Despite the progress achieved as a result of WHO’s Framework Convention on Tobacco Control and actions taken by many national governments, the consumption of tobacco products remains high and indeed may be increasing in some parts of the world and among certain social and demographic groups. Today tobacco is estimated to be still killing more than six million people a year, including the more than 600,000 non-smokers who are regularly exposed to second-hand smoke. For every one who dies, moreover, another 20 smokers suffer from life-threatening diseases. In the EU alone, more than 650,000 people die every year from smoking-related causes such as cancer, heart disease, stroke, emphysema, bronchitis, and chronic airway obstruction. Half of these deaths occur in the 35-69 year old age group which means a massive blow to the social and economic development of the countries they live and would otherwise have worked in.
Not all people are at equal risk of smoking or of smoking-related diseases, however. While middle-income and well-educated people in North America and Europe are smoking far less than they did in 2000, and far less than lower-income less well educated people, women and adolescents are smoking more now than they used to do. Globally, major differences are also emerging between countries. In the USA, for example, strong anti-smoking policies and better public information have helped to dramatically reduce the number of people who smoke and major health benefits have already been achieved as a result of this. In other parts of the world, especially developing countries, however, improved economic conditions and higher wages have led to a more buying power among people who used to be poor, and rates of tobacco smoking in these groups have grown. For much the same reason, migrants have also emerged as a high risk population.
Migrants tend to move from poor backgrounds and move to settings where their incomes are higher than they were at home. They also tend to live in ethnic minority communities where smoking is still popular. In the USA and other countries where rates of tobacco smoking in the general population have fallen in recent years, rates of smoking among migrants have remained very high, especially among women. One of the main reasons for this is that migrants tend to be overlooked by national health promotion and protection programs and smoking prevention campaigns often fail to reach them with meaningful information. Migrants have rarely been seen as a priority by national health and/or social protection departments and in most countries little is known about the psychosocial factors that drive them to smoke. This is especially so in the case of rural-urban migrants and irregular migrants who remain relatively invisible to national health authorities.
If global smoking rates are to be brought down and global health improved, much more attention will have to be given to this massive and still-growing population of people that is moving from one place to another in search of a better life, but which often sees its health deteriorate significantly as a result of smoking as well as other challenges. The continued neglect of migrants by national anti-smoking campaigns will thus not only harm migrants, but will eventually adversely affect the public health of host countries and increase the health care cost burden on them. Preventing smoking in migrant populations would be a win-win for everyone.
Manuel Carballo
