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Smoking already kills one in 10 adults worldwide. By 2030, perhaps a little sooner, the proportion will be one in six, or 10 million deaths per year—more than any other single cause. Whereas until recently this epidemic of chronic disease and premature death mainly affected the rich countries, it is now rapidly shifting to the developing world. By 2020, seven of every 10 people killed by smoking will be in low-and middle-income nations.