MAl-Nozha, Tobacco and the Third World. 1991; 11(2): 133-134 The association of cigarette smoking with coronary artery disease, chronic bronchitis, carcinoma of the bronchus, peptic ulcer, and cancer of the tongue, larynx, esophagus, and urinary bladder is well known [1]. The annual toll of premature deaths attributable to tobacco use will be approximately three million worldwide in the 1990s, and this will rise to ten million by the year 2025 [2]. While cigarette consumption is decreasing in the industrialized world by about 1% a year, in Asia and Latin America, it is exceeding the population growth by 7%, and in Africa by 18% [3].In this issue of the Annals, there are three tobacco-use-related papers; two on cigarette-smoking habits in Riyadh and Amman [4,5] and the third on jurak smoking [6]. Taha et al [4] report on the smoking habits of 2264 male students at King Saud University in Riyadh. They found that 37% of the students smoke and over half smoke more than 15 cigarettes per day. Thirty-six percent started smoking between the ages of 10 and 15 years. The authors recommend that an antismoking campaign should be mounted in the schools and that the Saudi government should consider legislation to prohibit the sale of tobacco to anyone younger than 18 years old.The second study comes from Jordan where Awidi [5] studied the pattern of smoking in greater Amman among 3489 individuals from various socioeconomic classes. The results indicated that 58.8% of the males and 27.4% of the females in the nonstudent population were smokers, compared with 30.8% of the males and 7.4% of the females in the student population. Smoking was more common among illiterate individuals (71.4%) than among individuals with various levels of education (range, 43.2 to 55.6%). Smoking was also more common among skilled and nonskilled workers than among professionals (58.1% versus 43.6%). Both Taha and Awidi's study revealed a high smoking prevalence among students and the general population in Riyadh and Amman. The findings in these studies are alarming and indicate that, unless an active antismoking campaign is mounted, epidemics of smoking-related diseases may occur in the near future.The third study comes from Jeddah where Khoja et al [6] studied the effect of jurak smoke condensate on the activities of four enzymes in the mouse liver and intestine. The levels of these enzymes were significantly affected, indicating that the substance is toxic. The authors concluded that the low content of tobacco leaves in jurak paste and filtration of the smoke by water in the sheesha reservoir are not sufficient to make the smoke risk free.In a recent study [7] on the smoking habits of 698 physicians in Riyadh, it was found that 38% of the male physicians and 16% of the female physicians are smokers and that 80% do not smoke at work. In the United States,