Tobacco will kill nearly six million people this year, including 600,000 non-smokers, because governments are not doing enough to persuade people to quit or protect others from second-hand smoke, the World Health Organization (WHO) said on Tuesday.

Since there is often a lag of many years between when people start smoking and when it affects health, the epidemic of tobacco-related disease and death has just begun, the WHO said. But by 2030, the annual death toll could reach 8 million.

The United Nations health body urged more governments to sign up to and implement its tobacco control treaty, warning that if current trends persist, tobacco could cause up to a billion deaths in the 21st century, a dramatic rise from the 100 million deaths it caused in the previous century.

So far, 172 countries and the European Union have signed up to the WHO’s Framework Convention on Tobacco Control (FCTC), which came into force in 2005 and obliges them to take steps over time to cut smoking rates, limit exposure to second hand smoke, and curb tobacco advertising and promotion.

The WHO noted some encouraging recent moves - Uruguay now requires health warnings that cover 80 percent of the surface of tobacco packs, and China last month implemented a ban on smoking in public places such as restaurants and bars.

But it said that if the FCTC was to achieve its full potential as the “most powerful tobacco control tool”, more needed to be done.

“It is not enough to become a party,” WHO director-general Margaret Chan said in a statement. “Countries must also pass, or strengthen, the necessary implementing legislation and then rigorously enforce it.”

Tobacco kills up to half its users and is described by the WHO as “one of the biggest public health threats the world has ever faced”. It causes lung cancer, which is often fatal, and other chronic respiratory diseases. It is also a major risk factor for cardiovascular diseases, the world’s number one killers.

The WHO said smoking is one of the biggest contributors to a worldwide epidemic of non-communicable, or chronic, diseases such as heart attack, stroke, cancer and emphysema, which accounts for 63 percent of all deaths worldwide, nearly 80 percent of which occur in poorer countries.

To mark World No Tobacco Day on May 31, the World Lung Foundation (WLF) campaign group launched a website of graphic and gruesome images of the health effects of smoking that health officials can download for use as warnings on tobacco packaging.

The WLF said that on average, smokers see images on tobacco packs 15 times a day, adding up to almost 5,500 times a year which makes pictures “a highly effective channel to inform smokers about the dangers of tobacco.”

One image shows a cut-open human chest in full color with black lungs protruding from inside.

“Countries that mandate large graphic pack warnings are not only fulfilling their legal obligations, they are taking a big step forward toward better informing smokers of the deadly harms of tobacco,” said Peter Baldini, the WLF’s chief executive.

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By Kate Kelland

LONDON