigration status) were more consistent with the results of prevalence than was the case with intensity, though there was variation across countries. Overall findings indicate the importance of studying the intensity as well as prevalence of smoking, as they are distinct and thus both required in order to assess tobacco-associated health risks and establish informed tobacco control policies.