Australia has proposed some of the world's toughest restrictions on cigarette marketing and advertising. And American health officials recently unveiled graphic new warning labels scheduled to appear next year.
It's all part of a growing international effort to get tough on smoking. But in Germany, anti-smoking activists are facing a tough battle even getting basic restrictions enforced.
Patrick Hauser, 36, proudly sparks another cigarette in his local neighborhood tavern in Neukolln. It's a rough-edged, working-class district of Berlin that's slowly surrendering to tapas bar and yoga gentrification.
Beneath a shelf lined with glass jars of ancient looking pickled eggs and vaguely unidentified vegetables, Hauser says he's proud that Berlin remains smoker-friendly. He says when it comes to lighting up, "the health mafia should mind their own business."
"We don't need politicians taking over, and we don't need health fanatics taking over because I don't do yoga, and I won't," he adds.
Hauser's anti yoga haunt is an official Raucherkneipe — or smokers' tavern. These tobacco-friendly establishments came into being after Berlin tried to restrict smoking in public places three years ago.
The so-called non-smoker protection laws call for bars and eateries to provide non-smoking facilities but it took just six months for the city's taverns to force a U-turn.
They argued before the constitutional court that the laws were destroying business. The judges agreed and ruled that smaller bars could waive the smoking regulations, provided they were clearly marked as smoking establishments.
That court victory had a ripple effect and today many restaurants and bars, regardless of size, openly ignore the smoking restrictions.
In a recent study the German Cancer Research Center found patrons smoking freely in four out of five bars in Germany.
The Cancer Center's Dr. Martina Potschke-Langer says Germany badly trails other European Union countries in addressing the public health risks of smoking.
"Germany needs a clear uniform law to protect non-smokers, one that applies to all bars and pubs, to prevent waiting staff and non-smoking patrons from being subjected to second hand smoke," Potschke-Langer says.
Now with regional elections coming in September a small but growing number of activists hope to get the issue on the Berlin ballot and force a referendum.
Bavaria did that last year, resulting in a tough ban on smoking in public places. But Bavaria is the exception. Most of the rest of the country is a free-smoke zone.
Dieter Reischinger, with the anti smoking group Fresh Air for Berlin, says too many Berliners don't want to be seen as intolerant so they tolerate people blowing smoke in their face and do nothing about it.
"It's almost impossible now to sit in an outside cafe because all the smokers are there," Reischinger says. "If you see people smoking on subway stations, for example, in subway stations people just look away, that's another problem."
The city's post- reunification ethos of tolerance at all costs even extends to children's playgrounds where some parents puff away while their kids play in the sandbox. A few neighborhoods have tried to ban smoking in playgrounds but the restriction is almost never enforced.
Doctor Johannes Spatz director of Fresh Air for Berlin calls this absurd considering that swallowing cigarette butts is one of the top causes of poisoning in children in Berlin.
"It's poisoning them," Spatz says. "Sometimes it's very severe, the poisoning, and therefore you have to forbid it. But the politicians are hesitating."
While the politicians stall the hard-core smokers in Berlin, and there are many, are rejoicing that the city remains so smoker-friendly, and that anti-smoking is still far from the top issue in this fall's regional election.