Gakidou E, et al. - Researchers calculated the prevalence of smoking tobacco use and attributable disease burden for 204 countries and territories, by age and gender, from 1990 to 2019 as part of the Global Burden of Diseases, Injuries, and Risk Factors Study. Multiple smoking-related indicators from 3625 nationally representative surveys were modeled. A systematic review and Bayesian meta-regression were performed for 36 causally linked health outcomes to estimate non-linear dose-response risk curves for current and former smokers. A direct estimation approach was used to calculate attributable burden, providing more comprehensive estimates of the health effects of smoking than previously available. The annual toll of 7·69 million deaths and 200 million disability-adjusted life-years attributable to smoking will increase over the coming decades in the absence of intervention. The data indicate that substantial progress in decreasing the prevalence of smoking tobacco use has been found in countries from all regions and at all stages of development, but a large implementation gap remains for tobacco control.