Cigarette smoking is the leading cause of preventable death and disease in the developed world, accounting for close to 20% of all deaths.^1,2 Most developed nations are approaching this problem by adopting policies and programmes intended to curb the use of tobacco.³ Prevalence of smoking and per capita consumption is declining in many industrialised nations. This is not the case, however, in many less developed countries where social changes and economic growth coupled with comparatively higher rates of population growth are contributing to increases in both total and per capita cigarette consumption.^4,5 This problem is almost certainly being exacerbated by effects flowing from the globalisation of the world cigarette industry and the increased trade in tobacco leaf products and marketing programmes and technologies by major transnational tobacco companies.

In recent years, several cigarette markets in Asian and eastern European countries formerly closed to imports have been opened to the United States and British cigarette companies. Entry of the transnational tobacco companies into these previously closed cigarette markets has resulted in competition between national monopolies and foreign cigarette manufacturers, fought out with an intensity never before experienced in these countries. In such situations, early indications point to sometimes dramatic growth in consumption,⁶ which is unlikely to be explained by population growth alone. In the cases of South Korea, Japan, and Taiwan national policies have been adopted to allow the entry of transnational tobacco companies into the domestic cigarette market, which has led to price competition (lower prices to consumers), increased retail availability, new and more vigorous cigarette advertising campaigns and promotions, and the targeting of non-smoking women and adolescents.^7–9 Lighter, highly flavoured, western brands have also been introduced in a trend that may result in increased consumption. Specific brands targeted …