Even at the over-crowded cancer ward in Yangon's main hospital few patients who landed there because of tobacco understood the links to the deadly disease until it was too late.
"I had no idea," said 60-year-old Hla Soe, a chronic smoker for more than half a century, a drip dangling from his right arm. "I'm from a village. I didn't quit until a year ago when I found out I had lung cancer."
Myanmar ratified the WHO tobacco treaty a few years ago, but laws and controls regulating the sale, marketing and use of tobacco products are poorly enforced.
Selling to minors is illegal, but boys 12 or younger can regularly be seen buying loose cigarettes from street side vendors.
Local companies use gimmicks to get around bans on advertising. Tay Za, one of the country's richest tycoons who is famous for his stable of luxury cars, places $5 or $10 bills lottery-style inside some of the packs of his brand.
Tobacco giants who bring with them decades of marketing experience and skills honed at capturing smokers for a lifetime are also in a strong position to exploit legal loopholes.
Under existing regulations, for instance, tobacco companies can promote their name by offering scholarships to children, sponsor community projects or using social networking sites such as Facebook.
It's also one of the few countries in the region that has not added pictorial warnings on cigarette packs, said Tara Singh Bam, a technical adviser on tobacco control at the International Union against Tuberculosis and Disease after wrapping up his second visit to the country since it opened up.
At the moment, only around 5 percent of the smoking population uses filtered cigarettes, according to WHO.
But Mary Assunta, senior policy adviser with the Southeast Asia Tobacco Control Alliance, expects habits to change as reforms energize the economy.
"We expect the economy to boom and a growing middle class to emerge with more disposable incomes," she said. Together with the existing pervasiveness of smoking, "this gives plenty of room for tobacco companies to focus on targeting the middle class and teenagers with cheap cigarettes."
"We can expect to see walls of cigarette packs at check-out counters and more prominent display panels of new brands the companies will introduce with attractive packaging."
This all terrifies Tin Maung, the 89-year-old anti-smoking campaigner, who considers Big Tobacco the biggest fight of his life.
"Money can shut the mouth of many and I anticipate a very steep uphill battle with my anti-smoking campaign."
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