Assessing sustainability effects of tobacco use and control in global supply chains.

Tobacco use presents substantial challenges for the environment, social and economic development along global supply chains. Here we assess the global sustainability impacts of tobacco use and control across global supply chains in 164 countries and regions. We find that tobacco use in the top ten downstream countries drove over 50% of global upstream impacts. High-income countries tended to have larger per capita impacts than low-income countries, displacing 42% of health burden and 34% of greenhouse gas emissions to upstream low-income countries. We also observe declines in environmental stressors, disease burden, and employment during 2010-2020, driven by impact intensity, production structure, and tobacco prevalence. Reducing the prevalence of tobacco use as appropriate by 2027 could generate substantial benefits to the environment, health, and economy, albeit with a reduction in employment relative to 2020 levels. Our analyses contribute to a just and sustainable transition towards a healthy and tobacco-free world.