The second fatal impact: cigarette smoking, chronic disease, and the epidemiological transition in Oceania.

The island countries of Oceania are now experiencing the epidemiological transition which has shifted patterns of morbidity and mortality from primarily infectious to mainly noncommunicable diseases. Prominent among these are many ailments known to be linked to or caused by tobacco smoking--especially to smoking of flue-cured, commercially made cigarettes. Cigarette manufacture by major tobacco transnational corporations began in the Pacific during the mid-1950s and production has grown rapidly since then. Cigarettes have been marketed aggressively, with a result that they have increasingly replaced the smoking of home-grown and twist tobacco. The history of tobacco production and marketing is sketched, and the literature on chronic diseases related to smoking is summarized for the Pacific region. The rise of anti-smoking movements in Oceania is then discussed, with particular attention to the PNG case during the 1980s.