The surge of tobacco products into developing countries began after World War II when the USA developed its “Food for Peace” scheme where tobacco was one of the export items. In the first 25 years of the initiative, the United States exported in excess of $1 billion worth of tobacco. This was the cause of the developing world’s initial exposure to Western-style cigarettes. The evolution of tobacco markets in these regions by TNCs, was continued from the 1960s onwards through the use of a wide variety of targeted and effective marketing schemes to help widen their customer base and potentially induce smoking habits. Smoking prevalence was increased further through the actions of national tobacco companies. In an attempt to counter the increased volume of tobacco being sold by TNCs in their countries, the national tobacco corporations also developed marketing schemes in an attempt to regain lost sales. As TNCs and national corporations went head to head, the overall expenditure on tobacco marketing increased with a corresponding rise in tobacco consumption. 
British American Tobacco (BAT), Britain’s largest and the world’s 2nd largest tobacco establishment (17.1% of the market share) , have had a huge hand in the growth of smoking in African countries. Whilst direct advertising is banned, BAT have devised innovative and technically legal ways to get around this hindrance. Mauritius, the small volcanic island off the West Coast of Africa, has the highest cigarette consumption per smoker in the world; on average, each smoking individual consumes 41 cigarettes per day . One of BAT’s marketing methods in Mauritius was to paint shops in the same colour and design as their cigarette brands in order to increase brand recognition. The visual link between this shop in Mauritius and the Matinee cigarette brand, one of BATs products, is glaringly obvious .
Whilst an increase in TNC presence and advertising clearly increases the chance of people wanting to smoke, it is the economic growth of African countries that means they can now afford to do so. Whilst Africa is still considered the poorest region in the world, it is a common misconception that it is not experiencing economic growth. In the 2000s, Africa experienced rapid economic growth, peaking at 6% in 2004 and remaining above the global average since 2001. The most significant force behind this economic growth has been the large global demand for resources which are sourced n Africa and the greatly improved ability of African nations to exploit them.  This growth in smoking prevalence is particularly clear in Nigeria, where the smoking rate has escalated by 50% in the last decade alone . Economic growth was a major driver behind this increase however, not the sole factor. Smoking rates are also increasing as the habit becomes more socially acceptable in developing countries. 
What is clearly present in all countries but particularly apparent in developing African regions, such as Mauritius, is that an increase in the smoking rate can be causally correlated to an increase in smoking related diseases. Tobacco products contain a multitude of carcinogens which greatly increase an individual’s chance of contracting lung cancer. They also contain nicotine, the constituent of cigarettes responsible for their addictive nature, which increases the chance of cardiovascular disease, especially Ischemic Heart Disease or a stroke, by increasing blood pressure and the likelihood of thrombosis. Smoking related diseases currently kill 100,000 people per year, with that figure projected to double by 2030. 
The increased smoking prevalence in developing African countries has coincided with the increased growth and sale of tobacco, in both the formal and informal sectors of the economy. It is often considered that the tobacco industry has a positive economic effect which at first glance, would appear to be the case. Taking Malawi as an example, the growth and sale of tobacco leaf is a huge component of the country’s formal economy and is a vital business for a country that had the world’s lowest GDP per capita in 2014 . The exportation of tobacco leaf, which makes up approximately 60% of Malawian exports , generates wealth in excess of $165 million per annum  whilst taxes levied on tobacco products provide further income. In addition, a considerable proportion of the population earn a living through the street vending of cigarettes (in the informal sector). The tobacco industry is clearly Malawi’s major generator of wealth and employment with over 5 million people indirectly employed in related industries or related to someone who is involved in the tobacco industry . When you consider all of the economic benefits listed above it is difficult to imagine that the tobacco industry actually has a detrimental effect on the economy of Malawi. however, research by the World Bank suggests that the tobacco industry inflicts a net cost on society when all social and environmental costs are also considered. 
Transnational Corporations, the buyers of the vast majority of tobacco produced in African countries, often prevent the tobacco farmers from turning over a profit. Tobacco TNCs have been known to force farmers into contracts which oblige them to buy seeds, fertilizers, pesticides and sometimes even technical advice, in advance of the growing season, or via a loan. They are then contracted to sell their product to the same TNC for a set fee which is often lower than the production costs which in some instances, results in the farmer making a net loss .
I have already mentioned some of the devastating health problems that are caused by smoking, the treatment of which costs a considerable amount of money. What is less apparent is that the production and sale of tobacco, in both the formal and informal sectors, indirectly increases healthcare costs further. In order to successfully grow a tobacco crop, pesticides must be used. Exposing humans to these chemicals can lead to serious and lasting health problems, such as respiratory ailments, cardiac disease and a range of different cancers. Exposure to these chemicals can occur through direct contact during agricultural work and through polluted water sources, caused by leaching. These diseases require extensive medical attention which only adds to a country’s healthcare expenditure. The actual harvesting of the crop can also increase healthcare costs further as handling fresh tobacco leaves can lead to a disease known as Green Tobacco Sickness , which can cause symptoms so severe that emergency medical attention is required . Whilst the sale of cigarettes in the informal sector does not directly cause disease or increase healthcare costs, it increases accessibility to smoking, especially for children. The sale of extremely cheap ‘single-stick’ cigarettes gives a low cost entry into the habit for the poorest, increasing the number who smoke and furthermore, the number who experience and need to be treated for smoking related illnesses.
Whilst it has long been known that smoking causes adverse health effects, the negative influence on the economy is becoming ever more apparent if the rapid growth in African smoking prevalence continues at the present rate, these problems don’t look like abating any time soon.
Contributed by Joseph Everest, Geography Editor
 04.10.15 http://ash.org.uk/files/documents/ASH_126.pdf
 John Smith & Roger Knill, AQA Geography AS, pg 273
 01.07.08 BBC 2 Documentary: “Bannatyne takes on Big Tobacco”
 04.10.15 https://en.wikipedia.org/wiki/Green_Tobacco_Sickness