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Major obstacles to tobacco harm reduction exist in high-income, “western” countries from the United States to Australia. Yet it’s vital to remember that of the world’s 1.1 billion smokers, who suffer 7 million annual smoking-related deaths, around 80 percent live in low- or middle-income countries where challenges are very different. Cigarette consumption rose by 52 percent in sub-Saharan Africa between 1980 and 2016, and the region’s fast-growing population means smokers’ numbers are set to swell further—underlining the urgency of Magero’s point.