Example Program Rationale A Rationale for a Comprehensive Tobacco Control Program in Philadelphia County, Pennsylvania The World Health Organization (WHO) has noted that tobacco "is one of the biggest public health threats the world has ever faced, killing nearly six million people a year. More than five million of those deaths are the result of direct tobacco use while more than 600,000 are the result of non-smokers being exposed to second-hand smoke. Approximately one person dies every six seconds due to tobacco, accounting for one in 10 adult deaths" (WHO, 2014, para. 4). In addition, it has been estimated that up to 50% of current users will die of a tobacco-related disease (WHO, 2014). To further quantify the burden of tobacco on the people of the world is to note that six million deaths is the equivalent of losing the entire population of the state of Maryland each year. The impact of tobacco use and secondhand smoke exposure has also been a problem in the United States. In 2013, the percentage of adult (> 18 years of age) smokers in United States was 17.8%, which is the lowest it has ever been, but it still totals 42.1 million people. Tobacco