# II. Background

Tobacco consumption Georgia faces high and increasing rates of tobacco consumption. The smoking prevalence in Georgia is among the highest in countries of the European region of the World Health Organization (WHO) (NCDCPH et al. 2016). Approximately one million Georgians are current tobacco users, and prevalence rates have increased over the last two decades (NCDCPH et al. 2016).

<mark>High prevalence of tobacco consumption is particularly concentrated among adult males (Table 1). In 2016, 57 percent of adult males were smokers and 51.5 percent were daily smokers (WHO 2017). Smoking among females is less common. Approximately 7 percent of women were smokers in 2016, and 6.2 percent were daily smokers (WHO 2017). More concerningly, the rate of current female smokers doubled in recent years (UNDP 2018). According to the Global Youth Tobacco Survey (GYTS 2017), 12 percent of teenagers (13 to 15 years old) consume tobacco, including 17 percent of boys, and 8 percent of girls.</mark> Smokeless tobacco is more common among the youth. Only 0.6 percent of adults (ages 18-64) consumed smokeless tobacco in 2010, but 3.4 percent of children (ages 12-15) consumed these products in 2014 (NCDCPH et al. 2018). Second-hand smoking affects a large share of the population. More than 40 percent of population—including children and pregnant women—are exposed to second-hand smoke (UNDP et al. 2016). Over 43 percent of students report suffering exposure to tobacco smoke at home (GYTS 2017).

Cigarette smoking is the most common form of tobacco consumption.<sup>2</sup> Filtered cigarettes are the most common type of tobacco product consumed, and only a small percentage of the population consumes unfiltered cigarettes or both (Little et al. 2019).<sup>3</sup> Evidence also suggests that smoking frequency (the number of cigarettes smoked daily) tends to be higher for individuals with low educational attainment and those unemployed (Little et al. 2019).<sup>4</sup> Table 1. Adult smoking prevalence in Georgia _<u>(Percent of adults)</u>_

||Male|Female|All|
|---|---|---|---|
|Current tobacco smokers|57.0|7.0|31.0|
|Dailytobacco smokers|51.5|6.2|28.0|

_Source:_ Taken from WHO 2017b. Data from the STEPS survey 2016, for adults aged 18 to 69.

> 2 <mark>Georgia was an important producer of tobacco leaves and manufactured cigarettes for the Soviet Union. The tobacco industry collapsed in the early 1990s after independence, leading to the dominance of domestic markets by international brands (Little et al. 2019).</mark>

> 3 According to a household survey on tobacco consumption patterns conducted in 2017, 87 percent of smokers consumed filtered cigarettes, 9 percent consumed unfiltered cigarettes, and 3 percent consumed both. Only 1 percent preferred other products, including cigars and e-cigarettes. The survey interviewed 2,997 smokers in the cities of Tbilisi and Kutaisi, and the municipalities of Zugdidi, Gori and Akhaltsikhe. It was not designed to be representative of the national population (Little et al 2019).

> 4 Individuals with less than secondary school education smoked 23 cigarettes per day, and those unemployed smoked 22 cigarettes per day (Little et al. 2019).

3