Projections of future tobacco use across the globe could be dramatically underestimating the extent of smoking in years to come, researchers have said.

The claim follows the publication of the results of a huge international survey into the use of tobacco among teenagers in more than 130 countries. The research, published in The Lancet, shows 9% of 13 to 15-year-olds smoked, and an even higher figure - 11% - used other tobacco products. But the team which conducted the Global Youth Tobacco Survey (GYTS) believe one of its most worrying findings was the apparent closing of the gap between the proportion of boys and girls who smoke. Previous research has suggested men are four times more likely than women to smoke across the world. But the GYTS showed boys were only 2.3 times more likely to smoke than girls globally, and in many countries there was no difference. According to the paper: "If the similarity in smoking rates by sex persists as these students age into adulthood, this shift in behaviour compared with older groups will have important implications for the global burden of chronic diseases and should be considered in future mortality projections." Team leader Charles Warren, from the Centers for Disease Control and Prevention, in Atlanta, said: "Tobacco use is a major worldwide contributor to deaths from chronic diseases and findings from the GYTS suggest current dire warnings that the annual death toll will double to 10 million by 2020 may be a conservative estimate. "The true toll from tobacco use could be even greater with high rates of non-cigarette tobacco use and high rates of smoking among young girls. "Reduction of tobacco consumption will require a redoubling of efforts to prevent initiation and promote cessation among the large proportion of young people who currently use tobacco." The survey also showed more than 30% of students were exposed to second-hand smoke at home, and more than 45% were exposed to second-hand smoke in public places.

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