1.1. billion people smoked in 2019. But the U.S. had fewer smokers.

Although smoking has decreased in the United States since the 1990s, new research shows there was a global record high of 1.1 billion people who smoked in 2019.
Published on Thursday, the number of smokers was directly tied to population growth, a new peer-reviewed study published in the medical journal The Lancet claims.
The study stated that in the last 30 years, smoking tobacco accounted for over 200 million deaths. The annual economic costs exceeded $1 trillion.
“I’m not surprised at all. Tobacco use smoking is still the No. 1 preventable cause of death worldwide,” Dr. Albert Rizzo, the chief medical officer for the American Lung Association, told USA TODAY.
Ten countries made up two-thirds of the global tobacco smoking population: China, India, Indonesia, the U.S., Russia, Bangladesh, Japan, Turkey, Vietnam and the Philippines.
The Centers for Disease and Control Prevention reported smoking decreased in the U.S. from 20.9% in 2005 to 14% in 2019. The U.S. also saw the lowest number of cigarette smokers between the ages of 18 to 25.
Despite the reported decrease in smoking in the U.S., Rizzo said other data remain high because nicotine is one of the most addictive substances. He said the “early adoption” of smoking in teens makes quitting extremely difficult later in life.
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Roughly 89% of smokers become addicted by the age of 25, and the authors of the study said there needs to be a targeted focus on young people, the Guardian reported.
Rizzo added nicotine addiction needs to be tackled with multiple interventions, including pharmacologic and counseling support. Although he said the ability to get coverage for medications and counseling may not be accessible depending on your insurance coverage.
Many smokers use nicotine as a stress reliever. Rizzo said the past year has brought on job, family and relationship stressors which can make it harder to quit as well.
Rizzo and the study’s lead author Marissa Reitsma agree the tobacco epidemic won’t end anytime soon.
“Young people are particularly vulnerable to addiction, and with high rates of cessation remaining elusive worldwide, the tobacco epidemic will continue for years to come unless countries can dramatically reduce the number of new smokers starting each year,” Reitsma told The Guardian.
The study estimated the prevalence of smoking in 204 countries, with 113 of them seeing an increase of smokers since 1990.
The study also said smoking was likely to increase over the next decades, and effective implementation and enforcement of tobacco control policies were needed to increase life expectancy and decrease health care costs.
New tobacco control policies have been introduced over the last few years, with the Biden administration announcing its plan to ban menthol cigarettes and flavored cigars in April.
“Banning menthol — the last allowable flavor — in cigarettes and banning all flavors in cigars will help save lives, particularly among those disproportionately affected by these deadly products,” Dr. Janet Woodcock, acting head of the Food and Drug Administration, said in a statement. “With these actions, the FDA will help significantly reduce youth initiation, increase the chances of smoking cessation among current smokers, and address health disparities experienced by communities of color, low-income populations, and LGBTQ+ individuals, all of whom are far more likely to use these tobacco products.”
And in 2019, former President Donald Trump signed legislation to raise the federal minimum age for the sale of tobacco products from 18 to 21.
Despite the “unsurprising” trends found in the study, Rizzo said tobacco use will decrease with continuous government and societal pressure and effort.
“We can’t relax our efforts despite any numbers or studies. We need to do everything we can to decrease the smoking prevalence.”
Follow reporter Asha Gilbert @Coastalasha. Email: agilbert@usatoday.com.