Introduction

More than 60 years have now passed since epidemiological studies first linked tobacco smoking to lung cancer; the 50-year anniversaries of the 1962 Royal College of Physicians of London and 1964 US Surgeon General's reports, which indicted smoking as causing lung cancer, are approaching.1 2 While millions of people have since died prematurely from smoking, the policy and prevention initiatives that were motivated by the scientific evidence in these and subsequent reports have finally led to a decline in smoking-caused diseases in many high-income and a few low- and middle-income countries.3

Will 2011 become the start of a similar pivotal era for non-communicable diseases (NCDs), as was the 1960s for tobacco control? There are parallels including the powerful descriptive evidence for multiple epidemics of NCDs—diabetes, cardiovascular diseases, chronic lung disease and cancer—and some avoidable causes are obvious to all—physical inactivity, poor diet, the persistence of tobacco smoking and harmful alcohol consumption. These epidemics have now received political attention at the highest level possible. The UN High-Level Meeting on Prevention and Control of NCDs was held on 19–20 September 2011 in New York, the first UN General Assembly summit involving heads of state to address the threat of NCDs and only the second special summit to take on a health issue directly. The first special summit was held on HIV/AIDS in 2001.

Such high-level governmental attention to NCDs worldwide is long overdue. Rates of obesity have risen precipitously in recent decades and predictably, higher rates of diabetes and cardiovascular disease will follow. There is well-grounded concern that the strategies of the multinational tobacco companies will continue to increase tobacco use in low- and middle-income countries as well. While HIV/AIDS, tuberculosis and malaria, have been central in the global health agenda, epidemics of NCDs already represent 60% of the global disease …