The tobacco industry predicts a global expansion of the tobacco epidemic in the next few years.The increases in consumption lie principally in the developing nations, while consumption in the industrialised countries will be static or in decline.In all the countries surveyed, the biggest growth between 1998 and 2008 is expected to be in Zimbabwe, followed by Côte d’Ivoire, Brazil, Morocco, Venezuela, Pakistan, United Republic of Tanzania and Bangladesh.

The greatest decline is expected in New Zealand, followed by the UK, South Africa, Hong Kong, Australia, Singapore and Finland. In Africa, only the South African market is expected to decrease. In the Americas, growth in Latin America is expected to compensate for declines in the USA and Canada, with the greatest increases in Brazil, Venezuela, Mexico, Peru, Chile and Uruguay.

In Europe, the forecast is mixed, with increases in some markets and decreases in others.

The biggest increase is expected in Norway, and the greatest decline in the UK.In the Middle East region, the highest growth is expected for Morocco, followed by Pakistan

and Tunisia. No country in this region is expected to experience a decline in consumption.

In South East Asia, Bangladesh will see the highest growth, followed by Thailand, while

consumption remains static in India.

In the Western Pacific, Vietnam tops the growth charts, while New Zealand, Hong Kong,

Australia and Singapore show the greatest decline. This transfer of the epidemic from rich to poor countries, with its health and economic consequences, is one that developing countries can ill afford. As long ago as 1986, the World Health Organization predicted that the differential in wealth between rich and poor countries would widen further as a result of tobacco, leading to compromise in sustainable development.

These projections are not inevitable; tobacco control interventions can make a difference.