In 1964, when the U.S. surgeon general's office published the famed report that officially confirmed the link between smoking and cancer, nearly half of American adults smoked.
To understand just how smoky life was back then, watch any episode of Mad Men, the TV series set on Madison Avenue in the early 1960s. Without a second thought, almost every character lights up regularly, at the office, at home, in restaurants, bars, cars, even at the dinner table in front of the kids.
Happily, those days are over. Over the past 40 years, anti-smoking efforts - education, lawsuits, advertising restrictions, cigarette taxes - have had a huge effect on our behavior. Just one in five adults now smokes.
But for much of the planet, the era of pervasive smoking is not over. In fact, it's just getting fired up. In many developing countries, particularly in Asia, smoking rates are above 50 percent. In some places, rates are rising. Especially worrisome: In many poor countries, rates of female smoking are increasing most rapidly.
These trillions of cigarettes will have enormous health consequences. The World Health Organization this year predicted that by 2030, tobacco-related deaths will rise to 8.3 million per year, up from 5 million now. More than 80 percent of those who die will live in developing countries, WHO says - places where health care systems are already strained beyond capacity. In the 20th century, by contrast, 70 percent of tobacco-related deaths occurred in rich countries.
The key engine behind this trend is corporate greed. In developed countries, tobacco use is dropping. To keep their profits high, multinational tobacco companies such as Philip Morris and British American Tobacco are expanding aggressively into new territory.
"They're looking to offset their losses," says Greg Connolly, a professor at the Harvard School of Public Health and an expert on Big Tobacco's global expansion. "Philip Morris has been trained in the U.S., the country that's the most hostile in the world to cigarette smoking. When they go into Armenia or India, it's easy."
In general, developing countries are a cigarette marketer's dream. They typically have little regulation, even less enforcement and low taxes, as well as customers and health officials who often don't realize tobacco's dangers.
