Worldwide smoking kills 6.3 million more than HIV, Malaria or TB. In India 10 people die from smoking each year and this is growing. Smoking will kill 33-50% of people that smoke an average of 15 years early and is the leading preventable cause of death in Australia, the UK and other western countries. As the epidemiological transition takes place smoking in India will grow as a cause of death. Already in India more people die from chronic diseases and accidents than from infectious diseases. Western countries have introduced tough anti-smoking laws. This has squeezed tobacco companies but they have been able to compensate and target poor and developing countries like India. Nationally, India has grasped the gravity of this threat and on October 2 banned smoking in public places. However, the rural communities where we work have a low level of awareness and are particularly vulnerable to tobacco companies and marketing. In terms of community health we all know that immunizations save lives. How many? Well we have to immunize about 150-300 kids to save one life. In tobacco control we only need to help 2-3 people quit to save one life. Now that is great return on an investment of resources. The cluster have chosen to make Tobacco Control one of their focus areas and have successfully implemented a number of programs to attempt to reduce the prevalence of smoking in Uttarakhand state.