Tobacco use is a powerful, independent predictor of deaths related to cardiovascular disease, and is an important contributor to deaths from major chronic diseases. Unfortunately, increasing rates of tobacco use throughout the world are contributing significantly to the burden of death and disability from these diseases, especially in developing countries. If current trends continue, the annual number of people killed by tobacco use will more than triple, to 10 million by 2030. However, we have an opportunity to reverse these trends and avoid this impending epidemic of tobacco-related deaths. In this, article, we examine the current global burden of tobacco-related diseases, and future projections, and conclude by emphasizing that: 1) effective strategies for curbing this epidemic are available; and 2) the time has rome for effective global tobacco-control action.