People have died from tobacco-related diseases since the opening of the first FCTC working group on 28 October 1999.
Tobacco is grown in more than 120 countries on more than 4 million hectares of the world's agricultural land.  While the amount of tobacco cultivated in developed countries is steadily decreasing, cultivation in developing countries has increased significantly, with hundreds of thousands of small farmers encouraged and supported by the tobacco industry to take up cultivation of a crop that is labour and input intensive and brings a host of health and environmental dangers, ‘without the slightest promise of wealth'. 
The World Health Organization (WHO) cites studies indicating that if the land taken up by tobacco cultivation was devoted to food production, it could feed between 10 and 20 million people.  Thus, WHO states that ‘hunger and malnutrition are made worse when countries use scarce land for tobacco production'.  Incentives offered by the tobacco industry, such as ready supply of agricultural inputs and the promise of guaranteed crop sales, push farmers in the developing world towards growing tobacco rather than traditional food crops. Yet most small tobacco farmers find that they make barely enough money to eat.
Tobacco cultivation harms the health of farming communities.  Tobacco is a very sensitive plant prone to many diseases, requiring large and frequent applications of pesticides, which expose farmers to a range of risks that include genetic damage, nausea, muscle twitching and convulsions, respiratory problems, kidney damage, and skin and eye irritation. The absorption of nicotine into the skin of those who tend tobacco crops causes ‘green tobacco sickness', the symptoms of which include nausea, vomiting, weakness, dizziness, headaches, abdominal cramps, and breathing difficulties. Tobacco cultivation also has negative impacts on the environment, including depletion of soil nutrients, pollution from pesticides and fertilisers, and serious deforestation (due to land clearance for tobacco cultivation and use of wood to cure tobacco leaves), which contributes to adverse climate change. 
The dramatic increase in tobacco production in developing countries has contributed to a fall in world prices for tobacco.  While financial returns for large tobacco manufacturers have increased with an oversupply of cheap tobacco leaf and an ever more technologically advanced manufacturing process, the profitability of tobacco growing has decreased significantly.  Tobacco growing is highly labour and input intensive, and many small tobacco farmers are trapped in cycles of poverty and debt. Tobacco is often grown on a credit system (whereby agricultural inputs are provided by a tobacco company and the farmer is obliged to sell all of the tobacco leaf to the company, at set prices which are sometimes lower than the value of the initial ‘loans', until the ‘debt' is paid off). Whole families, including children, are required to devote their time to the care of tobacco seedlings and the harvesting and curing of leaves. Children working with tobacco are placed at high risk of injury and illness, and are denied vital educational opportunities that could help lift them out of poverty. 
The notion that tobacco cultivation is highly profitable has been propagated by the tobacco manufacturing industry, which has for decades ‘encouraged countries and families to grow tobacco, claiming that it will bring them prosperity'.  Emerging studies show that there are a range of alternatives to tobacco growing that are likely to be more economically viable for small farming families and less harmful to farmers' health and to the environment. Research indicates that many tobacco farmers would like to switch to alternatives, but that they often face considerable challenges, including access to credit, markets, technical assistance, inputs and skills, and roads and other public infrastructure. Initiatives to diminish these barriers, protected from interference by the tobacco industry, will assist small farmers in securing long-term sustainable livelihoods. 
 International Labour Organization, Employment Trends in the Tobacco Sector: Challenges and Prospects (Report for discussion at the Tripartite Meeting on the Future of Employment in the Tobacco Sector, 2003) 10. See also: World Health Organization, Tobacco and Poverty: a Vicious Circle (2004); Food and Agriculture Organization of the United Nations, Projections of Tobacco Production, Consumption and Trade to the Year 2010 (2003); R Jacobs, FH Gale, TC Capehart, P Zhang, and P Jha, ‘The supply-side effects of tobacco control policies' in P Jha and F Chaloupka (eds), Tobacco Control in Developing Countries (2000) 311-341.
 International Labour Organization, Employment Trends in the Tobacco Sector: Challenges and Prospects (Report for discussion at the Tripartite Meeting on the Future of Employment in the Tobacco Sector, 2003); Campaign for Tobacco Free Kids, Golden Leaf, Barren Harvest: The Costs of Tobacco Farming (2001).
 See World Bank, Curbing the Epidemic: Governments and the Economics of Tobacco Control (1999) 61-2, 67-71; R Jacobs, FH Gale, TC Capehart, P Zhang, and P Jha, ‘The supply-side effects of tobacco control policies' in P Jha and F Chaloupka (eds), Tobacco Control in Developing Countries (2000) 311-341.