A supplement published in the journal Cancer Causes and Control featured 11 studies showing the disproportionate impact of tobacco use, secondhand smoke exposure, and tobacco-related cancer and disease among those those of lower socioeconomic position and, in some cases, by gender and race/ethnicity.
"Tobacco's impact has reached epidemic proportions around the world," Dr. Donna Vallone, senior vice president for research and evaluation at legacy and co-editor of the special supplement, said in a statement. "This special issue confirms what we have known in public health for many years: Tobacco is not an equal opportunity killer, it impacts the health and economies of poor nations."
The World Health Organization said nearly 80 percent of the world's 1 billion smokers live in low- and middle-income countries in Latin America, Asia, and Africa.
Studies conducted in Vietnam and China show how vulnerable populations -- including women and children, racial/ethnic minorities and the poor -- are disproportionately affected by secondhand smoke exposure, Vallone said.
In addition, data from Southeast Asia show a five-fold mortality increase from oral cancers among tobacco chewers compared to never chewers with a strong and inverse association with education.
"This is a critical opportunity for preventing the progression of tobacco use among women in many low- and middle-income countries particularly those in Sub-Saharan Africa and Asia," Vallone said. "The supplement allows us to take a look at where the burden lies, so that interventions can be tailored accordingly."