Tuberculosis and tobacco together constitute a considerable threat to global health. Several recent initiatives by non-governmental organisations and the World Health Organization have highlighted the need for concerted approaches to lung health that require addressing both of these major threats. However, the emphasis has been on independent effects on health and on independent strategies to control. There is a clear case for closer partnering between researchers, service providers and policy makers in addressing tuberculosis and tobacco. This is based upon growing epidemiological and laboratory evidence that indicate that tobacco is a risk factor for tuberculosis and for death from tuberculosis. Despite the fact that a very high percentage of tuberculosis patients smoke in all settings for which data are available, opportunities to treat tobacco dependence in such patients are under-utilised. This paper will recommend areas that require research, policy development and immediate action.