This week the journal reports the 40 year results from the world's longest running study of smoking and death, which finds that in Britain about half of all regular cigarette smokers will eventually be killed by their habit (p 901,1 p 9112). Next week more than 1000 delegates will attend the ninth world conference on tobacco and health in Paris. These provide an opportunity to take stock of the current status of tobacco and health worldwide.

The World Bank estimates that the annual tobacco consumption will remain stable between 1990 and 2000 at 1.9 kg per person aged 15 and over.3 That apparent stability masks two divergent trends: falls in tobacco use in the industrialised world and increases in developing regions.

Per capita tobacco consumption is expected to fall by 17% during this decade (from 2.4 kg to 2.0 kg a year) among the 35 “established market economies” of the world. At the same time per capita consumption is predicted to rise by 12% (from 1.7 kg to 1.9 kg a year) in the 180 “demographically developing economies.” Increases in con-sumption are also expected in five of the six formerly socialist economies of Europe for which the World Bank made projections.3

Smoking is responsible for three million deaths a year worldwide. If current smoking patterns continue that toll will have risen to 10 million deaths a year by 2025.*RF 4-6* Following trends in consumption, deaths attributable to tobacco will …