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CHICAGO (AFP) - They say no publicity is bad publicity, but this is likely to be a very uncomfortable week for big tobacco. Beleaguered tobacco executives, already reeling from their defeat in U.S. courts, can expect an onslaught of bad news this week as the world's top medical experts gather here for a conference on smoking.

Larger, and more aggressive than in previous years, the 11th World Conference on Tobacco OR Health has a mission: to make it a public health crusade to wipe out smoking.

"We need to give it the same kind of attention as we did with polio in the 1950s and 60s. Polio is a forgotten disease now," said Dr Thomas Houston, co-chairman of the conference.

He has little patience for the argument that smoking is a matter of free will. "Smoking is a chronic relapsing disease. It's a physical dependency like cocaine - that can be treated. Adults don't choose to smoke. Fourteen-year-olds do. Most adult smokers want to quit."

Sponsored by heavyweight U.S. medical organizations - including the American Medical Association (AMA) and the American Cancer Society - the gathering will bring together more than 4,000 medical experts and public health officials from 120 countries. The last world conference on tobacco was held in Beijing in 1997.

They will be spotlighting the human cost of the habit: four million deaths globally this year from tobacco-related illnesses, including lung cancer and heart disease. The death toll will soar to 10 million a year by 2030 if current trends continue, with the burden shifting from industrialized countries to the developing world, according to Houston.

By 2030, 70% of smoking-related deaths will be in developing countries, where health care systems are least able to deal with the problem. "Their health care systems will be devastated economically," said Houston, who is also the AMA's Director of Science and Public Health Advocacy. "And the ability to deliver the anti-smoking message is much less sophisticated in Bangladesh and Kenya than in the United States, where some states have waged very effective education campaigns," he added.

The challenge for public health experts now is to meld together the different strands of the anti-smoking campaign. Advertising, taxes, grass-roots organization, anti-smoking legislation, and political will have to be part of a comprehensive offensive, according to Houston.

He points to the success of Massachusetts and California in the United States in cutting their smoking rates. "There was no one magic bullet," according to Gregory Connolly, director of the tobacco control program at the Massachusetts Department of Health.

But a series of initiatives helped this northeastern state cut cigarette sales by one third since late 1993, and delivered one of the lowest adult smoking rates in the country, next to Utah. Now, less than 25% of adults in Massachusetts still puff on a daily basis.

Crucially, the state tripled the taxes on cigarettes - prices for an average pack of 20 soared from $1.85 a pack in 1993 to $4.25 dollars in 2000 - offered free counseling and nicotine replacement therapy to smokers wanting to quit, and ran very negative television advertisements slamming smoking.

"What it shows is, a well-funded, comprehensive, sustained program can have impressive results," said Connolly. "Before we launched this campaign in October 1993, we had the same number of smokers wanting to quit every year. They just weren't being successful."

Gro Harlem Brundtland, Director General of the World Health Organization (which is one of the conference's honorary sponsors) will be opening the 11th World Conference on Tobacco OR Health later Sunday. The gathering runs through Friday, August 11