In recent years the tobacco control community has shifted its focus to low and middle-income countries (LMICs), which are becoming a major market for tobacco companies seeking to expand their profits and compensate for dwindling markets in higher-income countries. While some LMICs already have alarming smoking prevalence levels, many currently hover on the cusp of the epidemic. Such is the case in much of Sub-Saharan Africa (SSA). Already burdened by infectious diseases, the region now faces the extra burden of noncommunicable diseases related to tobacco use. The goal is to prevent another epidemic. This objective raises unique challenges in an area where the negative health effects of tobacco use are not yet widespread and where governments do not yet consider tobacco control as a health or development priority.

Attracted to the notion of staving off another epidemic in SSA, the Bill and Melinda Gates Foundation and the International Development Research Centre (IDRC) partnered in the fall of 2007 to analyze the status of the tobacco problem in a number of SSA countries, and to identify those countries in which an intervention might be most effective. The original plan was to conduct situational analyses in these countries; that is, to gather all existing data on current tobacco use, tobacco farming, tobacco control policies and the key players involved in the field. African researchers would gather, synthesize and analyze data at the country level so that local governments, civil society, universities and potential funders could use this information to understand opportunities for and obstacles to tobacco control, as well as the capacity for action in each country.