In its second report on the global tobacco epidemic, the World Health Organization said that only 5.4 percent of the world's population was covered by comprehensive smoke-free laws in 2008, up from 3.1 percent in 2007.
This means that 154 million more people are no longer exposed to the harms of tobacco smoke in work places, restaurants, bars and other indoor public places.
Seven countries-Colombia, Djibouti, Guatemala, Mauritius, Panama, Turkey and Zambia-implemented comprehensive smoke free laws in 2008, bringing the total to 17.
These findings, and others are contained in the WHO Report on the Global Tobacco Epidemic, 2009.
"Although this represents progress, the fact that more than 94 percent of people remain unprotected by comprehensive smoke-free laws shows that much more work needs to be done," said WHO Assistant Director-General for Non-communicable Diseases and Mental Health Dr Ala Alwan.
"Urgent action is needed to protect people from the death and illness cause by exposure to tobacco smoke," he added.
WHO chose to make smoke-free environments the focus of the report because of the harm of second-hand smoke, which causes about 600,000 premature deaths per year, countless crippling and disfiguring illnesses and economic losses in the tens of billions of dollars per year.
"There is no safe level of exposure to second-hand tobacco smoke.herefore, action is needed by governments to protect their people," Dr. Alwan said.
"The WHO Report on the Global Tobacco Epidemic, 2009 is an essential resource," he said.
The report devotes particular attention to the WHO Framework Convention on Tobacco Control's Article 8,which addresses protection from exposure to tobacco smoke.The Framework Convention, which took effect in 2005, is ratified by nearly 170 countries.
The report also describes countries' efforts to implement the tobacco control package called MPOWER, which WHO introduced in 2008 to help countries implement some of the demand reduction measures in the WHO Framework Convention and its guidelines.
These measures are: 1) Monitor tobacco use and the policies to prevent it 2) Protect people from tobacco smoke 3) Offer people help to quit tobacco use 4) Warn about the dangers of tobacco 5) Enforce bans on tobacco advertising, promotion and sponsorship 6) Raise taxes on tobacco. Less than 10 percent of the world's population is covered by any one measure, the report states.
The report tracks the global tobacco epidemic, giving governments and other stakeholders a tool to see where evidence-based demand reduction interventions have been implemented and where more progress is needed. It gives country-by-country tobacco use prevalence figures as well as data about cigarette taxation, bans on tobacco advertising, promotion and sponsorship, support for treatment of tobacco dependence, enforcement of tobacco-free laws and monitoring of the epidemic.
"Slowly but inexorably, WHO and its Member States are making progress in controlling the epidemic of tobacco," said Dr Douglas Bettcher, Director of the WHO Tobacco Free Initiative.
"Comprehensive tobacco control will help countries to reduce the rising number of heart attacks, strokes, cancers and other noncommunicable diseases."
"People need more than to be told that tobacco is bad for human health," Dr Bettcher added.
"They need their governments to implement the WHO Framework Convention," he added.
Tobacco use continues to be the leading preventable cause of death, killing more than five million people per year. Unless urgent action is taken to control the tobacco epidemic, the annual death toll could rise to eight million by 2030, the report states.
More than 80 percent of those premature deaths would occur in low- and middle-income countries-in other words, precisely where it is hardest to deflect and to bear such tremendous losses.
Other key findings of the report include:
Five more countries-Djibouti, Egypt, Islamic Republic of Iran, Malaysia and Mauritius-met the best practices for health warnings on cigarette packages.
Three more countries-Israel, Romania and the United Arab Emirates-offered comprehensive help to quit.
Only one country-Panama-joined the small group of countries that bans all forms of tobacco advertising, promotion and sponsorship. More than 90 percent of people lack protection from tobacco industry marketing.
Six more countries-Czech Republic, Estonia, Fiji, Finland, the Netherlands and Seychelles-levied tobacco taxes higher than 75 percent of retail price.
Of the world's 100 most populous cities, 22 are smoke-free.