The global burden of tobacco was going to get a lot worse before it got better, an expert from the World Lung Foundation said in Cape Town on Friday.

And it was developing countries that would bear the brunt of this burden and its "huge" economic implications, Dr Judith Mackay, coordinator of tobacco control at the WLF, told a media briefing on the fringe of a major international lung health conference.

She said tobacco, responsible for five million deaths a year, was as significant a worldwide killer as tuberculosis.

Without effective action, by 2030 the number of annual deaths would have risen to about 10 million.

"The tobacco burden will get a lot worse before it gets better," she said.

The number of smokers was projected to rise from the current worldwide total of 1.3 billion, to 1.64 billion by 2030.

Mackay said the 10 million deaths would be made up of people who were currently smoking.

"So it represents an increase that has gone on over the last 30 years. These are all smokers who will come up and die," she said.

"The number of smokers reflects what will happen with children who are being born, or under-10s, 10- to 20-year-olds now.

"And that's why we need a sort of pincer approach, to try and help smokers quit, and try and stop children start smoking.

"I'm very confident that things are being put in place that will eventually bring this epidemic down. Robustly confident.

"But I'm still realistic, and I think it's going to be a major struggle. There's not going to be a single tobacco farmer out of work in my lifetime, that's for sure.

"That on the one hand is rather daunting and depressing... but I don't think that the enormity of the problem should paralyse us into inactivity."

Restricted to men

Though there had been a significant rise in smoking rates in developing countries, the prediction by tobacco control experts that rates among women would increase had not materialised.

This could be because of the influence of Islam, or Confucianism in China, where one in every worldwide three cigarettes was smoked, or because anti-smoking health messages had been effective.

Among other causes for hope was the passage of the Framework Convention of Tobacco Control, which read like a "good national law", and the fact that many individual countries had already taken tough action on smoking.

Mongolia's tobacco control laws were a lot better than in many Western countries, while Bhutan had banned all smoking.

Head of operations at the International Union Against TB and Lung Disease Karen Slama said there was compelling scientific evidence that smoking and exposure to smoking increased TB rates.

The World Health Organisation had estimated that probably more than 30 percent of the global TB burden could be attributable to smoking.

Effective tobacco control could reduce the pool of people who had TB, and among those who had TB, could reduce the number who moved from TB to death.

"You can save millions of dollars in TB treatment costs," she said.

Sapa