Of the 120 000 people who die from smoking each year in the UK, more than half die from a respiratory disease. In 1997 deaths from lung cancer, chronic obstructive pulmonary disease (COPD), and pneumonia caused by smoking totalled over 63 000,¹ all of which were potentially avoidable. These figures show that preventing smoking is more relevant to respiratory medicine than any other speciality. In this issue of Thorax Abdullah and Husten² review the priorities for tobacco control in the developing world and summarise the difficulties of developing smoking cessation in countries already severely challenged by generally low levels of health service funding and infrastructure, by competing public health priorities such as HIV, by low levels of public awareness of smoking as a dangerous behaviour, and other issues. However, one of the problems they identify that is especially relevant in the UK is the need to engage medical professionals in smoking cessation.

The National Health Service (NHS) approach to smoking cessation in the UK has changed radically in the past 5 years. Although the effectiveness of behavioural support and nicotine replacement therapy (NRT) for smoking cessation …