'This is an industry absolutely without a moral radar,'' he told The Sunday Age. ' Last week, The Lancet reported ''alarming patterns'' of tobacco use in developing countries. Overall, consumption is growing in these nations by more than 3 per cent every year. At a time when Australia's adult smoking rate - one of the lowest in the world at 16.6 per cent - continues to drop by about 1 per cent a year, in parts of Asia as many as two thirds of men smoke, and women and children are increasingly taking up the habit. In China, schools are sponsored by the state-run tobacco industry, while in India mouth cancer rates in children are soaring as a chewing tobacco epidemic takes hold. The biggest commercial player, Philip Morris, has seen its net revenue soar in the Asia-Pacific region from $5.6 billion in 2007 to nearly $11 billion last year, and it has set up production in Malaysia, Indonesia and the Philippines. In a statement to The Sunday Age, a Switzerland-based media adviser for Philip Morris International outlined the market's potential: ''A home to over half of the world's population, the Asian region is very important for any global consumer goods company. Tobacco has been used in Asia for centuries.''

British American Tobacco's revenue has grown from $1.8 billion to $4.2 billion over the same period in the region. Spokesman Scott McIntyre was unapologetic, saying the company has had a presence in the developing world since the early 1900s. ''Just because people live in a developing nation, does that mean they have less of a right to choose what legal products they purchase than Australians? Or do Australian health experts believe they should have control over individuals in other countries. We believe education on the health risks of smoking is the most effective way for governments to reduce smoking rates.'' In China, where one in three of the world's cigarettes are smoked, the government-owned China National Tobacco Corporation, which has a near monopoly, generates taxes and profits of about $9 billion per month. China has 330 million smokers. In Indonesia, where the average age for starting smoking is under 10, there are 65 million.

In India, chewing tobacco is creating major health problems. Five million children are addicted, and mouth cancers are being seen in those as young as 13. Professor Daube said the combination of large markets, low taxes, cheap labour, corruption, poor literacy levels and lax advertising restrictions makes the Asia-Pacific region attractive to tobacco companies. ''There's massive evidence from industry documents that they see developing countries as essentially their saviour market. One of the reasons is the lower levels of education, so people simply aren't aware of the dangers,'' he said. ''These countries also have other incredibly urgent problems, so if you're dealing with nutritional disease and struggling to provide basic health services, the governments have other immediate priorities than tobacco.'' While the conservative culture in many Asian countries has kept smoking rates very low for women (between 3 and 5 per cent), increased equality is reversing the trend. Aggressive marketing is driving the shift, according to Dr Mary Assunta, director of the international tobacco control project at Cancer Council Australia, who has worked in the Asia-Pacific region for 20 years. ''In Indonesia you see cigarette packs in the market that look like lipstick cases and they sell skinny cigarette sticks so they can fit into the purse of young girls very easily. The prevalence rate for teenage girls is increasing and teenage smokers grow up into adult smokers so you get a more sustained, larger base of customers. These prospective markets have the potential for huge profits,'' Dr Assunta said.

The industry denies it targets children, despite cigarette companies sponsoring music concerts, sporting events and even schools in some Asian countries. Philip Morris said in its statement that it was an ''advocate'' for banning cigarettes sales to minors. ''In Indonesia, seeking a minimum age law and, importantly, measures to enforce it has been one of our principle objectives, along with laws that restrict advertising and sponsorship and mandate larger health warnings.'' But an advertisement last year for Sampoerna, an Indonesian tobacco company bought by Philip Morris in 2005, ran the slogan: ''Dying is better than leaving a friend; Sampoerna is a cool friend.'' Simon Chapman, professor of public health at the University of Sydney and one of the world's foremost tobacco control campaigners, says that ''you go to somewhere like Bali and it's like getting in a Dr Who Tardis and going back in time''. ''There's no such thing as smoking restrictions and there is advertising absolutely everywhere, with rock bottom prices and no health warnings. I saw a cigarette advert recently with a guy astride a Harley Davidson and the slogan was, 'For real men'. The idea was that if you want to have that Western look with an American motorcycle … then here you go, have a cigarette.'' Tobacco companies make no secret of their hopes for a bright future in Asia. Next month, Jakarta will play host to the global tobacco industry at World Tobacco Asia 2012, a trade convention. The event website boasts that Indonesia is a ''tobacco friendly market'' with no smoking bans or restrictions. ''Ensure you take advantage of this growing market,'' exhibitors are urged.

But some countries are fighting back. In Thailand, home to some of south-east Asia's toughest tobacco laws, while smoking rates are still higher than developed countries, they are falling. Health warnings on packs are now mandated in Malaysia, Vietnam, Thailand and Singapore. Plain packaging laws are being considered by the Indian Parliament, and in the Philippines the government has proposed a ''sin tax'' on alcohol and tobacco. The industry is fighting hard, claiming the move will decimate the local economy by putting hundreds of thousands of tobacco factory workers and farmers out of a job. Dr Assunta urged governments spooked by the figures to look at who is providing them. ''The manufacturing facilities of these cigarette companies are highly mechanised. They're able to produce 10,000 sticks a minute so they're not employing hundreds of thousands of people as they claim. In many situations, in Malaysia, in Indonesia, the Philippines, actually very few farmers are full-time tobacco farmers.'' Turning the tobacco tide in Asia will be difficult. The measures that led to Australia's low smoking rates - tough legislation, government backing and sustained investment in Quit campaigns - are not easy for struggling nations battling a cashed-up industry.

The fight has been boosted by support from Microsoft founder Bill Gates and New York mayor Michael Bloomberg, who have donated more than $US600 million to anti-tobacco campaigns in the developing world since joining forces in 2008. But as one public health expert observed, ''It's a start but it's still a pin against a herd of elephants.'' Even in countries with strict tobacco control legislation, it can take decades to see smoking rates come down. That's why Australia's pioneering plain packaging legislation - while not the complete solution - is viewed by public health reformers as an important step in curbing the march of Big Tobacco. The industry's dogged resistance to the laws is a sign that they are fearful of a domino effect. ''In countries where educational attainment is low, and where some of the traditional mass media communications aren't as easy to use as they are here, the pack is symbolic of something glossy and if the pack suddenly turns into something ugly and repellent, it's not a fashion statement. It is a fabulous means of communicating the dangers of smoking,'' Professor Daube said.

''For the industry plain packaging is probably more important for developing countries than it is here so if it takes off any further it's a tobacco industry nightmare.'' Scott McIntyre from British American Tobacco says their profit growth will come from ''adult population growth, higher prices and increased market shares'', and that regulation is the responsibility of governments. Professor Daube, who admits to being ''really, really depressed'' about tobacco consumption in the developing world, can't hide his disgust. Loading ''Once those big industry executives become personally accountable for the literally millions of deaths they're causing, that will be the turning point.''

■ jstark@theage.com.au