Tobacco use remains the single largest preventable cause of premature mortality worldwide. It is a driver of cardiovascular disease, cancers, chronic respiratory disease, and a wide range of other conditions. Despite decades of evidence, tobacco continues to exert a profound influence on global health, particularly in low- and middle-income countries where industry expansion has been most aggressive.

This episode explores:

• The epidemiology of tobacco use globally• Patterns of consumption across regions and age groups• The health consequences of smoking and smokeless tobacco• Second-hand smoke and population-level exposure• The political economy of the tobacco industry• The WHO Framework Convention on Tobacco Control (FCTC)• Population strategies: taxation, advertising bans, plain packaging• Behavioural and pharmacological approaches to cessation• Emerging products, including e-cigarettes

Tobacco is not merely a behavioural issue - it is a structural and commercial determinant of health. Effective control requires legislation, taxation, public education, clinical support, and vigilance against industry tactics that undermine policy.

The chapter frames tobacco control as one of the clearest examples of public health success when evidence, policy, and advocacy align - yet also as a reminder that gains are fragile and require sustained commitment.

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Key Takeaways

• Tobacco is the leading preventable cause of global mortality• Most tobacco-related deaths now occur in LMICs• Second-hand smoke contributes significantly to disease burden• Taxation is among the most effective control strategies• Comprehensive policy requires legislative and behavioural approaches• Industry interference remains a central barrier• Tobacco control demonstrates the power of population-level intervention

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