SEOUL - Smoke-filled bars and packed cancer wards reflect decades of neglect of no-smoking policies in Asia, where both high- and low-income countries are belatedly waking up to a growing tobacco-related health epidemic.
Researchers say inadequate public awareness of smoking risks, coupled with aggressive tobacco marketing, has left Asian nations with some of the highest smoking rates in the world at a time when sustained anti-smoking campaigns have lowered rates in the US and parts of Europe.
Roughly 60 per cent of the world's population lives in Asia, where "tobacco control programmes are less well-developed, particularly in low- and middle-income countries like China and India", said a major regional study published April in PLOS Medicine.
In developed countries like Japan and South Korea, it is only recently that the authorities have made genuine moves to cut smoking rates that were once as high as 85 per cent among adult males.
European countries have spearheaded raising taxes on tobacco - backed by the World Health Organisation as the most cost-effective way to curb smoking. But Asian countries have been slow to follow suit.
Last week, however, the South Korean government proposed a massive 80 per cent increase in cigarette prices.
In a country where 44 per cent of the male population smokes, Health Minister Moon Hyung-Pyo said the time had come to grapple seriously with the "biggest threat to national health".
Opposition critics criticised what they saw as a desperate bid to raise tax revenues to fund a growing welfare bill and said the move would hit low-income earners the hardest.
"Smoking was long regarded as a way for hard-working Korean men to counter the stress of the country's rapid industrialisation," said Kim Jin-Young, a sociology professor at Korea University.
"Governments were very wary of raising taxes on cigarettes and alcohol for fear of an electoral backlash," Kim told AFP.
"But the public perception is changing now, with people putting more of an emphasis on public health than before," he added.
The South Korean tobacco market is estimated to be worth around $9.0 billion a year.
In April, state health insurers filed a lawsuit against three domestic and foreign tobacco makers, seeking damages of 53.7 billion won for payouts over tobacco-related illnesses.
They claimed to have spent about 1.7 trillion won each year to help treat diseases caused by smoking.
In Japan, where more than 30 per cent of men smoke, the government raised taxes on cigarettes in June - the first increase for 17 years.
"Japan's smoking rate is really a legacy of the wartime national policy of promoting smoking as a source of national budget," said Hiroshi Yamato, a doctor and smoking expert at the University of Occupational and Environmental Health in Kitakyushu, western Japan.
The tobacco industry was a state monopoly until 1985 when it was privatised as Japan Tobacco, which still controls more than 60 per cent of the market and wields substantial political influence.
"Japan is still way behind in terms of anti-smoking policies especially measures against secondhand smoke," said Yamato.
"You can still smoke in a lot of public places in Japan such as office buildings, coffee shops, restaurants and bars," he added.
South Korea only banned smoking in public places in July 2013, with small restaurants and bars exempted until 2015.
Too little, too late?
Although global smoking rates have fallen, more people smoke worldwide today than in 1980, mainly due to population surges in countries like China and India.
China had nearly 100 million more smokers in 2012 than it had three decades ago, even though its smoking rate fell from 30 to 24 per cent in that time, according to data published in January in the Journal of the American Medical Association.
China has close to 300 million smokers, and efforts to ban smoking in public areas have suffered from lax enforcement.
Tobacco use is linked to 1.2 million deaths a year in China and around one million in India, and studies suggest the toll is going to increase exponentially.
A paper published in the British Medical Journal this year said China risked accumulating 50 million tobacco deaths between 2012 and 2050.
And because of the long latency of diseases associated with smoking, the full impact of decades of laissez-faire policies has yet to be felt.
"Many Asian countries are in the early stages of the tobacco epidemic," said the PLOS Medicine study.
"So it is likely that the burden of diseases caused by tobacco smoking will continue to rise over the next few decades, and much longer if the tobacco epidemic remains unchecked," it said.