If you walk into a coffee-house and see more women smoking than was the case years ago – that picture may indeed be true, says a recently released global study on tobacco consumption. While Indian men increasingly show signs of snuffing out the habit, tobacco consumption among women remains virtually unchanged. And as the overall population increases, that translates into the paradoxical situation of increasing number of smokers, despite a decrease in the percentage of the population that smokes. “India has more female smokers – over 12.1 million – than any country except the United States. In 2012, female smoking prevalence was 3.2 percent, which is virtually unchanged since 1980,” says the study done by the Institute for Health Metrics and Evaluation (IHME), University of Washington. But in the same period between 1980 and 2012, smoking prevalence among Indian men decreased from 33.8 percent to 23 percent, says the study, done across 187 countries in the ear-marked period. In fact, smoking is the third top risk for health loss in India, leading to nearly one million local deaths each year. These developments come against a global back-drop where trends in age-standardised tobacco use vary greatly by country and gender, with places such as Mexico and Canada seeing rapid declines while others, such as Russia and China, seeing increases since 2006. However, male smokers continued to outnumber female smokers, since 1980, and the global rate of decline in female smoking prevalence was consistently faster than in men, the study found. According to the most recent figures from the Global Burden of Disease (GBD) study, coordinated by IHME, tobacco use (excluding second-hand smoke) led to nearly one million deaths, 6.1 percent of years of life lost due to premature death, and 5.1 percent health loss in India. IHME arrived at its estimates based on a wide range of data sources, including in-country surveys, government statistics, and World Health Organization data, and the estimates cover all ages. Previous estimates have been focused on fewer data sources and a more limited age range, the study said. The greatest health risks for both men and women are likely to occur in countries where smoking is pervasive and where smokers consume a large quantity of cigarettes. These countries include China, Ireland, Italy, Japan, Kuwait, Korea, the Philippines, Uruguay, Switzerland, and several countries in Eastern Europe. The number of cigarettes smoked annually has grown to more than 6 trillion. In 75 countries, smokers consumed an average of more than 20 cigarettes per day in 2012. Smokers in India consumed an average of 8.2 cigarettes per day. There have been three phases of global progress in reducing the age-standardised prevalence of smokers: modest progress from 1980 to 1996, followed by a decade of more rapid global progress, then a slowdown in reductions from 2006 to 2012. This was in part due to increases in the number of smokers since 2006 in several large countries, including Bangladesh, China, Indonesia, and Russia, the study found.