By Anna Goldie London

The number of deaths related to smoking will increase to 10 million a year worldwide by 2030--more than the total number of deaths from malaria, maternal and serious childhood diseases, and tuberculosis combined, according to a World Health Organization report.

Seven in 10 of these deaths will occur in the developing world, where three quarters of the world's smokers live and where access to treatment remains low. Research has shown that the poorest households in Bangladesh were twice as likely to smoke as rich ones, with the average male smoker spending twice as much on tobacco than on clothing, housing, health, and education combined.

The report found that the average smoker in the developing world could add up to 500 calories to the diet of a child with the money spent on tobacco, saving the lives of 350 children a day. Steve Palmer of Cancer Research UK said, "Tobacco companies now operate on a global basis, but smoking is not high on the agenda in the developing world."

As the number of smokers in the developed world drops tobacco giants have focused on the developing world and taken advantage of the relaxation of trade barriers. Concentrations of tar in tobacco in the developing world are higher than in the United Kingdom or United States and are combined with aggressive, aspirational advertising. More than 40 developing countries do not require health warnings on tobacco packaging.

The report also highlighted the lack of instruction given to medical students on tobacco dependence treatment. Only a third of the world's medical books include sections on the subject, although 88% of medical schools include the topic of tobacco as part of their curriculum.

David Simpson, author of Doctors and Tobacco and the director of the International Agency on Tobacco and Health said that there is a long way to go when it comes to educating the developing world about the dangers of smoking: "In the United Kingdom we have had leadership by doctors who push people to quit and have lobbied the government, but this has passed the developing world by.

"In many developing countries, the smoking rate among doctors is well above the average, often because they can afford to smoke. We have found that the less a doctor knows of the harmful effects of smoking the less he or she will do for patients, in many developing countries the awareness is very mixed in doctors and the general population."

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