Document Type


Publication Date



Recent tobacco control regulation in North America and Western Europe has had a salutary effect, even if smoking remains a pressing public health hazard. But in the 21st century, the tobacco industry has quietly moved its locus of activity to lucrative, emerging markets: the vast populations in Africa, Asia, Eastern Europe, and Latin America. The poorest, least educated, and sickest people on earth inhabit these regions. "Big Tobacco's" new marketing strategy will cause untold morbidity for the world's most vulnerable.

However, there are a variety of effective tobacco control policies that nations can and should enact. The World Health Organization treaty, the Framework Convention for Tobacco Control, requires signatory nations to adopt a variety of tobacco control policies to the fullest extent permissible under their constitutions. The Second Conference of FCTC Parties recently set regulatory goals in Bangkok, Thailand, including the first FCTC protocol on illicit trade of tobacco products, a second protocol on cross border advertising regulations.

Effective tobacco control policies include: national tobacco regulatory agencies; comprehensive bans on tobacco advertising, promotion, and sponsorship; health warnings on cigarette packets that cover at least half of the packet, convey the risks, rotate messages, and use images; mandating smoke-free environments; and tax and price policies that make smoking prohibitively expensive.

This article examines legislation and regulation from all parts of the world in each of these spheres, and evaluates their effectiveness. The imperatives of science, ethics, and human rights oblige society to reduce the burden of smoking, particularly among the most disadvantaged.

Publication Citation

298 JAMA 2057-2059 (2007)