Tobacco use is the single most important preventable cause of death in the world today. Tobacco related morbidity and mortality continue to escalate, particularly among the low and middle income countries (LMIC) of the world. In India, tobacco consumption represents an emerging, significant and growing threat to health of people. The three major tobacco related diseases in India (cancer, coronary artery disease and chronic obstructive airway disease) poses a huge economic burden on people who suffer from these diseases and the nation’s health care system. Smoking also acts synergistically with other risk factors of CVDs and exacerbates the risk of sudden cardiac death, stroke, peripheral vascular disease and aortic aneurysm. A concerted action is required at international, national and societal level in order to curb the epidemic of tobacco, which in turn will immensely help in reducing the burden of CVDs. Tobacco control can only be successful if this situation is tackled at multiple levels.