The Side Effects of Smoking. Which Countries Smoke Most?

Cigarettes are the most lethal consumer product on the planet, responsible for over 7 million deaths annually₂ and therefore the biggest preventable cause of disease in the world₃. A billion people smoke₄. The tobacco industry has resisted with misinformation and well-funded public-relations campaigns, opposing and undermining health measures wherever it can; if defeated, firms continue the same abuses in other countries₅. The industry has such rich and influential lobbies that most governments find it difficult to make progress in curbing smoking rates.

If you smoke, you are more likely to drink. If you smoke or drink, you are also more likely to do drugs. Only 15% of men in the highest professional classes smoke, but 42% of unskilled workers do₆. Smoking is higher amongst those who are already in trouble: single mothers smoke at 55%, most homeless do and practically all drug addicts do₆. Smoking during late pregnancy reduces the IQ of babies by an average of 6.2 points₇ and causes increased antisocial behaviour. Aside from the financial cost to taxpayers and the health costs to individuals, indirect negative economic effects result from increased rates of disease and sick days lost from work₂.

The table on the right show which countries have the worst (highest) smoking rates and which countries have the fewest smokers. The numbers given are the averages from all years throughout the 2020s (so far).

1. The Effects of Smoking on Health
2. Social Issues
   1. Irresponsible Parenting
   2. National Economic Costs
   3. Workplace Politics
   4. The Broken Culture of Poverty and Poor Decision-Making
3. Effective Measures to Reduce Smoking Rates
4. The Tobacco Lobby: Fake Science, Legal Aggression, Lies and Misinformation
5. Smoking Rates in the UK: The Slow Victory of Public Health Over the Tobacco Industry
6. Smoking Rates by Region
7. All Countries' Smoking Rates
8. Links

“Smoking is one of the leading causes of statistics.”

Fletcher Knebel
Penguin Dictionary of Modern Humorous Quotations

1. The Effects of Smoking on Health₈

#health #IQ #parenting #smoking

Smoking is the biggest preventable course of disease in the world_9,10,11, responsible for over 7 million deaths annually₂, and is a direct cause of many types of cancer₁₂ and disability₁₃. Smoking risks chronic bronchitis, emphysema and asthma and heart problems, and its damage to your breathing makes smokers less likely to exercise₁₄. It increases aging by damaging DNA; each year you smoke a pack per day, you age the equivalent of 2 years₁₅. Half of all long-term smokers will die from a related disease₁₆. Giving up smoking reduces your risk of Coronary Heart Disease by half within a year of stopping₁₇. It reduces average life spans by 12 to 15 years₄. Since anecdotal evidence began in the 17th century₁₈, the dangerous health risks of smoking are attested to by more evidence than for any other cause of disease.

Smoking does not just effect those who chose to smoke. Being subject to smokers' fumes ('passive smoking') also causes harmful side-effects₁₉ including cancer, heart disease, asthma and lung damage_17,20. The World Health Organisation says that "second-hand smoke [in] restaurants, offices, homes, or other enclosed spaces [also] kills around 1.6 million people prematurely every year"₂. This has been particularly problematic for children and those who work in restaurants and public houses₂₁. Mothers who smoke risk their own babies_14,22,23 and cause them lower IQ_24,25, ADHD₂₅ and behavioural problems₂₄.

For more, see:

• "The Effects of Smoking on Health" by Vexen Crabtree (2018).

2. Social Issues

2.1. Irresponsible Parenting₂₆

#health #parenting #smoking #UK #uk_health

“Advice to stop smoking is often given by doctors to pregnant women from the onset of pregnancy because there are biological risks to the foetus when a mother smokes₁₄. Smoking by mothers causes a range of disadvantages for the future lives of their baby; it is linked with lower IQ and ADHD₂₅. Avoiding smoking, and avoiding passive smoking, both help mothers protect their unborn babies and gives them the best chance at a healthy birth₂₂.”

"The Effects of Smoking on Health: 4. The Effects on Unborn Children of Their Mother Smoking" by Vexen Crabtree (2018)

“In 1991 in the UK 16% of 11-15 year-old children smoked, but by 2016 this had fallen to 3% (but still, that's far too many children)₂₇; they are more likely to smoke if they live with others who do so₂₈. There has also been improvement in how many mothers remain smokers whilst carrying a baby to term, falling to below 11% in 2016₂₈.”

"Smoking Rates in the UK: The Slow Victory of Public Health Over the Tobacco Industry: 4. The Broken Culture of Poverty and Poor Decision-Making"
Vexen Crabtree (2018)

The younger people start to smoke, the more they cost themselves and society. One scientist points out that the "vast majority" of smokers start doing so as children₂₉. One of the key preventative measures according to a Public Health organisation in the UK is to encourage healthy behaviours in children, which in turns makes it more likely that as adults they also live healthily - "we need to focus much more on prevention and early intervention, helping people to help themselves and their communities to be as healthy as they can be and for as long as possible. [...] We all need to take responsibility for our own health and wellbeing, but for many it is more difficult than it should be. For example, healthy behaviours in childhood and the teenage years set patterns for later life yet we know that not all children have a realistic opportunity of a good start in life" (PHE 2013 ₃₀). Such effects are such a part of common sense that it is tempting to think that parents who smoke are engaging in a form of long-term child abuse. In other words: a prerequisite for responsible parenting is to give up smoking.

The effect of smoking takes place across all income classes. It affects the children of professionals as much as the children of the unemployed: Money cannot make up for the loss accrued from smoke (and passive smoking) during pregnancy. It so happens that smoking is also correlated with low IQ, hence, having parents who smoke causes a double whammy of issues.

2.2. National Economic Costs ₃₁

Aside from the financial cost to taxpayers and the health costs to individuals, indirect negative economic effects result from increased rates of disease and sick days lost from work.

“The economic costs of tobacco use are substantial and include significant health care costs for treating the diseases caused by tobacco use as well as the lost human capital that results from tobacco-attributable morbidity and mortality.”

World Health Organisation₂

2.3. Workplace Politics

#france

There has long been a bone of contention between smokers, who take frequent breaks outside, and non-smokers, who are more inclined to feel guilty (however misguided) over such breaks. This small-scale conflict highlights a greater debate over human free will. For those who take frequent smoke breaks do so in addition to any standardized workplace breaks, to which most non-smokers tend to stick. The latter view the former's extra breaks as frivolous, whereas smokers view them as normal. The view of the militant anti-smoker is that smokers have chosen to smoke, and therefore are skiving work. The view of smokers is that we live in a culture that simply accepts "smoke breaks". It seems those who have chosen the less responsible lifestyle choice are being rewarded with extra time off, therefore encouraging ill-health.

The measures that some French companies have taken - clocking people's smoking time against their wages - has the potential to officially take into account the time-management practices of smokers and non-smokers. If computer-game addicts were often seen sneaking off to the rest room for a quick game, then, that time too should be deducted. Such methods can be taken too far, but, if in the case of smoking we can discourage a public health issue through time-monitoring, it is probably a good idea, and it will also appease activist non-smokers.

2.4. The Broken Culture of Poverty and Poor Decision-Making

“Today only 15% of men in the highest professional classes smoke, but 42% of unskilled workers do. Despite punitive taxation - 20 cigarettes cost around £5.00, three-quarters of which is tax - 55% of single mothers on benefits smoke. The figure for homeless men is even higher; for hard drug users it is practically 100%. [...] The lower down they are on practically any pecking order - job prestige, income, education, background - the more likely are people to be fat and unfit, and to drink too much.”

The Economist (2007)₆

The psychologists Davison & Neale pointed out in 1997 that smoking is more common amongst unskilled and manual workers, prevails among "less educated" individuals₃₃, and is associated with poverty. Steven Jackson reported almost the same percentages as The Economist, in 1998:

“Approximately 15 per cent of professionals smoke in comparison to over 40 per cent of unskilled manual workers.”

"Britain's Population: Demographic Issues in Contemporary Society" by Stephen Jackson (1998)₃₄

Smoking is intertwined deeply with "trash culture". If you smoke, you are more likely to drink. If you smoke or drink, you are also more likely to do drugs. Such was the conclusion of the 1999 publication from the Office for National Statistics entitled "Smoking, drinking and drug use among young teenagers in 1998". A key factor of trash culture is that it is self-promoting. Once trash habits become accepted, they spread themselves. This entire culture is itself a harmful disease.

Amongst young teenagers, "the likelihood of having ever used drugs is strongly related to smoking experience: 63% of regular smokers had used drugs, compared with only 1% of those who had never smoked". With drinking the statistics are also similar and cyclic: 44% of young teenagers who drink also get involved in drugs, compared with only 1% of children who don't drink. And importantly, in case it is doubted that all these factors propagate one another, "virtually no children who had never smoked or drunk had ever used drugs".

3. Effective Measures to Reduce Smoking Rates ₃₁

#health #ireland #smoking #tobacco #tobacco_lobby

There are some uncontentious and proven steps that help reduce national tobacco use. (1) Use tax to increase the cost of cigarettes and tobacco; the evidence is 'crystal clear' that this reduces consumption_35,36. (2) Break the positive image of smoking in society - the expectation of something good drives continued involvement in smoking before addiction becomes the main factor behind consumption₃₇. (3) Starting with Ireland in 2004, 79 countries have come to protect non-smokers with smoke-free laws₂ especially in indoor areas such as restaurants, although sometimes also in general public areas "like parks and beaches"₃₈. This ensures that smokers and non-smokers can both freely exist, without impeding on each others' rights to choose. (4) Mandate health warnings on tobacco products as the industry has utterly refused to educate its own customers. These were introduced in 2003 across the EU₂₁ and since then, at least 110 countries have followed suit₂. (5) Enforce a minimum age for purchasing tobacco₃₅ to ensures that customers have a better chance to understand the seriousness of the risks before they choose to get involved.

There are also a few harsher steps that are required if the tobacco industry rejects public health moves, continues to campaign with health misinformation, or undermines the other measures that government can take: (6) Insist on plain packaging on cigarettes with no PR content removes the positive (and often deceitful) messages that tobacco firms put on packaging₃₉. Finally, (7) ban tobacco advertising altogether, a step taken by 68 countries₂. Every one of these measure has been opposed by the tobacco industry and politicians within their influence₄₀.

For more, see:

• " Effective Measures to Reduce Smoking Rates" by Vexen Crabtree (2025).

4. The Tobacco Lobby: Fake Science, Legal Aggression, Lies and Misinformation

#health #smoking #tobacco_lobby

Tobacco companies are fundamentally opposed to public health, and rely on generating addicted customers₂. They have resisted, undermined and campaigned against all programmes that aim to educate the public on the harms of smoking or that try to reduce smoking rates. When child labour was made illegal throughout much of Europe and health and safety laws prohibited the direct handling of toxins by factory workers, tobacco firms like British American Tobacco simply moved production abroad and continued those horrendous practices elsewhere₄₁. They have opposed limits on advertising cigarettes to children and continue to do so in countries where it is still legal. They've refused to put health warning on products and ran legal battles against attempts to make them do so under grounds of intellectual property rights. They've campaigned against legislation against smoking in public places in order to protect non-smokers and children from the effects of passive smoke and created fake organisations that pretend to be 'citizen's groups' who oppose such bans. Tobacco firms have created fake science reports, funded many reports and then only published ones that cast doubt on established health science. They put more money (billions upon billions) in PR campaigns against public health messages than government and health bodies are able to match, permanently and successfully causing the public in most countries to severely underestimate the risks and harms of smoking._{5,2,10,42,43,44,45}

For more, see:

• " The Tobacco Lobby: Fake Science, Legal Aggression, Lies and Misinformation" by Vexen Crabtree (2025).

5. Smoking Rates in the UK: The Slow Victory of Public Health Over the Tobacco Industry₄₆

#health #smoking #UK #uk_health

With determination and persistence, it is possible to fight against multinational tobacco companies, and most of the developed countries of Europe have done very well in doing so. The UK is a prime example:

“Smoking is the UK's biggest cause of preventable death and 100,000 people die from related diseases every year₄₇. The health of the nation affects everyone in the long-run₉ - although in 2016/17 tax on cigarettes earned the government £7.6 billion₂₈, in 2010 statistics showed the total cost to the economy of smoking (including NHS costs) was £13.7 billion₄₈. 474,000 hospital admissions every year in England are directly due to smoking₂₈.

But things are moving in the right direction. Since the 1970s, the government has enacted a stream of laws to improve public health: strong restrictions on advertising cigarettes, enforced health warnings on packs, increased costs, banned sports sponsorships and banned smoking in public enclosed spaces._28,10,21. Each of those measures was fought through long legal and PR campaigns by the tobacco industry_10,21. But it is working, and smoking rates in Great Britain have declined from 50% in 1974 to 16% in 2016, and the spectre of childhood smoking has declined to 3%._28,27”

"Smoking Rates in the UK: The Slow Victory of Public Health Over the Tobacco Industry"
Vexen Crabtree (2018)

6. Smoking Rates by Region ₄₉

#health #smoking

All regions of the world are seeing a long-term reduction in smoking rates of compustible cigarettes; however good this may be, note that vaping is not included in this WHO dataset - although the downwards trend looks like it preceding the general availability of vaping equipment, especially in some regions, therefore, the reduction in traditional smoking habits is unlikely to be due in full due to smokers switching to vaping.

Within these regions, poorer countries are not well equipped to mitigate against the health effects of tobacco addiction. The World Health Organisation says that "around 80% of the 1.3 billion tobacco users worldwide live in low- and middle-income countries, where the burden of tobacco-related illness and death is heaviest₂. "When people in poorer countries take up the habit, where the risks are compounded by poor diets, by not having access to healthcare, and by high levels of pollution, the likelihood of tobacco causing illness is even higher"₅₀ and when illness does occur, poor countries are less able to care for patients, especially as smoking causes some particularly difficult diseases.

7. All Countries' Smoking Rates ₄₉

#health #smoking

Average smoking rate in the 2020s (so far):