Numerous global efforts have been made to cut tobacco use and they have had some success, however, a commentary published in CMAJ (Canadian Medical Association Journal) suggests that more can be done to reduce the number of deaths from smoking.

Since it was adopted back in 2005, the World Health Organization's (WHO) Framework Convention on Tobacco Control agreement has been signed by more than 170 countries. However, smoking rates in many low- and middle-income countries are still high compared with Canada and other high-income countries where efforts to curb smoking have been more successful.

According to researchers, people who smoke regularly have a threefold higher risk of dying from smoking than nonsmokers. They can substantially reduce this risk if they quit by the age of 40.

In order to meet WHO's recommended 30 percent reduction in smoking by 2025, countries need to triple tobacco taxes. If this reduction is achieved, it would save an estimated 200 million lives by the end of the 21st century.

"The only plausible way to reduce smoking to this extent would be to triple tobacco excise taxes in most low- and middle-income countries," Dr. Prabhat Jha of the University of Toronto, writes. "Estimates suggest that tripling excise tax would double the retail price of tobacco products and reduce consumption by about 40 percent in these nations."

According to WHO estimates, annual global sales of tobacco have risen over the last 25 years, from 5 million cigarettes to 6 trillion according.

Global efforts must counter the tactics and large budgets of tobacco companies if they want to reduce tobacco use, according to the commentary.

"The Framework Convention on Tobacco Control is a great achievement in global health. Now is the time to take stronger steps to implement its important provisions. If we do, we might expect to achieve unprecedented numbers of lives saved in the next few decades of the 21st century," the authors concluded.