The future of tobacco

Tobacco is a perpetually controversial topic. It causes millions of deaths every year and will continue to do so as addiction to nicotine spreads in developing countries in the most popular form of its delivery, the cigarette.

The history of the public health war against tobacco is filled with victories and losses. Many of the victories, such as advertising bans, have been pyrrhic, in that restrictions that fall short of full eradication have been circumvented, and successful marketing has continued through means that are uncontrolled by national parliaments—Formula One motor racing is a good example. Attempts to regulate tobacco as a drug have failed in the United States and have not been seriously attempted elsewhere, although the European Union has some limited restrictions on tar, nicotine, and carbon monoxide. Canada requires disclosure of the constituents of smoke but applies no restrictive regulations.

The decline in the prevalence of smoking is depressingly slow. The smokable forms of the drug are still used by between a quarter and a half of adults in most countries, and use is increasing among women. Although …