Addressing the chronic disease burden with tobacco control programs.

Address correspondence to: Samira Asma, DDS, MPH, Global Tobacco Control, Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy. NE, MS K-50, Atlanta, GA 30341-3717; tel. 770-488-5487; fax 770-488-5767; e-mail . Tobacco use is the single largest preventable cause of death worldwide. Tobacco use is increasing rapidly in many developing countries while declining in some developed countries. Its contribution to the burden of disease and death will change between 2003 and 2030. In 2030, despite the declines in some developed countries, tobacco use will still continue to be the single largest preventable cause of death in the world, causing more than 10 million deaths annually.1 This increase will not be shared equally: deaths in developed regions are expected to rise from 1.6 million in 1990 to 2.4 million in 2030, whereas deaths in Asia—home to a third of the world’s population—are expected to escalate from 1.1 million in 1990 to 4.9 million in 2030.1 The importance of rapidly expanding prevention efforts to reverse an acute worsening of the global epidemic cannot be overemphasized. Effective arrays of interventions are available to prevent tobacco use in both developing and developed countries.2 The challenge is to integrate these interventions so they work in concert with each other to optimize the reduction of tobacco use. This article examines the burden of tobacco use and its impact on major chronic diseases and provides a framework for integrating evidence-based interventions through a multifaceted strategy to reduce tobacco use that can be applied in any country.