While countries in Europe, the Americas, and Australia/New Zealand have reduced tobacco use over the past 50 years, they by no means have all the answers. There are populations within these geographic areas that still have high tobacco use rates. Since context does matter, as Pebbles Fagan notes above, it is important to hear from advocates and researchers in so-called "developing countries" as to what they find important. How do we get them linked in to this conversation?

A couple of other thoughts:
*One area of policy/legislation to pursue is to curb the political and economic power of the tobacco industry. While the industry's image may be a bit tarnished (at least in the U.S.), it is as profitable and innovative as ever.
*Policies and legislation, while important, are a piece of the larger effort. Public education, social marketing campaigns, cessation assistance (not solely focused on pharmaceuticals) are also important in changing social norms and behavior around tobacco use.
*More work needs to be done on understanding how broader social policies (e.g. public welfare and education policies) impact tobacco use. As Hilary Graham suggests in her 2007 book entitled "Unequal Lives," policies that reduce social inequities may be critical to reducing inequalities in tobacco use.

The global impact of tobacco in the upcoming years prompts us to think carefully about what policies are needed to reduce tobacco use and its consequences. Its important to remember that policies may differ depending on the context. Its important for each country to determine what is needed based on the culture, socio-political context, and resources.

For example, based on evidence in the US we know that clean-indoor air policies help to protect people from second-hand smoke exposure. But, we also know that implementation and enforcement in communities has varied. For developing countries, its important understand how the policy will be implemented and enforced and understand how voluntary or non-voluntary policies operate in specific cultures and environments. Furthermore, its important to understand who the gatekeepers are for vuluntary and non-voluntary policies. In the home, where voluntary policies may be implemented, who has control over the development, implementation, and adherence to policies? This may vary depending on the culture.