While much of the industrialized world has seen a big drop in the number of smokers, the opposite is true of many emerging and developing markets in Asia. Health officials are concerned.
Big tobacco companies like big numbers, and they're finding them in Asia, with the world's largest and fastest growing population.
Take China with its estimated population of 1.3 billion people: More than 300 million Chinese already smoke. Or consider India with its 1.2 million people: Around 275 million people there are tobacco users, according to recent World Health Organization (WHO) figures.
Having a puff
Those are significant numbers in their own right. But a closer look at them shows even greater potential for profit-driven tobacco companies: In China, for instance, just over 2 percent of tobacco users are women and about 10 percent of teenagers smoke.
The WHO is acutely aware of Asia's potentially dangerous demographics when it comes to having a puff.
"Countries with low numbers of people smoking are markets waiting to be tapped," said Edouard Tursan D'Espaignet of WHO's tobacco control program. "In many Asian countries like China and India where men already smoke at an incredibly high rate, women and young people are now being targeted by the tobacco industry."
Tursan D'Espaignet warned of an "onslaught coming their way" and from the terrible illness and death it will bring.
Already, approximately 1 million smokers in China die each year from tobacco-related diseases and about 100,000 people die from exposure to second-hand smoke, according to the Campaign for Tobacco-Free Kids. If current trends continue, the non-governmental organization expects the country's smoke-related death toll to reach 2 million by 2020.
Huge Chinese market
Kicking the habit may not be so easy for China, however. The country is both the largest consumer and producer of tobacco in the world. More than 20 million Chinese farmers produce nearly 40 percent of the global supply. Clearly, there's money to be made.
China's tobacco sales in the first half of this year rose 2.8 percent from a year ago to 1.31 trillion cigarettes, according to the State Tobacco Monopoly Administration. And for the same period, the sector remained one of the country's most profitable, with state-owned tobacco companies reporting a combined profit of 152.04 billion yuan (US$24.08 billion). The government collected 480.7 billion yuan in tax revenues for the period.
Yet, China is aware of the rising health risk and is taking action, according to Tursan D'Espaignet. "We're heartened by developments in China in recent months," he told DW, pointing out that while one part of the state benefited from the tobacco industry, another realized the long-term impact on society.
Tursan D'Espaignet lauded Australia's unprecedented move to prohibit tobacco companies from using their logos on cigarette packets, paving the way to show graphic images associated with smoking habits. And he expects several other countries, including Singapore and India, to follow.
So does E. Ulysses Dorotheo, a director with the anti-smoking group Southeast Asia Tobacco Control Alliance (SEATCA). "The Australian High Court's decision was a victory for public health not only in Australia but throughout the world," he told DW. "It could definitely be a model for Southeast Asia and we are hoping that countries that already have pictorial warnings such as Brunei, Malaysia, Singapore and Thailand will follow suit."
Dorotheo warns of growing tobacco use, primarily smoking, in Southeast Asia. He attributes the upward trend to "increasing affordability of cigarettes in low and middle-income countries, aggressive marketing by tobacco companies and lack of effective regulation in a number of countries, mostly because of strong lobbying by the industry."
Nevertheless, Tursan D'Espaignet claims the WHO's Framework Convention on Tobacco Control, which opened for signature in 2003 and has been adapted by more than 170 countries, has led to strong measures for tobacco control around the world, including Southeast Asia.
In June, for instance, Vietnam passed a law banning smoking in public places and all tobacco advertising. SEATCA welcomed the law, calling it an "historic and important milestone" for the country.
Vietnam has about 15.3 million smokers.
Singapore is seen as one of Asia's most determined countries to curb tobacco usage. Smoking is banned in nearly every public area. Cigarettes are expensive, about US$9 per pack, and packages already contain graphics. Yet the government says smoking is on the rise.
Indonesia, by comparison, is the complete opposite. The country of 240 million is one of the last vestiges of laissez-faire tobacco controls in the world and is paying with the price of growing addiction. Its problem is illustrated with a video circulating on the Internet, showing a toddler with a 40-cigarette-a-day habit.
Indonesia has no ban on advertising. Consumers see ads of well-known athletes promoting smoking and even sporting events named after sporting events.
Some 17.3 million smoke in the Philippines, one of Asia's highest rates, and about 87,000 people die per year of tobacco-related disease, according to Philippine Health Undersecretary Paulyn Jean Ubial.
'Copy the movie stars'
Cambodia also has a smoking problem. Suy Vet, a 33-year factory worker in the Stem Reap province, admits it's sometimes tough not to smoke when everyone is smoking.
"People smoke because their parents smoke or their friends smoke or they're stressed," he told DW. "People smoke because it is also very cheap to smoke here. And they also like to copy movie stars."
WHO claims that tobacco kills half its users. The agency warns in its recently published Global Adult Tobacco Survey that if the current trend continues, it will cause up to 1 billion deaths in the 21st century.
One of best ways to prevent these deaths, Tursan D'Espaignet argues, is to make tobacco products expensive. "Increasing taxes to make tobacco products as unaffordable as possible is the best way to go," he said.
Author: John Blau
Editor: Sarah Berning