Smoking is the leading preventable cause of death worldwide. On average a smoker can expect a decrease of 10 years in life expectancy. 1 It is estimated that during the 20th century 100 million deaths were attributable to smoking, a figure that is expected to rise to 150 million deaths between 2000 and 2025 and further increase throughout the 21st century. There are an estimated 1 billion smokers worldwide, which is expected to increase by 30 million new smokers each year. While consumption per adult per day has decreased in high income countries, there is still an upward trend in low and middle income countries.