PIP: Over the past 2 decades, the Third World has become the site for growing tobacco production and consumption. Between 1960-75, tobacco production increased 5-fold in Africa, 46-fold in Latin America, but only 13-fold in Europe. Of the world's 10 top tobacco producers, 5 are in developing countries. Similarly, consumption of cigarettes is increasing twice as fast in developing as in developed countries. In some parts of India, Latin America, and the Philippines, over 70% of people smoke. This pattern can be expected to reproduce an epidemic of smoking-related diseases in the Third World before the end of the century, including lung cancer and coronary heart disease. Smoking also can be expected to affect stillbirth and infant mortality rates. For many Third World countries, tobacco is a valuable cash crop and an important source of foreign exchange. Fertile lands are used to expand tobacco cultivation rather than to produce food for local populations. The Third World tobacco industry is dominated by Wester tobacco companies based in the US, UK, and South Africa. Much of their profit comes from tobacco exports to developing countries and from their subsidiaries there, especially in light of increased awareness in developed countries of the hazards of smoking. Western governments should pressure international tobacco companies to reduce and eventually stop exports to the Third World. Third World Governments should be urged not to depend on tobacco growth and to substitute it for food crops. Health Departments should undertake surveys to determine the prevalence of smoking and, on the basis of study results, introduce appropriate health education measures. Physicians should recommend to governments legislative measures to control smoking. Finally, there should be a ban on advertising, health warnings on cigarette packets, a ban on smoking in public places, and restrictions on the sale of cigarettes to children.