Situation and trends
According to the 2003 World Health Survey (WHS), smoking prevalence, on a global level, is actually slightly lower in urban parts of the world than in rural areas. The global prevalence of smokers in urban areas was 24.3% (95%CI: 23.7-24.9) compared to 25.8% (95%CI: 25.2-26.5) in rural areas. While this shows smoking is not necessarily concentrated in urban areas around the world, there are some urban characteristics that can exacerbate the health impact of smoking. For instance, there might be greater availability of tobacco products and targeted marketing, especially in developing countries, that contribute to higher smoking rates in the city. The absolute number of smokers in urban areas can be considerably large even if prevalence is lower than in rural areas. Furthermore, population density is higher and inequalities in socioeconomic status and living conditions are often worse in big cities, creating the potential for greater exposure to secondhand smoke as well as unequal exposure to the harmful effects of tobacco smoke among the poor.