In this two-part series for the BBC World Service, Sue Armstrong investigates the growing pressure on developing countries as tobacco companies battle for the hearts and lungs of new smokers.
At the same time, some poorer tobacco growing countries like Malawi are becoming ever more dependent on tobacco as a cash crop. How do they resolve the dilemma between health and wealth?
This is a question of personal interest to Sue Armstrong, since her own grandfather was chairman of Imperial Tobacco in India in the early 1900s. And her father - a doctor and long-time pipe smoker – used to grow his own tobacco in his garden. Finally convinced by the medical case against tobacco, he gave up smoking in the 1970s.
In much of the rich world, smoking is on the wane in the face of rising taxes on cigarettes, bans on promotion and lawsuits against tobacco companies. Less than 21% of British people and 24% of Americans now smoke - the lowest rates on record. But elsewhere, smoking is exploding.
The World Health Organization predicts that tobacco will kill more than eight million people worldwide each year by 2030, with 80% of these premature deaths in low- and middle-income countries. Tobacco companies produce more than five trillion cigarettes a year - enough for 830 cigarettes for every person on earth.
In India, 195 million people smoke or chew tobacco and there are nearly a million tobacco-related deaths a year.
And in China more than 300 million people smoke. That is equivalent to the entire population of the US, and one third of the world's smokers.
In part one, we hear about Malawi's growing dependency on tobacco as a cash crop, with at least 80,000 subsistence farmers now growing tobacco.
Malawi's government has tried to introduce minimum prices, but small farmers like Elson Matope hardly cover their costs, and continue to live on less than a dollar a day, despite supplying the raw material for one of the richest industries in the world.
First broadcast on 27 August 2010