Intended for healthcare professionals


Tobacco smoke and environmental injustice

BMJ 2018; 363 doi: (Published 08 October 2018) Cite this as: BMJ 2018;363:k4201
  1. Nicholas S Hopkinson, reader in respiratory medicine
  1. National Heart and Lung Institute, Imperial College, London, UK
  1. n.hopkinson{at}

Burning the developing world’s resources

“My country, Malawi, has lost most of its forests to tobacco,” Paul Desanker, a manager in the UN Framework Convention on Climate Change adaptation programme, told the eighth conference of parties to the WHO Framework Convention on Tobacco Control last week.

Tobacco smoking remains a leading preventable cause of death, killing more than seven million people a year,1 with health effects across a huge range of acute and chronic conditions.2 The WHO Framework Convention on Tobacco Control, established 15 years ago, is the first ever global health treaty. Ratified by 181 countries, and covering 90% of the world’s population, the treaty calls on parties to implement policies that protect individuals and limit the activities of the tobacco industry.

Key measures are highlighted in the MPOWER framework3—monitoring tobacco consumption; protecting people from passive exposure through smoke free laws; offering support to quit; warning of the dangers of tobacco; enforcing bans on tobacco advertising, promotion, and sponsorship; and raising taxes on tobacco. Evidence is compelling …

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