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BACKGROUND: The Association of Southeast Asian Nations (ASEAN) has made tobacco use prevention a primary health issue. All ASEAN countries except Indonesia have ratified the World Health Organization Framework Convention on Tobacco Control (WHO FCTC), the world's first public health treaty on tobacco control. METHODS: Global Youth Tobacco Survey (GYTS) data were collected from representative samples of students in school grades associated with ages 13-15 in Cambodia, Indonesia, Laos (Vientiane), Malaysia, Myanmar, Philippines, Singapore, Thailand and Vietnam (Hanoi). RESULTS: Current cigarette smoking ranged from less than 5% (Vietnam and Cambodia) to 20.2% in Malaysia. Current use of tobacco products other than cigarettes was less than 10% in all countries. Boys were significantly more likely than girls to smoke cigarettes or use other tobacco products. Exposure to second-hand smoke in public places was greater than 50%, direct pro-tobacco advertising exposure was greater than 75% and over 10% of students were exposed to indirect advertising. Over 60% of students who currently smoked cigarettes wanted to stop, but 80% who tried to quit in the year prior to the survey failed. CONCLUSIONS: Efforts to reduce the current and projected harm caused by tobacco use in the ASEAN countries are urgently needed. ASEAN countries need to expand their national comprehensive tobacco prevention and control programs and enforce those laws already passed. Without this effort little reduction can be expected in the burden of chronic diseases and tobacco-related mortality. [ABSTRACT FROM AUTHOR]