In July 2011, the World Health Organization suggested a target of a 40% relative reduction in prevalence of current daily tobacco smoking among adults over 15 years of age by 2025 (from a 2010 baseline). This does not include smokeless tobacco or some of the new forms of tobacco. The reduction has yet to be adopted by Member States, but it is a start in encouraging countries to set targets within the overall parameter.

The future is mixed. On the one hand, many nations are beginning to take even stronger measures, and smoking prevalence is forecast to reach single figures, below 5 percent in 2040—the “2040 end game.” On the other hand, even if smoking prevalence rates decline and youth uptake is reduced, the number of smokers in the world will most likely rise for the foreseeable future, due principally to world population growth in low- and middle-income countries.

One major future issue is that of smokeless products and alternative nicotine delivery systems. Tobacco companies are shifting from marketing traditional cigarettes to marketing alternative products, and this will have an effect on current tobacco control strategies, such as clean indoor-air policies. Will e-cigarettes be allowed in previously smoke-free areas, and will tax rates be modified to encourage non-combustible products?

Many countries, including low-income ones, have shown that tobacco can be controlled and smoking rates can be reduced. These successes can be reproduced by any responsible nation, but only through concerted, comprehensive, and sustained governmental and community action. It is clear that preventing youth initiation and encouraging cessation require steadfast political will to tackle the tobacco industry and allocate appropriate resources proportional to the health and economic magnitude of the tobacco problem.

The means to curb this pandemic are clear and within reach.