New research published in The Lancet in May revealed that the number of smokers worldwide reached an all-time high of 1.1 billion. In 2019, deaths related to smoking hit 8 million and numbers continue to rise as more and more young people pick up the habit. Despite smoking prevalence has decreased over the last three decades, it has increased for males in 20 nations and women in 12. China, India, Indonesia, the United States, Russia, Bangladesh, Japan, Turkey, Vietnam, and the Philippines accounted for two-thirds of the world’s smokers. China has 341 million smokers, accounting for nearly one-third of the world’s total.

The research analyzed trends in 204 countries as part of the Global Burden of Disease study, which studies health issues that affect mortality and disability at national, regional, and worldwide levels. The findings showed that half of all countries had made little progress in reducing uptake among 15- to 24-year-olds, and the average age at which someone began smoking was 19 years old. According to the study’s authors, governments should focus on reducing the number of smokers among young people since 89% of new smokers become addicted by 25 years old but are unlikely to start beyond that age. “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,” said Marissa Reitsma, the study’s lead author, a researcher at the Institute for Health Metrics and Evaluation.