Tobacco currently kills 6 million people each year, increasingly in the low- and middle-income countries, which will bear the economic brunt of this epidemic. Tobacco control takes health professionals to very new destinations, away from the traditional curative medical model to mastering the corridors of power, using the media, and political lobbying and advocacy. None of these skills is taught in medical schools.The magnitude and future expansion of the tobacco epidemic is beyond controversy, as is the fact that the economic costs of tobacco outweigh any benefits. The tools needed to reduce the epidemic are also known and accepted, and these are virtually identical in all countries. It only requires political will to implement these.All countries should ratify and implement the WHO Framework Convention on Tobacco Control and commit adequate funding to counter this global pandemic.Action must be based on the science of epidemiology, prevalence, health effects, economic burden, success of action taken and tracking the tobacco industry.