Europe is failing to curb tobacco use – particularly in women and girls – and will have the world’s highest prevalence by 2030, the World Health Organization’s (WHO) European region revealed this week.

Of the region’s 53 states, tobacco use is highest in Serbia, North Macedonia, Bulgaria and Montenegro – all exceeding 30% prevalence in people over the age of 14.

The global average for tobacco use in people aged 15 and over is 19.5%, while in the WHO European Region it is 24.1%.

The rate of female smokers is the highest in the world at 17.3% – or one in five women. This is almost double the prevalence of the next highest region, 9.1% in the Americas. 

Europe is the only WHO region not expected to meet the global target of a 30% reduction in tobacco use among women by 2025. It is currently projected to achieve only a 12% reduction between 2010 and 2025.

“The 62 million female smokers in the European Region represent over 40% of the 143 million female smokers in the world,” according to the WHO, which released 10 new factsheets on tobacco consumption this week.

“European girls aged 13 to 15 now have the highest tobacco use rates among their age group anywhere in the world,” continued Kluge. 

“That is not an accident, it’s the result of deliberate industry strategy targeting young people with flavoured products and sophisticated social media marketing. 

“Countries like Belgium, Denmark and the Netherlands are proving it is possible to push back – by regulating novel products, banning flavours and restricting advertising. Every country in this region should be doing the same, to protect future generations.”

Slow decreases

While Europe’s tobacco consumption is decreasing, it is happening fairly slowly. In 2000, 47,5% of European men used tobacco, and by 2025 this was 30,3%. In women, tobacco use decreased from 22,3% in 2000 to 17,3% in 2025.

“Tobacco use already causes over 1.1 million deaths from noncommunicable diseases in the European Region each year – and without accelerated action, we will stay the worst-performing region in the world by 2030,” said Dr Hans Henri P. Kluge, WHO Regional Director for Europe. 

“We have a responsibility to change course now: to shield young people from nicotine addiction, prevent industry interference in health policy, and enforce the regulations that will prevent a lifetime of avoidable harm.”

Uneven use of taxes

Tax increases are being applied in some European countries – and in 28 countries, taxes represented more than 75% of the retail price of the most popular brand of cigarettes in 2024  – an increase from 16 countries in 2008.

Twelve countries have increased prices since 2014, including Belgium, Czechia, Finland, France, Germany, Kazakhstan, North Macedonia, Slovakia, Turkmenistan, Ukraine, the United Kingdom and Uzbekistan. 

But cigarettes have become more affordable in 19 countries – up from just nine in 2022 – which may lead to higher smoking initiation, the WHO warned.

Cigarettes are cheapest in Belarus, Uzbekistan, Tajikistan and Azerbaijan,  and most expensive in Turkmenistan, Ireland, the UK and France.

Uneven regulation

The region has the second-highest e-cigarette use prevalence in the world, with an estimated 31.4 million users, and regulation of e-cigarettes is fragmented.

“Decades of progress are at risk unless policies keep pace with a rapidly evolving nicotine landscape,” said Kristina Mauer-Stender, Regional Adviser for Tobacco Control at WHO/Europe. 

“Applying the same strong tobacco control tools to new and emerging products is essential if we want to protect young people and sustain public health gains.”

The fact sheets show that, while most countries in the region have strong tobacco monitoring systems and require large health warnings on packaging, implementation is uneven across other measures. 

Only 18 countries have comprehensive smoke-free laws covering all public spaces. Just 12 provide national quit lines and cover the cost of cessation services. Comprehensive bans on tobacco advertising and promotion exist in only 13 countries.

Image Credits: Zaya Odeesho/ Unsplash, pixabay.