One in three adults worldwide (>1.1 billion people) smokes; 80% live in low- and middle-income countries. Tobacco use causes five million deaths each year and, if current smoking patterns continue, will kill 10 million persons annually by 2020. From 1970 to 2000, tobacco leaf production decreased by 36% in developed countries but more than doubled in developing countries. China is the world's leading producer and consumer of tobacco. Seven multinational tobacco companies dominate the world cigarette market, led by Altria, British American Tobacco, and Japan Tobacco, which collectively manufacture more than 2 trillion cigarettes per year. Extensive knowledge exists about effective tobacco control interventions. However, dissemination of best practices and adoption and implementation of recommended policies are fragmentary. The Framework Convention on Tobacco Control (ratified by 140 countries as of October 1, 2006) provides a template outlining the ingredients for a comprehensive tobacco control campaign.