• Smoking caused disease
• harm reduction
• advocacy
• cessation
• environmental tobacco smoke

The global tobacco industry kills six million people every year. It does this in a deliberate, systematic manner, complete with business plans, lobbying, political contributions and favours, and cash bonuses to its executives who kill the most people by successfully selling them their deadly cigarettes and other tobacco products.

Six million people. Every year. When one repeats those phrases, slowly and aloud—six million people, every year—it seems astounding that Malone et al,1 in this issue of Tobacco Control, need, at this late date, to present compelling data calling for the denormalisation of the tobacco industry. Yet the industry still walks among us and kills its users with relative impunity throughout the world. Why is this? Why has there not been greater public outrage and the political will necessary to end the scourge of the tobacco industry?

There are likely many answers, but consider these few:

• Tobacco use is considered by many smokers to have been a personal choice and a personal failing, making it embarrassing for them or their families to stand up to the tobacco industry.

• Most victims of tobacco-caused disease die and disappear quickly, limiting their opportunity to confront the tobacco industry.

• The tobacco pandemic has developed slowly and insidiously, over more than a century, making the tobacco industry appear just a normal business.

• Tobacco is old news—much of the public and the media accept tobacco, and the tobacco industry, as mainstream behaviour and business.

• Insufficient numbers of strong tobacco control advocacy groups have arisen (although exceptions abound) to challenge public and political attitudes towards the tobacco industry.

• The specific effects of tobacco use—health and economic—are not as broadly known as might be expected and this lack of knowledge has inhibited the development of actions to denormalise the industry.

• Until recently, the multinational tobacco companies have controlled the playing field, lying to the public and the media about the devastating health and economic effects of their products.

More recently, advocates the world over have begun to turn the issues above against the tobacco industry and tobacco use is on the decline in most of the high-income, and many middle-income, countries. But the tobacco industry has now set its sights on the vast and vulnerable low-income populations of the world. Denormalisation of this rogue industry, as Malone et al show, can be one of the most effective tools in turning the tobacco tide and making it a tsunami against the shameful industry that caused it.