Aim: To comprehensively review adult and youth smoking prevalence data in Pacific Island countries and territories (PICT).
Methods: MEDLINE search for period 1986-2006 and search of World Health Organization and Centres for Disease Control and Prevention databases.
Results: Smoking prevalence in PICT ranges from 22%-57% (males) and from 0.6%-51% (females). All PICT male populations (except Palau) report higher rates than in Australia and New Zealand. Nauru, Tokelau, French Polynesia, New Caledonia, and Kiribati report high rates of female smoking. Youth rates of smoking range from 3%-68% (although unavailable for many PICT). Palau, Northern Mariana Islands, Guam, Cook Islands, and American Samoa report very high levels of youth smoking in both males and females. Smoking prevalence appears to have decreased in the last 30 years in male populations with a variable picture in female populations.
Conclusions: PICT continue to show high levels of smoking prevalence, with youth smoking rates particularly concerning. There is a need for more robust and systematic collection and publication of smoking prevalence data in PICT, especially youth data, but this should not delay urgently required action to reduce tobacco use in PICT. The Framework Convention on Tobacco Control provides a powerful tool, but its provisions should be implemented rapidly, particularly increased tobacco taxation.