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Supporting the urban poor to quit tobacco: adding years to lives
  1. Kamran Siddiqi1,
  2. Helen Elsey2
  1. 1Department of Health Sciences, University of York, York, UK
  2. 2Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
  1. Correspondence to Dr Kamran Siddiqi, Department of Health Sciences, University of York, Seebohm Rowntree Building, Heslighton, York YO10 5DD, UK; kamran.siddiqi{at}

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Tobacco use is in decline in most high-income countries (HICs); however, the number of tobacco users are rising in many low/middle-income countries (LMICs).1 Consequently, by 2030 tobacco-attributable deaths are projected to rise to 8.3 million per year with more than 80% occurring in LMICs.1 Furthermore, the tobacco-attributable burden is not evenly distributed within these nations; being highest in socioeconomically disadvantaged and marginalised sections of society.2 The urban poor—the participants of the trial published by Sarkar et al3 in Thorax—are particularly vulnerable. For example, 55% of the poorest 20th centile of urban male residents in South Asia use tobacco in contrast to 40% of the richest.4 Quitting tobacco leads to immediate benefits and if stopped before the age of 40, the associated risk of death is reduced by 90%.5 However, tobacco being an addictive substance, most users struggle to quit and many only do so with behavioural and/or pharmacological support.6 According to Global Adult Tobacco Survey, more than 30% of smokers in LMICs attempted to quit in the previous year (15% in China).7 However, in most countries in particular LMICs, cessation advice or services are not available.8 Even where they are, the urban poor are least likely to receive cessation advice …

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