Thanks to celebrity activism and widespread media attention, HIV, malaria and starvation are well-known diseases of the third world. But there's another resource-draining plague afflicting these countries, one hiding in plain sight: smoking.
While the smoking population is half what it was a generation ago in the U.S. and other industrialized nations, with only one in five using tobacco, it's different in Africa and East Asia, where time stands still when it comes to cigarettes.
Smoking rates of 40% or more of the population are common in these regions, making for an extra-tough health hazard when medical services are as limited as filterless, hand rolled smokes are plentiful.
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We assembled a list of the countries where the highest percentage of citizens smoke according to the most recent public health data available and ranked them based on that figure. But we also took it further, estimating the potential drain on each nation's potential income opportunity due to smoking deaths as compared to the nation's gross domestic product.
Societal costs in those countries can't be calculated the same way they would be in the U.S., where most studies measure how much smokers burden taxpayers with extra Medicare and Medicaid payments. For poor countries, there is no Medicare-like program to fund. Nor is there enough data about the economic impact of other diseases to make real comparisons.
"In Africa, these health care systems don't exist, at least not in the form we're used to," says Tom Glynn, Director of International Care Control for the American Cancer Society. Only Kenya, he says of Africa's low income nations, has a medical care system that reasonably resembles that of the western world.
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