FRIDAY, Aug. 17 (HealthDay News) -- Despite global tobacco control efforts, in low- and middle-income countries, nearly half of men use tobacco, women are starting to smoke at earlier ages, and quit ratios are low, according to a study published in the Aug. 18 issue of The Lancet, a theme issue on respiratory medicine.

Gary A. Giovino, Ph.D., from the State University of New York in Buffalo, and colleagues analyzed data on adult tobacco use from the 2008 to 2010 Global Adult Tobacco Survey of 14 low- and middle-income countries.

The researchers found that, in the participating countries, 48.6 percent of men and 11.3 percent of women used tobacco products. Tobacco smoking rates differed greatly between men and women: 40.7 percent of men (ranging from 21.6 percent in Brazil to 60.2 percent in Russia) but only 5.0 percent of women (ranging from 0.5 percent in Egypt to 24.4 percent in Poland). Most smokers (82 percent) preferred manufactured cigarettes. Older female smokers started to smoke at an earlier age than older male smokers, but among younger smokers, both genders started to smoke at similar ages. In Russia, China, India, Egypt, and Bangladesh, quit ratios were less than 20 percent.

"With behaviors and lifestyle in flux globally and marketing rampant, we can expect initiation of tobacco use to begin at younger ages than at present, and pressures on young women to smoke to increase," write the authors of an accompanying editorial. "In view of the health burden of tobacco use, the underinvestment in tobacco control is extraordinary."

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